National Healthcare Corp GRP Market Analysis: Market Share and Coverage by State

Payer Overview

National Healthcare Corp GRP is positioned as a modest national commercial and group health carrier, ranked #216 among US accident & health payers by premium. The company reports $38.1M in US premium and operates in 3 states, giving it a concentrated but clearly defined regional footprint. Estimated total members for the organization amount to 5.9K, and it operates through 1 affiliated subsidiary.

While National Healthcare Corp GRP does not hold a #1 market position in any state, its presence is concentrated in a small set of states where it writes meaningful premium and serves the bulk of its membership. This concentrated geographic exposure gives the payer local negotiating leverage in its core markets while keeping its national competitive footprint limited.

Premium by Scope

National Healthcare Corp GRP's premium is exclusively within the US States & DC scope, accounting for 100.00% of its reported premium. There is no reported premium in US territories or foreign jurisdictions, indicating the payer's operations and underwriting are focused on the U.S. mainland. For providers, this concentration means contracting and reimbursement negotiations should prioritize the payer's core states where membership and premium are actually written.

National Market Footprint

National Healthcare Corp GRP's premium is heavily concentrated in Tennessee, where it writes $26.4M in premium and serves roughly 3.99K members. The overall membership base is modest at 5.9K, and total premium is $38.1M, reflecting a regional operator rather than a national scale competitor. For national provider networks, this means the payer will matter most in a handful of local markets rather than as a broad national contracting counterparty.

Providers and health systems should expect the payer to exert the most negotiating leverage in Tennessee given its premium and membership concentration. Contracts that target multiple states will need to prioritize local market economics in Tennessee, with secondary attention to South Carolina and Missouri where volumes are smaller.

State-by-State Market Position

National Healthcare Corp GRP shows a clear Southeastern concentration, with its largest presence in Tennessee and additional exposure in South Carolina. Missouri represents a smaller Midwest foothold. The strongest region is the Southeast, driven by the $26.4M written in Tennessee, while Midwest exposure is limited to $3.84M in Missouri.

This geographic distribution implies that multi-state provider groups should focus contracting and network-development efforts on Tennessee to capture the majority of this payer's membership and premium. Secondary market strategies in South Carolina and Missouri can be pursued but will yield smaller incremental membership and revenue given the payer's modest presence there.

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

Nationally, the largest age bands are 6–18 (878 members), 55–64 (859 members), and 45–54 (831 members), indicating a strong presence among children and middle-aged adults. The smallest age bands are Under 6 (342 members) and 75+ (344 members), suggesting a lower proportion of very young children and seniors.

Tennessee, the payer's largest state, mirrors the national profile with a concentration in the 6–18, 45–54, and 55–64 age bands. Missouri and South Carolina also show similar distributions, though Missouri has a slightly higher proportion of younger members relative to its total. Overall, the demographic profile is consistent across states, with no state showing a dramatic skew toward older or younger populations.

Estimated Members by State

NATIONAL HEALTHCARE CORP GRP's estimated member distribution is highly concentrated in , with , followed by with , and with . This geographic concentration aligns with the payer's premium volume and market share, as Tennessee is also the state with the highest premium written and market share.