SCAN GRP Market Analysis: Market Share and Coverage by State

Payer Overview

SCAN GRP is a US-focused health insurance organization that ranks as the #202 in the US A&H market by premium and reports $62.2M in US premium. The company operates across 3 states and DC count is not included, and it serves an estimated 12.4K members through 4 affiliated subsidiaries. The payer does not hold a #1 market position in any state.

SCAN GRP's footprint is concentrated in the Southwest and Mountain West, with most premium tied to a small number of states. That concentration shapes contracting priorities: network breadth and competitive reimbursement strategies will be most impactful in its core states rather than nationally.

Premium by Scope

SCAN GRP's reported premium is exclusively within the US States & DC scope, representing the entirety of its reported premium. This concentrated premium footprint implies that provider contracting and network negotiations should be prioritized within its US state markets, as there is no reported exposure to US territories or foreign markets.

National Market Footprint

SCAN GRP's premium is highly concentrated in a small set of western states, with $39.3M in Arizona and $21.7M in Nevada driving most of the carrier's volume. The small national footprint and 12.4K members indicate that contracting leverage will be local rather than national. Providers should focus negotiation efforts in Arizona and Nevada to capture the majority of this payer's business.

The narrow geographic concentration suggests the payer may prioritize depth of network and competitive local rates in its core states rather than broad national product distribution. Multi-state provider groups should evaluate opportunities in Arizona first, followed by Nevada, as those markets contain the bulk of SCAN GRP's premium and membership.

State-by-State Market Position

SCAN GRP's strongest presence is in the West and Southwest regions. Arizona is the top state by premium and estimated membership, followed by Nevada and then New Mexico. The pattern shows a clear regional cluster rather than a dispersed national footprint.

Because the payer's premium and membership are clustered in a few contiguous western states, multi-state provider groups with facilities in the region can approach contracting with a regional strategy: prioritize Arizona and Nevada where the payer has scale, and treat New Mexico as a secondary market. For national providers, this distribution means limited nationwide leverage; for local and regional systems, it presents targeted opportunities for deeper network participation and collaboration on value-based arrangements.

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 for SCAN GRP are 6–18 (1,959 members), 35–44 (1,769 members), and 55–64 (1,721 members). The smallest segments are the youngest (Under 6, 743 members) and oldest (75+, 793 members). This distribution indicates a strong presence among families and working-age adults, with a moderate senior population.

Arizona, the largest state by membership, mirrors the national profile, with substantial numbers in the 6–18, 35–44, and 55–64 bands. Nevada shows a similar pattern, though with fewer seniors relative to Arizona. New Mexico, with a much smaller member base, has a more evenly distributed age profile but is too small to significantly impact the overall demographic mix. No state skews notably older or younger compared to the national average, but Arizona's larger population amplifies the overall trends.

Estimated Members by State

SCAN GRP's estimated member distribution is highly concentrated in Arizona (), followed by Nevada (), and a much smaller presence in New Mexico (). This geographic concentration aligns closely with the payer's premium volume and market share, with Arizona representing the largest share of both premium and membership.