Payer Overview

M MELE GRP occupies a modest position within the national accident & health market as the #237 ranked US A&H payer by premium. The company reports $16.3M in US premium and operates across 2 states, giving it a focused but clearly regional footprint. Estimated Total Members for the organization are 2.1K, and it operates through 2 affiliated subsidiaries.

While M MELE GRP does not hold a #1 position in any state, its concentrated presence in a small number of states can support targeted provider contracting strategies that prioritize depth over breadth. This regional concentration allows the payer to negotiate with multi-hospital systems in specific markets while avoiding the complexities of a nationwide network.

Premium by Scope

M MELE GRP's premium is exclusively within the US States & DC scope, representing 100.00% of its reported premium. There is no reported premium in US territories or foreign jurisdictions for this payer.

This concentration implies that providers evaluating contracts with M MELE GRP should focus on its US state markets, where network depth and local reimbursement terms will matter most. With the entire premium base on the US mainland, national or multi-territory contracting considerations are less relevant for this payer.

M MELE GRP's premium is concentrated in the Northeast, with $10.2M written in NJ and $6.09M in PA, totaling $16.3M nationwide. The estimated member base is 2.1K, with the largest share of members in New Jersey (about 1.42K). This regional concentration suggests negotiation leverage and network focus should be prioritized in the New Jersey market, followed by Pennsylvania.

For national provider groups, the payer's footprint is small but meaningful in targeted hospitals and practices across the Northeast. Providers should evaluate contract terms and referral patterns in NJ first, where the payer has the greatest premium exposure, and then consider replication in PA where scale is smaller.

State-by-State Market Position

M MELE GRP's presence is strongest in the Northeast region, driven by New Jersey and Pennsylvania. New Jersey is the largest state by premium and members, followed by Pennsylvania; both are within the same Census region, which benefits multi-state provider groups that operate throughout the Northeast. The lack of presence in other regions (Midwest, South, West, Southwest) indicates limited national scale.

For multi-state provider systems, the distribution means focused contract negotiations in a compact geographic area can cover the majority of this payer's business. Given the payer's modest overall premium, providers should weigh the administrative effort of separate agreements against the revenue opportunity represented by $16.3M in premium and 2.1K members.

Estimated Member Demographics

Nationally, the largest age bands are 55–64 (323 members), 6–18 (322 members), and 45–54 (300 members), indicating a balanced distribution across pre-senior, pediatric, and adult populations. The smallest bands are Under 6 (126 members) and 75+ (130 members), reflecting fewer very young and senior members.

New Jersey skews slightly younger, with higher counts in the pediatric and young adult bands compared to Pennsylvania. Pennsylvania has a relatively higher proportion of members in the 55–64 and 65–74 bands, suggesting a modestly older insured population. This distribution impacts provider service needs, with New Jersey requiring more pediatric and adolescent care, while Pennsylvania may see increased demand for chronic disease management and preventive services for older adults.

Estimated Members by State

M MELE GRP's estimated member distribution is concentrated in New Jersey (1,415 members) and Pennsylvania (699 members), for a national total of 2,114 members. New Jersey accounts for nearly two-thirds of the payer's insured population, aligning with its higher market share and premium volume in the state.

Despite Pennsylvania's lower market share and premium, it still represents a significant portion of the payer's membership. This geographic concentration means providers in New Jersey are more likely to encounter M MELE GRP members, while Pennsylvania providers should be aware of the payer's presence, especially in regions with higher insured counts.

For providers, this distribution suggests that contracting strategies should prioritize New Jersey, where the payer's footprint is largest. Multi-state provider groups operating in both states should tailor their engagement and reimbursement negotiations to reflect the payer's member concentration and demographic mix.