Medicare: Many HMOs Experience High Rates of Beneficiary Disenrollment
(Letter Report, 04/30/98, GAO/HEHS-98-142).

Pursuant to a congressional request, GAO reviewed the feasibility of
computing health maintenance organizations' (HMO) voluntary
disenrollment rates from readily available data and analyzed the extent
to which these rates varied among plans, focusing on: (1) disenrollment
rates for all Medicare HMOs operating in 1996; (2) the disenrollment
rates of plans operating in the same markets; (3) disenrollment rates of
relatively new plans; and (4) the percentage of disenrollees who
switched to fee-for-service.

GAO noted that: (1) annual disenrollment rates exceeded 20 percent of
plans' average monthly membership at more than 40 Medicare HMOs in 1996;
(2) in one extreme case, the number of members who disenrolled from a
plan equaled 71 percent of that plan's average monthly membership; (3)
in contrast, 32 HMOs had disenrollment rates below 5 percent; (4)
comparing disenrollment rates among HMOs operating in different markets
may be misleading; (5) local market characteristics, such as the
competition between plans or beneficiaries' familiarity with managed
care, may affect plans' disenrollment rates; (6) in some cases, a rate
that is relatively high in one market might be relatively low in
another; (7) for example, in 1996 the highest disenrollment rate in the
Portland-Vancouver area (7.4 percent) was below the lowest rate in Miami
(10.1 percent); (8) among plans operating in the same market,
disenrollment rates varied substantially; (9) in many markets, the
highest disenrollment rate exceeded the lowest disenrollment rate by
more than fourfold; (10) for example, in Houston, Texas, the highest
disenrollment rate was nearly 56 percent while the lowest rate was 8
percent; (11) the data clearly indicate that competing plans vary widely
in their ability to retain members but do not reveal why; (12)
disenrollment rates that are high relative to rates at competing plans
could, for example, be caused by plans' poor marketing practices,
less-generous benefits, higher beneficiary out-of-pocket costs, or
inferior service; (13) HMOs in operation for less than 2 years tended to
have higher annual disenrollment rates than older plans; (14) however,
rapid disenrollment rates--that is, the percentage of new members who
left within 3 months of their enrollment--tended to be slightly lower
for plans that were in operation for less than 2 years; (15) many HMO
members who disenroll switch to fee-for-service Medicare; and (16) in
markets served by at least two plans, more than one-third of
disenrollees switched to fee-for-service.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  HEHS-98-142
     TITLE:  Medicare: Many HMOs Experience High Rates of Beneficiary 
             Disenrollment
      DATE:  04/30/98
   SUBJECT:  Health maintenance organizations
             Statistical data
             Health care programs
             Beneficiaries
             Comparative analysis
             Managed health care
             Health services administration
IDENTIFIER:  Medicare Health Maintenance Organizations Program
             
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Cover
================================================================ COVER


Report to the Special Committee on Aging, U.S.  Senate

April 1998

MEDICARE - MANY HMOS EXPERIENCE
HIGH RATES OF BENEFICIARY
DISENROLLMENT

GAO/HEHS-98-142

Medicare HMO Disenrollment Rates

(101532)


Abbreviations
=============================================================== ABBREV

  BBA - Balanced Budget Act of 1997
  GHP - Group Health Plan
  HCFA - Health Care Financing Administration
  HMO - health maintenance organization
  MSA - metropolitan statistical area
  NECMA - New England county metropolitan area
  PMSA - primary metropolitan statistical area

Letter
=============================================================== LETTER


B-279786

April 30, 1998

The Honorable Charles E.  Grassley
Chairman
The Honorable John B.  Breaux
Ranking Minority Member
Special Committee on Aging
United States Senate

Most Medicare beneficiaries live in areas where they can choose to
receive health care through the program's traditional fee-for-service
arrangement or from a managed care plan that contracts with Medicare. 
Many beneficiaries who wish to enroll in a health maintenance
organization (HMO) can choose from among several available plans.  In
1996, we recommended several steps that the Health Care Financing
Administration (HCFA), the agency that administers the Medicare
program, could take to help beneficiaries choose a managed care plan
wisely.\1 Among other things, we recommended that HCFA publicize
HMOs' disenrollment rates.  Because Medicare beneficiaries enrolled
in HMOs can easily switch to another plan or to fee-for-service,
disenrollment rates may reflect beneficiaries' relative satisfaction
with available HMOs. 

