Payer Overview

PACIFICSOURCE HLTH PLAN GRP Market Analysis: Market Share and Coverage by State

PacificSource Health Plans is a regional health insurer focused on the Pacific Northwest and Mountain West. It combines significant local market share in select states with a compact national footprint.

PACIFICSOURCE HLTH PLAN GRPHealth InsuranceHealthcare MarketProvider ContractingReimbursementORMTIDWA

Payer Overview

PacificSource Health Plans is the #45 largest US A&H payer by reported premium, with a US premium of $4.03B and a US market share of 0.28%. The organization reports a presence in 4 states and DC is not included in that count, and it covers an estimated 535.1K members across its footprint. PacificSource Health Plans operates through 3 affiliated subsidiaries.

The payer's business is concentrated in the Pacific Northwest and nearby Mountain West, which shapes its provider contracting leverage and network design. Given the concentrated premium base of $4.03B, regional provider groups and health systems in those states will encounter a counterparty with material local scale but limited national reach.

Premium by Scope

Scope	Jurisdictions	Premium	Share of Payer Total
US States & DC	4 states	$4.03B	100.00%
Total	4 states	$4.03B	100.00%

PacificSource Health Plans' premium is exclusively within the US States & DC scope as reported; there is no recorded premium in US territories or foreign jurisdictions. This concentration means the payer's risk exposure and contracting priorities are focused on a small set of domestic states. For provider organizations, that implies negotiations and network strategies should prioritize the payer's strong states rather than expecting material leverage or influence in territories or international markets.

Subsidiary	Domicile
Pacificsource Community Health Plans	OR
Pacificsource Community Solutions	OR
Pacificsource Health Plans	OR

Subsidiary

Domicile

Pacificsource Community Health Plans

Pacificsource Community Solutions

Pacificsource Health Plans

State	Market Share	Premium Written	Estimated Members
ID	5.08%	$327M	70.3K
MT	7.39%	$227M	58.8K
OR	13.2%	$3.36B	386K
WA	0.34%	$115M	19.4K
National Total	—	$4.03B	535.1K

State

Market Share

Premium Written

Estimated Members

5.08%

$327M

70.3K

7.39%

$227M

58.8K

13.2%

$3.36B

386K

0.34%

$115M

19.4K

National Total

—

$4.03B

535.1K

Age Band	Oregon	Idaho	Montana	Washington	National Total
Under 6	20853	4446	3219	1172	29690
6–18	56109	12942	8598	2882	80531
19–25	34162	6955	5552	1657	48326
26–34	49805	8310	6841	2760

Age Band

Oregon

Idaho

Montana

Washington

National Total

Under 6

20853

4446

3219

1172

29690

6–18

56109

12942

8598

2882

80531

19–25

34162

6955

5552

1657

48326

26–34

49805

8310

6841

2760

State-by-State Market Position

PacificSource Health Plans' footprint is strongest in the West. The payer's top position is in Oregon where it posts a 13.2% market share and writes $3.36B in premium, making Oregon the clear center of gravity. Montana and Idaho are secondary markets with 7.39% and 5.08% shares respectively, each representing meaningful but smaller premium pools of $227M and $327M. Washington represents a modest presence at 0.34% and $115M written.

This geographic distribution — concentrated in the West and Mountain West — means multi-state provider groups with operations in these regions should prioritize negotiation resources around Oregon and then address state-level network adequacy in Idaho and Montana. For providers pursuing scale, aligning contracting and care management initiatives to the payer's Western footprint will capture the majority of PacificSource Health Plans' membership and premium.

Estimated Members by State

PACIFICSOURCE HLTH PLAN GRP's estimated member distribution is highly concentrated in Oregon, with 386,530 members, followed by Idaho (70,338), Montana (58,765), and Washington (19,435). This geographic concentration aligns closely with the payer's market share, as Oregon is their strongest state both in share and member count. Idaho and Montana, while smaller in absolute numbers, still represent significant populations for provider contracting.

The alignment between market share and member count is clear: states with higher market share also have higher member counts. Oregon's dominance means providers in this state will encounter PACIFICSOURCE members frequently, impacting care delivery and reimbursement strategies. In Idaho and Montana, the payer remains a major player, while Washington's smaller member base suggests a more limited impact. Providers should prioritize contracting and care models in Oregon, with tailored approaches for Idaho and Montana based on local member demographics.

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Payer Overview

PACIFICSOURCE HLTH PLAN GRP Market Analysis: Market Share and Coverage by State

Payer Overview

Premium by Scope

National Market Presence

Estimated Member Demographics

State-by-State Market Position

Estimated Members by State