Payer Overview
Provider Partners Health Group Market Analysis: Market Share and Coverage by State
Provider Partners Health Group is a regional-focused health insurer with concentrated premiums in a small group of states. The payer plays a modest role nationally but can be strategically important in its core markets for provider contracting.
Payer Overview
Provider Partners Health Group operates as a national accident & health carrier ranked as the #153 largest US A&H payer by premium. Its US premium footprint is $230.87M and it holds a US market share of 0.02% across 6 states, with an estimated total membership of 33.3K. The organization operates through 6 affiliated subsidiaries.
The company does not hold a #1 ranked position in any state. Its commercial premium is concentrated in a handful of states, and the current footprint suggests negotiating leverage is strongest where premium and membership cluster together while outside those pockets Provider Partners Health Group is a smaller regional counterparty for provider networks.
6 rows
| Subsidiary | Domicile |
|---|---|
| Provider Partners Health Plan Inc | MD |
| Provider Partners Health Plan of Illinois | IL |
| Provider Partners Health Plan of Missouri | MO |
| Provider Partners Health Plan of North Carolina Inc | NC |
| Provider Partners Health Plan of Pennsylvania Inc | PA |
| Provider Partners Health Plan of Texas Inc | TX |
National Market Presence
| State | Market Share | Premium Written | Estimated Members |
|---|---|---|---|
| IL | 0.08% | $48.7M | 7.02K |
| MD | 0.04% | $9.87M | 2.03K |
| MO | 0.18% | $49.4M | 7.95K |
| NC | 0.01% | $2.12M | 0.32K |
| PA | 0.03% | $26.5M | 3.04K |
Estimated Member Demographics
| Age Band | Maryland | Missouri | Pennsylvania | Texas | Illinois | North Carolina | National Total |
|---|---|---|---|---|---|---|---|
| Under 6 | 122 | 495 | 166 | 837 | 423 | 18 | 2062 |
| 6-18 | 309 | 1276 | 442 | 2180 | 1100 | 46 | 5354 |
| 19-25 | 167 |
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.