In August 1997, the Congress enacted the Balanced Budget Act of 1997
(BBA) which, among other things, mandated that HCFA make comparative
information available to beneficiaries, including data on health
plans' disenrollment rates.\2 However, HCFA is not required to
publish disenrollment rates until the fall of 1999, when the agency
will conduct the first annual Medicare-sponsored health information
fair.  Moreover, the BBA is unclear as to whether HCFA must publish
disenrollment rates for plans that have been in operation for less
than 2 years. 

This letter responds to your request that we evaluate the feasibility
of computing HMO voluntary disenrollment rates from readily available
data and analyze the extent to which these rates vary among plans. 
Specifically, we (1) calculated disenrollment rates for all Medicare
HMOs operating in 1996, the most recent data available to us at the
time of our analysis; (2) compared the disenrollment rates of plans
operating in the same markets; (3) analyzed disenrollment rates of
relatively new plans; and (4) computed the percentage of disenrollees
who switched to fee-for-service. 

To conduct our study, we analyzed the data HCFA provided us that
contained the records of every beneficiary who was enrolled in a
Medicare risk-contract HMO in 1996.\3 We did not count as
disenrollees individuals who died, lost their Medicare eligibility,
or moved out of their plans' service areas.  We were also careful not
to count administrative changes, such as one plan merging with
another, as disenrollment.  Because disenrollment rates may be
misleading for small or very new plans, we do not report rates for
plans that have fewer than 250 members or that have operated for less
than 7 months.  Appendix I describes our methodology.  We did our
work between January 1997 and April 1998 in accordance with generally
accepted government auditing standards. 


--------------------
\1 Medicare:  HCFA Should Release Data to Aid Consumers, Prompt
Better HMO Performance (GAO/HEHS-97-23, Oct.  22, 1996). 

\2 P.L.  105-33. 

\3 Approximately 87 percent of the beneficiaries enrolled in Medicare
managed care in December 1996 were in "risk contract" HMOs, so-called
because the plan assumes the financial risk of providing care for the
fixed per-beneficiary fee that Medicare pays. 


   RESULTS IN BRIEF
------------------------------------------------------------ Letter :1

Annual disenrollment rates exceeded 20 percent of plans' average
monthly membership at more than 40 Medicare HMOs in 1996.  In one
extreme case, the number of members who disenrolled from a plan
equaled 71 percent of that plan's average monthly membership.  In
contrast, 32 HMOs had disenrollment rates below 5 percent.  Comparing
disenrollment rates among HMOs operating in different markets may be
misleading.  Local market characteristics, such as the competition
between plans or beneficiaries' familiarity with managed care, may
affect plans' disenrollment rates.  In some cases, a rate that is
relatively high in one market might be relatively low in another. 
For example, in 1996 the highest disenrollment rate in the
Portland-Vancouver area (7.4 percent) was below the lowest rate in
Miami (10.1 percent). 

Among plans operating in the same market, disenrollment rates varied
substantially.  In many markets, the highest disenrollment rate
exceeded the lowest disenrollment rate by more than fourfold.  For
example, in Houston, Texas, the highest disenrollment rate was nearly
56 percent while the lowest rate was 8 percent.  The data clearly
indicate that competing plans vary widely in their ability to retain
members but do not reveal why.  Disenrollment rates that are high
relative to rates at competing plans could, for example, be caused by
plans' poor marketing practices, less-generous benefits, higher
beneficiary out-of-pocket costs, or inferior service. 

