Payer Overview
WISCONSIN PHYSICIANS SERV INS GRP Market Analysis: Market Share and Coverage by State
Wisconsin Physicians Serv Ins Grp is a regional-focused health insurer with a dominant Wisconsin presence and smaller operations in four additional states. It functions as a modest national player with concentrated Midwestern strengths that influence provider contracting locally.
Payer Overview
Wisconsin Physicians Serv Ins Grp ranks as the #128 largest US A&H payer by premium and reports $352.73M in US premium, representing a 0.02% US market share across 5 states. The organization operates through 3 affiliated subsidiaries and serves an estimated 57.6K members overall, with its core franchise concentrated in the Midwest.
The company's footprint is focused on Wisconsin while maintaining smaller presences in Illinois, Florida, Michigan, and Ohio. This concentrated geography means that national commercial strategies are anchored by a strong state-level position in Wisconsin even as the payer remains a modest-sized national participant.
3 rows
| Subsidiary | Domicile |
|---|---|
| Epic Life Insurance Company | WI |
| Wisconsin Physicians Services Insurance Corporation | WI |
| Wps Health Plan Inc | — |
National Market Presence
| State | Market Share | Premium Written | Estimated Members |
|---|---|---|---|
| FL | 0.01% | $9.29M | 1.06K |
| IL | 0.01% | $6.12M | 0.883K |
| MI | <0.01% | $786K | 0.112K |
| OH | <0.01% | $2.82M | 0.384K |
| WI | 1.21% | $333.71M | 55.2K |
| National Total | — | $352.73M | 57.6K |
The payer's national footprint is highly concentrated in Wisconsin, where it writes $333.71M in premium and covers 55.2K members. Outside Wisconsin the combined premium is modest at roughly $19.02M, spread across Florida, Illinois, Michigan, and Ohio. For national network strategies, this concentration suggests Wisconsin-focused contracting will move the needle most for the payer's revenue and membership base.
Given the 57.6K estimated total members and the strong Wisconsin dominance, providers negotiating with Wisconsin Physicians Serv Ins Grp should prioritize agreements and performance metrics that reflect Wisconsin market dynamics. Expansion opportunities exist in the smaller state markets but will have limited immediate impact on the payer's aggregate scale.
State-by-State Market Position
Wisconsin is the clear center of gravity for this payer, representing the only meaningful market position and the sole top-tier ranking. The Midwest shows the strongest presence due to this Wisconsin concentration, while the Northeast, West, and Southwest show no material footprint. The Southeast has a light presence via Florida, but it is comparatively minor.
Top-ranked performance is singularly in Wisconsin, which drives most premium and membership. For multi-state provider groups, this distribution means contracting and operational focus should be Midwest-centric with targeted, lower-effort engagement in Florida, Illinois, Michigan, and Ohio. National negotiations will have limited leverage unless Wisconsin terms are prioritized.
Estimated Member Demographics
| Age Band | Wisconsin | Florida | Illinois | Ohio | Michigan | National Total |
|---|---|---|---|---|---|---|
| Under 6 | 3303 | 53 | 53 | 23 | 6 | 3440 |
| 6–18 | 8755 | 144 | 138 | 61 | 17 | 9115 |
| 19–25 | 5357 | 92 | 83 | 36 | 11 | 5579 |
| 26–34 | 6409 | 126 | 113 | 46 | 13 | 6708 |
| 35–44 | 7635 | 150 | 129 | 52 | 14 | 7981 |
| 45–54 | 7336 | 155 | 124 | 53 | 15 | 7683 |
| 55–64 | 8433 | 168 | 125 | 56 | 17 | 8800 |
| 65–74 | 4642 | 88 | 68 | 32 | 11 | 4841 |
| 75+ | 3292 | 77 | 50 | 23 | 8 | 3451 |
Nationally, the largest age bands are 6–18 (9,115 members), 55–64 (8,800 members), and 35–44 (7,981 members). Wisconsin, the payer's dominant state, mirrors this distribution, with the highest counts in these age bands. The senior population (65–74 and 75+) is notably smaller, both nationally and in each state.
Florida and Illinois show slightly higher proportions in the older age bands relative to their total members, but overall, the member base is concentrated in children and working-age adults. Michigan and Ohio have very small member counts, with no significant skew toward any age band.
Estimated Members by State
WISCONSIN PHYSICIANS SERV INS GRP's estimated member distribution is highly concentrated in Wisconsin, with 55,163 members out of a national total of 57,597. Florida follows with 1,055 members, Illinois with 883, Ohio with 384, and Michigan with 112. This geographic concentration aligns closely with the payer's market share and premium volume, as Wisconsin is the only state where the payer holds a significant market share (1.21%).
The other states—Florida, Illinois, Ohio, and Michigan—have minimal member counts, reflecting their very low market shares (0.01% or less). For providers, this means that contracting opportunities and care delivery impact are overwhelmingly focused in Wisconsin, with only niche presence in the other states. Multi-state provider groups will find the payer's influence almost entirely limited to Wisconsin, and should prioritize engagement there for network and reimbursement strategies.