TENNSESSEE RURAL HLTH GRP Market Analysis: Market Share and Coverage by State
TENNSESSEE RURAL HLTH GRP is a regional health insurer focused on concentrated state markets with a dominant presence in Tennessee. The payer's modest national premium makes it a niche but locally significant contracting counterparty.
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Payer Overview
TENNSESSEE RURAL HLTH GRP is a specialized regional health insurer with a concentrated national footprint, operating as the #140 ranked US A&H payer by premium. The organization writes the bulk of its business in the onshore US market — $275.11M in US premium — and holds a 0.02% US market share while reporting operations across 5 states.
The plan serves an estimated 41.8K members and operates through 2 affiliated subsidiaries. The payer does not hold a #1 position in any US state. Its premium and membership are heavily concentrated in Tennessee, shaping provider contracting dynamics and network leverage primarily within that state.
Subsidiary Filings
National Market Presence
National Market Footprint
The payer's premium is overwhelmingly concentrated in Tennessee, with $264.19M written there versus much smaller premiums in Alabama, Indiana, Kansas, and Oklahoma. Estimated membership follows the same pattern: 39.98K members in Tennessee out of 41.8K total, indicating high geographic concentration. For national provider networks and contracting teams, this means negotiations and network design should prioritize Tennessee, where the payer has scale and local leverage.
Outside Tennessee, the payer's presence is niche: the combined premium in the other four states totals roughly $10.92M, representing limited negotiating leverage for broad multi-state contracts. Provider groups with major footprints in Tennessee will find the most material commercial opportunity with this payer.
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State-by-State Market Position
TENNSESSEE RURAL HLTH GRP's strongest presence is in the Southeast, driven overwhelmingly by Tennessee. The payer is effectively a regional player with meaningful concentration in the Southeast and only token exposure in the Midwest (Indiana, Kansas) and the Plains (Oklahoma). With $264.19M in Tennessee premium and 39.98K members there, the company's bargaining power and network impact are localized.
About ACA Marketplace Data
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.
Member Demographics
Estimated Member Demographics
Nationally, the largest age bands are 55–64 (6,052 members), 6–18 (6,318 members), and 45–54 (5,979 members), indicating a strong presence among both working-age adults and school-aged children. The smallest segments are the youngest (Under 6, 2,475 members) and oldest (75+, 2,368 members) populations.
Tennessee, the payer's dominant state, mirrors the national profile with a concentration in adult age bands, but also maintains a substantial pediatric population. Other states, such as Alabama and Indiana, have much smaller member counts and do not show significant skew toward any particular age band. Overall, the demographic distribution is balanced, with a slight tilt toward adults, suggesting providers should focus on chronic disease management and preventive care for this population.
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Related Subsidiaries
Members Health Insurance Company
Coming soon
Trh Health Insurance Company
Coming soon
References
- 1.2024 Market Share Reports for the Top Accident and Health Insurance Groups and Companies by State and Countrywide. National Association of Insurance Commissioners (NAIC). Retrieved Aug 11, 2026.Ranks the largest accident and health insurance carriers nationwide and by state, the source for this payer's market share and direct-premium figures.
- 2.Health Insurance Exchange Public Use Files (Exchange PUFs). Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.Plan-level enrollment, premium, and cost-sharing data submitted by issuers participating in the ACA Marketplace, the source for this payer's exchange presence figures.
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.