HMOs in operation for less than 2 years tended to have higher annual
disenrollment rates than older plans.  However, rapid disenrollment
rates--that is, the percentage of new members who left within 3
months of their enrollment--tended to be slightly lower for plans
that were in operation for less than 2 years.  Many HMO members who
disenroll switch to fee-for-service Medicare.  In markets served by
at least two plans, more than one-third of disenrollees switched to
fee-for-service. 


   BACKGROUND
------------------------------------------------------------ Letter :2

The number of Medicare beneficiaries enrolled in risk-contract HMOs
more than doubled over the past 3 years, from 2.3 million in December
1994 to 5.2 million in December 1997.  The number of Medicare risk
HMOs increased from 154 to 307 over the same time period.  The growth
in Medicare managed care enrollees and plans is expected to continue,
fueled in part by the BBA, which provided for new types of Medicare
managed care plans and increased plan payments in many areas that
previously lacked a fee-for-service alternative. 

Recognizing beneficiaries' need for comparative information on
available choices, the Congress included several consumer information
provisions in the BBA.  To help beneficiaries judge quality and
performance, HCFA is required to publicize plans' disenrollment
rates, enrollee satisfaction measures, health outcome measures, and
record of compliance with certain requirements.  HCFA is also
required to provide beneficiaries with comparative information on
plans' benefits, premiums, service areas, and supplemental benefits. 
HCFA is working to meet these requirements and recently launched an
Internet Web page containing data on HMOs' benefits and premiums. 

As we reported in 1996, Medicare beneficiaries voluntarily disenroll
from their HMOs for a variety of reasons.\4 High disenrollment rates
may result from the poor education of enrollees during an HMO's
marketing and enrollment process:  enrollees may be ill informed
about HMO provider-choice restrictions in general or the operation of
their particular plan.  High disenrollment rates may also result from
beneficiaries' dissatisfaction with access or quality of care. 
Alternatively, high disenrollments may reflect a different aspect of
relative satisfaction--beneficiaries' awareness that competing HMOs
are offering better benefits or lower premiums.  A 1992 study
reported that 48 percent of disenrollees from Medicare HMOs cited
dissatisfaction as their reason for leaving, 23 percent cited a
misunderstanding of HMO services or procedures, and 29 percent cited
some other reason.\5 While rates alone cannot distinguish among
possible causes for disenrollment, a relatively high disenrollment
rate should caution beneficiaries to investigate further before
enrolling. 

Currently, Medicare beneficiaries enrolled in an HMO may decide each
month to switch to another available managed care plan or to
fee-for-service.  However, BBA provisions will curtail this option
beginning in 2002.\6


--------------------
\4 GAO/HEHS-97-23, Oct.  22, 1996. 

\5 Frank W.  Porell and others, Factors Associated with Disenrollment
from Medicare HMOs:  Findings from a Survey of Disenrollees (Boston: 
Health Policy Research Consortium of Brandeis University, 1992). 

\6 Every November beginning in 2001, beneficiaries will decide how
they will receive their Medicare benefits during the following year
by selecting traditional fee-for-service, a managed care plan, or
some other available option specified in the BBA.  With some
exceptions, beneficiaries are expected to remain in the health plan
they select for the entire calendar year.  However, beneficiaries
will be able to make one switch during the first 6 months of 2002. 
In 2003 and beyond, beneficiaries will be able to make one switch
during the first 3 months of each year.  These switches are in
addition to those made during the planned annual open season. 


