Community Health Network Group Market Analysis: Market Share and Coverage by State

Payer Overview

Community Health Network Group operates as a regional health insurance organization that holds the #79 rank among US accident & health payers, writing $1.62B in premium across the US market and representing 0.11% of the US market. The company reports a footprint in 1 states and serves an estimated 274.2K members, operating through 2 affiliated subsidiaries.

The payer’s US premium is concentrated in a single state footprint and there is no reported premium in US territories or foreign markets. That concentrated profile shapes negotiating leverage with statewide provider systems and favors depth over breadth in provider contracting strategies.

Premium by Scope

Community Health Network Group's premium is exclusively within US states and DC for the available data, with $1.62B written in that scope. There is no reported premium in US territories or foreign markets. This concentration implies that provider groups evaluating the payer should focus on its state-level contracting dynamics and regulatory environment, as national or territory negotiation strategies do not apply.

National Market Footprint

Community Health Network Group's premium and membership are concentrated in the state of Washington, with $1.62B in premium and 274K estimated members. This single-state concentration indicates the payer's negotiating leverage and network strategy will be driven by Washington-specific market dynamics rather than a diversified national footprint. For provider contracting, the concentrated membership suggests opportunities to build deep, system-wide partnerships within Washington but limited influence outside that market.

State-by-State Market Position

Community Health Network Group shows its strongest presence exclusively in the West region, with all measured premium and membership located in Washington. Because the payer does not report measurable presence in the Northeast, Midwest, South, or Southwest, multi-state provider groups will need to treat this payer as a state-focused partner rather than a regional or national contracting counterparty. The concentrated profile—$1.62B in Washington and 274K members—means statewide reimbursement rates and network access policies will determine the success of any partnership with this payer.

The Affordable Care Act (ACA) established federally-facilitated health insurance marketplaces ("exchanges") where individuals and small businesses can shop for and enroll in health plans, often with income-based subsidies. Issuers that participate in these marketplaces are required to report enrollment, claims, and denial data to CMS (Centers for Medicare & Medicaid Services) each year.

The sections below cover this payer's ACA marketplace-specific footprint — enrollment, plan portfolio, and claims/denial-rate data. This is a narrower, separate population from the NAIC-based commercial data shown earlier on this page (total premium, market share, and membership across all lines of business): ACA marketplace enrollment is typically a small fraction of a payer's total commercial book, and the two datasets should not be treated as equivalent. CMS claims-transparency reporting has also been inconsistent industry-wide since 2020 — many issuers have little or no data for 2021 onward, so a single reporting year is common and does not necessarily indicate anything about the payer's current ACA presence.

Estimated Member Demographics

The largest age bands nationally are 35–44 (42,888), 6–18 (40,667), and 26–34 (38,944), indicating a strong presence among families and working-age adults. The senior population (65+) is relatively modest, with 22,412 in the 65–74 band and 15,350 in the 75+ band. This suggests that COMMUNITY HLTH NETWORK GRP's member base is primarily commercial, with limited Medicare exposure.

Washington, the only state with reported member estimates, mirrors the national profile exactly, as all estimated members are concentrated there. There is no evidence of a state-level skew toward older or younger populations; the age distribution is consistent across the reported data.

Estimated Members by State

COMMUNITY HLTH NETWORK GRP's estimated member count is concentrated entirely in Washington, with 274,223 members. No other states report estimated members, reflecting the payer's highly localized footprint. This aligns with the market share data, where Washington is the only state with a significant share (4.84%) and premium volume.