Payer Overview
Gemstone Holdings Grp Market Analysis: Market Share and Coverage by State
Regional health insurer focused on a dominant position in a single state. Operates through a small group of subsidiaries and concentrates underwriting and membership in one primary market.
Payer Overview
Gemstone Holdings Grp is the #69 largest US A&H payer by reported premium, writing $2.23B in the US market and holding a 0.15% US market share across 1 states. The company reports an estimated 478.7K covered lives and operates through 2 affiliated subsidiaries, with its strongest market position concentrated in Idaho where it is the market leader.
The firm's US presence is tightly focused: its US premium footprint is limited to a single state, making its commercial scale highly regional. That concentrated position shapes its provider contracting dynamics, local bargaining power, and strategic priorities around that top-ranked state.
2 rows
| Subsidiary | Domicile |
|---|---|
| Blue Cross of Idaho Care Plus Inc | — |
| Blue Cross of Idaho Health Services Inc | ID |
National Market Presence
National Market Footprint
| State | Market Share | Premium Written | Estimated Members |
|---|---|---|---|
| ID | 34.58% | $2.23B | 479K |
| National Total | — | $2.23B | 479K |
Gemstone Holdings Grp's national presence is highly concentrated in the West, with $2.23B of premium written and 479K estimated members located in Idaho. The insurer's market share of 34.58% in that single state indicates substantial local scale, while nationally the company remains a niche player. For provider contracting, the concentration implies that network leverage and reimbursement negotiations will be strongest in Idaho, where the payer represents a large share of local covered lives and premium.
Because the carrier's footprint is confined to one state, multi-state provider groups should treat Gemstone Holdings Grp as a regionally critical counterparty only if they have material operations in Idaho. The payer's concentrated membership pool makes statewide network participation and reimbursement terms especially valuable to providers operating within Idaho.
Estimated Member Demographics
| Age Band | Idaho | National Total |
|---|---|---|
| Under 6 | 30259 | 30259 |
| 6–18 | 88085 | 88085 |
| 19–25 | 47339 | 47339 |
| 26–34 | 56560 | 56560 |
| 35–44 | 68143 | 68143 |
| 45–54 | 61360 | 61360 |
| 55–64 | 62135 | 62135 |
| 65–74 | 37994 |
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