   DISENROLLMENT RATES EXCEED 20
   PERCENT AT MANY MEDICARE HMOS
------------------------------------------------------------ Letter :3

Many Medicare HMOs across the nation experience high rates of
beneficiary disenrollment.  In 1996, annual disenrollment equaled 71
percent of average plan membership at PCA Health Plans of Florida
(PCA-Jacksonville, Florida)--the highest HMO contract service-area
disenrollment rate in the nation that year.\7 Nearly 1 of 6
beneficiaries who joined PCA left the plan within 3 months.  Of the
194 HMOs that operated a Medicare risk contract for at least 7 months
in 1996 and had at least 250 members, about one-fifth (41) had annual
disenrollment rates in excess of 20 percent.  Rapid
disenrollment--that is, the percentage of new members who left their
plans within the first 3 months--was 10 percent or higher at 21 HMOs. 
Despite sometimes sizable membership losses, most Medicare risk HMOs
(90 percent) attracted enough new members to increase in size during
1996. 

In contrast, a number of HMOs had low disenrollment rates.  Annual
voluntary disenrollment was less than 5 percent of average membership
at 31 HMOs in 1996.  Rapid disenrollment rates were below 3 percent
at 65 HMOs.  (See tables 1 and 2.) Some of the national variation in
disenrollment rates may be the result of differences among markets. 
For example, disenrollment rates may tend to be high in areas where
competition is strong or where many beneficiaries are unaccustomed to
managed care.  In some cases, a rate considered relatively high in
one market may be considered low in another.  For example, in 1996
the highest annual disenrollment rate in the Portland-Vancouver area
(7.4 percent) was less than the lowest rate in Miami (10.1 percent). 



                          Table 1
          
               Distribution of HMOs by Annual
                  Disenrollment Rate, 1996

Annual disenrollment rate                   Number of HMOs
----------------------------  ----------------------------
Greater than 30%                                        20
21% -30%                                                21
11% -20%                                                60
5% -10%                                                 62
Less than 5%                                            31
==========================================================
Total HMOs\a                                           194
----------------------------------------------------------
\a Excludes HMOs that operated less than 7 months in 1996 or that had
an average monthly membership below 250. 

Source:  GAO analysis of HCFA data. 



                                Table 2
                
                     Distribution of HMOs by Rapid
                        Disenrollment Rate, 1996

                                                                Number
                                                                    of
Rapid disenrollment rate                                          HMOs
--------------------------------------------------------------  ------
Greater than 15%                                                     4
10% -15%                                                            17
3% -9%                                                             108
Less than 3%                                                        65
======================================================================
Total HMOs\a                                                       194
----------------------------------------------------------------------
\a Excludes HMOs that operated less than 7 months in 1996 or that had
an average monthly membership below 250. 

Source:  GAO analysis of HCFA data. 


--------------------
\7 Some HMOs had higher disenrollment rates in portions of their
service areas. 


   AMONG COMPETING HMOS,
   DISENROLLMENT RATES VARY WIDELY
------------------------------------------------------------ Letter :4

Among plans competing in the same market, disenrollment rates often
vary widely.\8 For example, in Tampa, Florida, PCA had an annual
disenrollment rate of 59 percent in 1996--much higher than the
10-percent disenrollment rate at Prudential Health Care Plan (see
fig.  1).  Nearly 12 percent of all new PCA members left the plan
within the first 3 months of enrolling, while only 3 percent of
Prudential's new enrollees left that quickly.  The differences in the
disenrollment rates at the two plans cannot be explained by
differences in plan size, experience, or market conditions.  Both PCA
and Prudential had been operating Medicare risk contracts for about 2
years and had approximately the same number of enrollees (7,600 and
9,200, respectively) in the Tampa market.  Moreover, the wide
variation in HMOs' disenrollment rates is not unique to the Tampa
market.  In 55 percent of the markets served by four or more HMOs,
the highest disenrollment rate was greater than four times the lowest
rate in that market.  For example, disenrollment rates ranged from 8
percent to 56 percent in Houston, from 3 percent to 34 percent in Los
Angeles, and from 8 percent to 38 percent in Washington, D.C. 

   Figure 1:  Annual Rate of
   Voluntary Disenrollment at HMOs
   in the Tampa Market, 1996, as a
   Percentage of Average Number of
   Plan Members

   (See figure in printed
   edition.)

