Security Health Plan of WI Inc. Market Analysis: Market Share and Coverage by State

Payer Overview

Security Health Plan of WI Inc. is a regional health insurer operating primarily within the U.S. mainland that plays a defined role in the national accident & health market as the #82 ranked US A&H payer by premium. The company writes $1.48B in US premium with a US market share of 0.1%, and it reports a footprint across 1 states with an estimated 245.4K total members. Security Health Plan of WI Inc. does not hold a #1 position in any state and operates through 0 affiliated subsidiaries.

The payer's US operations are concentrated in a single state, reflecting a focused geographic strategy rather than a multi-state footprint. That concentration means contracting and network strategies will be driven by state-level dynamics and relationships rather than national-scale network design.

Premium by Scope

Security Health Plan of WI Inc.'s premium is exclusively within the US States & DC scope based on the available data, with $1.48B reported in that category. There is no reported premium in US territories or foreign jurisdictions, indicating the payer's operations are concentrated on the U.S. mainland.

For providers evaluating this payer, the concentration implies negotiations and network strategies should be tailored to the payer's single-state strength rather than negotiated as part of a multi-jurisdictional portfolio.

Security Health Plan of WI Inc. shows a highly concentrated national footprint, with $1.48B in premium and 245K estimated members all located in Wisconsin. This concentration means the payer's negotiating leverage and provider network strategy will be driven by Wisconsin market dynamics rather than national scale. For provider contracting, this creates an opportunity to focus relationship-building and reimbursement models specifically around Wisconsin regulatory and utilization patterns.

Given the single-state concentration, the payer's exposure to regulatory shifts, Medicaid expansion decisions, and state-level cost trends is amplified. Providers should prioritize state-specific performance metrics and local network partnerships when engaging with this payer.

State-by-State Market Position

Security Health Plan of WI Inc.'s strongest presence is in the Midwest region, represented solely by Wisconsin where it holds a 5.38% market share. There are no top-ranked (#1) states for this payer, and its limited geographic distribution means regional expansion is limited under the current footprint. For multi-state provider groups, the payer's distribution suggests limited value in negotiating national master agreements; instead, focus efforts on localized agreements and value-based arrangements tailored to Wisconsin population health needs.

The single-state concentration simplifies payer contracting complexity but increases sensitivity to local market shifts. Providers should align quality programs and pricing strategies with Wisconsin's utilization and regulatory environment to maximize reimbursement and network inclusion.

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

The largest age bands nationally for SECURITY HLTH PLAN OF WI INC are 6–18 (38,949 members), 55–64 (37,518 members), and 35–44 (33,968 members). This indicates a strong presence among school-age children, middle-aged adults, and pre-retirement seniors. The distribution is relatively balanced, with no single age band dominating the member profile.

Wisconsin, the only state with significant membership, mirrors the national demographic profile exactly. There is no notable skew toward older or younger populations in Wisconsin compared to the national total, as all members are concentrated in this state. This uniformity simplifies provider planning and care delivery strategies for the payer's population.

Estimated Members by State

SECURITY HLTH PLAN OF WI INC's estimated member count is 245,414 in Wisconsin, which represents the entirety of its national membership. There are no significant members reported in other states or territories, as indicated by the data appendix. This concentration aligns with the payer's market share, which is highest in Wisconsin and negligible elsewhere.

For providers, this means that contracting and care delivery strategies should be focused exclusively on Wisconsin. The alignment between member count and market share rank underscores the payer's regional strength and the importance of local provider relationships. Multi-state provider groups will find limited opportunity with this payer outside Wisconsin, making it a highly localized contracting target.