Source:  Group Health Plan File, Feb.  1997. 


--------------------
\8 An HMO's service area may extend over a wide geographic area and
encompass more than one market area.  To facilitate fair comparisons
among competing plans, we defined market areas and computed the
annual disenrollment each plan experienced within those market areas. 
Because of data limitations, we calculated rapid disenrollment rates
over plans' entire contract service areas.  In appendix II, we group
plans by market and present their market area annual disenrollment
rates.  In appendix II, we also list disenrollment rates for each
plan's service area.  For a particular plan, market area and service
area disenrollment rates can differ because disenrollment is not
evenly distributed over the plan's service area. 


   NEW MEMBER DISENROLLMENT RATES
   ARE SLIGHTLY LOWER IN NEW HMOS
------------------------------------------------------------ Letter :5

New plans tend to have higher annual disenrollment rates than more
established plans.  This may be because older plans have learned
through experience how to better satisfy their Medicare members. 
Alternatively, older plans may have a larger proportion of members
who are accustomed to managed care or who are reluctant to make any
health care changes.  Thus, lower disenrollment rates at established
HMOs may partly reflect the characteristics of their members.  This
latter explanation is supported by the data on rapid disenrollment
rates.  The disenrollment rate of new enrollees varies substantially
among HMOs but tends to be slightly lower at HMOs with less than 2
years of experience. 

Because of the rapid growth of Medicare managed care, many plans are
relatively new.  In 1996, 41 percent of Medicare HMOs had operated
for less than 2 years and 15 percent had operated for less than 7
months (see fig.  2).  According to HCFA officials, the BBA requires
the agency to disclose disenrollment rates only for plans in
operation for 2 or more years.  However, the law does not prohibit
HCFA from publishing rates of plans with less operating experience. 
We calculated disenrollment rates for HMOs with as little as 7 months
of experience and a minimum membership average of 250 members per
month.  Appendix II lists HMOs' years of experience and average
monthly membership because this information may be important to
beneficiaries considering a particular managed care plan.  (Fig.  3
shows the distribution of HMOs by average monthly membership.)

   Figure 2:  Distribution of
   Medicare Risk HMOs by Years in
   Operation as of December 31,
   1996

   (See figure in printed
   edition.)

Note:  Does not add to 100 percent because of rounding. 

Source:  HCFA Group Health Plan System. 

   Figure 3:  Distribution of
   Medicare Risk HMOs by Size of
   Plan, 1996

   (See figure in printed
   edition.)

Source:  HCFA Group Health Plan System. 


   MANY HMO DISENROLLEES SWITCH TO
   FEE-FOR-SERVICE INSTEAD OF
   ANOTHER AVAILABLE HMO
------------------------------------------------------------ Letter :6

Many beneficiaries who disenroll from a managed care plan switch to
traditional fee-for-service Medicare.  In areas served by only one
plan, HMO disenrollees have no other option.  However, many
disenrollees could join a different managed care plan but switch to
fee-for-service instead.  In the 92 urban market areas served by two
or more plans, more than one-third (36 percent) of HMO disenrollees
switched to fee-for-service.  Even in markets served by multiple
plans, the proportion of beneficiaries changing to fee-for-service
can be high.  For example, in Miami--a market served by nine
HMOs--more than 46 percent of beneficiaries who disenrolled from
United HealthCare of Florida during 1996 switched to fee-for-service
rather than join another HMO.  (The percentage of each plan's
disenrollees who switched to fee-for-service is shown in app.  II.)


   AGENCY COMMENTS AND OUR
   EVALUATION
------------------------------------------------------------ Letter :7

In commenting on a draft of this report, HCFA officials agreed that
the variation of HMO disenrollment rates among plans operating in the
same markets is useful information.  HCFA is interested in making
disenrollment information more meaningful by developing a
disenrollment survey to determine why beneficiaries leave HMOs.  In
addition, HCFA officials said they are interested in factors that
might explain the variation in rates, such as quality of and access
to care, NCQA accreditation, incidents of fraud or abuse, and the
extent of the provider network.  However, at the time the officials
made these comments, HCFA had not decided on its methodology for
calculating disenrollment rates or the minimum size and age of plans
it would report rates on.  HCFA officials said they will address
these and many other methodological issues before HCFA publishes
disenrollment rates--currently scheduled for the fall of 1999. 


---------------------------------------------------------- Letter :7.1

As agreed with your office, unless you publicly announce its contents
earlier, we plan no further distribution of this report until 30 days
after its issue date.  We will then send copies to appropriate
congressional committees, the Secretary of Health and Human Services,
and others who are interested. 

If you have any questions about this report, please contact me at
(202) 512-7114 or James C.  Cosgrove, Assistant Director, at (202)
512-7029.  Other contributors include George M.  Duncan, Beverly
Ross, and Wayne Turowski. 

Sincerely yours,

William J.  Scanlon
Director, Health Financing
 and Systems Issues


METHODOLOGY
=========================================================== Appendix I

We used Health Care Financing Administration (HCFA) data to compute
beneficiary disenrollment rates for each health maintenance
organization (HMO) that operated a Medicare risk contract during
1996.  To measure voluntary disenrollment, we excluded disenrollments
caused by death, loss of Medicare eligibility, or moves outside
plans' service areas.  We also did not count as voluntary
disenrollment administrative changes such as one plan merging with
another. 


   DATA SOURCES
--------------------------------------------------------- Appendix I:1

We used the February 1997 Group Health Plan (GHP) file to identify
beneficiaries who were enrolled in a risk plan during any part of
1996.  We then merged enrollees' GHP data with additional data
contained in the enrollment database.  From these data, we calculated
monthly new enrollments, new disenrollments, and membership at all
risk plans operating in 1996. 

We used HCFA's October 1996 Service Area File to determine the
counties and parts of counties each plan served.  We used this
information to group HMOs in market areas defined by metropolitan
statistical areas (MSA) or New England county metropolitan areas
(NECMA) in the six New England states.  To calculate plans' market
area disenrollment rates, we analyzed disenrollment within the MSA or
NECMA in comparison with the plans' membership within the same area. 


   RATE CALCULATIONS
--------------------------------------------------------- Appendix I:2

To compute total voluntary disenrollment rates, we first divided the
sum of 1996 voluntary disenrollments by the number of member-months
(the sum of total monthly enrollments for each month in 1996), to
compute a rate of disenrollment per member-month.  We then multiplied
this result by 12 to obtain the rate per member-year (this rate could
represent a single member who stayed in the plan for all 12 months or
12 members who each stayed in the plan for only 1 month).  Finally,
we multiplied the result by 100 to express disenrollment per 100
member-years.  Conceptually, this disenrollment rate compares a
plan's total voluntary disenrollment with its average monthly
membership.  For example, a plan that had voluntary disenrollments of
1,000 members during 1996 and averaged 5,000 members per month would
have a total voluntary disenrollment rate of 20 percent.  This
methodology is conceptually similar to, but computationally somewhat
different from, the methodology in our October 1996 report.\9

We analyzed whether HMO disenrollees switched to a different managed
care plan or to fee-for-service.  For each HMO, we then calculated
the proportion of disenrollees who switched to fee-for-service. 

We computed each plan's rapid disenrollment rate by summing its 1996
disenrollments that occurred within 3 months of enrollment and
divided that sum by total new enrollments from November 1995 to
December 1996. 


--------------------
\9 GAO/HEHS-97-23, Oct.  22, 1996. 


MEDICARE RISK HMO VOLUNTARY
DISENROLLMENT RATES, 1996
========================================================== Appendix II

The four tables in this appendix detail the voluntary disenrollment
rates, by Bureau of the Census major geographic region--Northeast,
South, Midwest, and West--for Medicare risk HMOs. 


   EXPLANATION OF COLUMN HEADINGS
-------------------------------------------------------- Appendix II:1

Metropolitan area:  U.S.  Bureau of the Census statistical area: 
metropolitan statistical areas (MSA), primary metropolitan
statistical areas (PMSA), or New England county metropolitan areas
(NECMA). 

HCFA contract #:  Plan contract number assigned by HCFA. 

Plan name:  Name of risk plan as reported by HCFA. 

Plan age:  Number of years and months between the plan's first
enrollment of beneficiaries and December 31, 1996. 

Average monthly membership:  Average monthly membership in 1996. 

Vol.  rate:  Voluntary annual disenrollment rate. 

FFS as % of vol.:  Percentage of disenrollees who switched to
Medicare fee-for-service. 

Rapid rate:  Percentage of new members who disenrolled within 3
months of enrolling. 


   SORT ORDER
-------------------------------------------------------- Appendix II:2

Plans are listed by census region and metropolitan area.  In
metropolitan areas with two or more plans, plans are listed in
descending order of voluntary disenrollment rate. 



                                        Table II.1
                         
                            Voluntary Disenrollment Rates for
                           Medicare Risk HMOs, Northeast Region

                                         Within metropolitan        Overall contract
                                                areas                  statistics
                                         --------------------  --------------------------
                                   Plan
                                    age   Average         FFS   Average         FFS
HCFA                               yrs.   monthly        as %   monthly        as %  Rapi
contrac                               /  enrollme  Vol.    of  enrollme  Vol.    of     d
t #      Plan name                 mos.        nt  rate  vol.        nt  rate  vol.  rate
-------  ------------------------  ----  --------  ----  ----  --------  ----  ----  ----
Albany-Schenectady-Troy, NY MSA
-----------------------------------------------------------------------------------------
H3361    WellCare of New York,      1/3       441   7.9  68.6     2,878  11.7  57.9   2.5
          Inc.
H3368    Capital Area Community     0/3     1,460    \a    \a     1,479    \a    \a    \a
          HP

Allentown-Bethlehem-Easton, PA MSA
-----------------------------------------------------------------------------------------
H3962    Keystone Health Plan       0/7       447  19.9  82.7     1,863  19.5  82.1   4.3
          Central, Inc.
H3931    U.S. Health Care Systems   11/     5,408   6.4  85.0    63,494   5.3  62.1   3.3
          of PA                       2
H3956    Aetna Health Plans of      2/6       519   5.8  56.7     9,065  16.6  39.0   4.2
          Central/East PA
H3954    Geisinger Health Plan      2/9        99    \a    \a    15,028   3.0  73.6   1.8

Altoona, PA MSA
-----------------------------------------------------------------------------------------
H3957    Keystone Health Plan       1/8     1,047    \a    \a    48,663   5.2  83.0   2.1
          West
H3954    Geisinger Health Plan      2/9       184    \a    \a    15,028   3.0  73.6   1.8

Atlantic-Cape May, NJ PMSA
-----------------------------------------------------------------------------------------
H3152    HMO of New Jersey, Inc.    3/2     2,584  12.0  54.0    32,261  11.0  55.4   5.1
H3156    Amerihealth HMO, Inc.       0/       395   9.9  71.8     2,056   9.1  66.8   2.7
                                     11
H3157    Aetna Health Plans of       0/       924   7.3  58.1    11,688   9.1  51.2   1.9
          New Jersey                 11
H3154    Medigroup, Inc.             0/       213    \a    \a     3,994  22.4  75.9   6.9
                                     10
H3155    First Option Health Plan    0/       139    \a    \a     2,996  11.2  84.4   3.7
          of NJ, Inc.                11
H3107    Oxford Health Plans (New    4/        16    \a    \a     9,417   8.1  65.5   3.6
          Jersey), Inc.              10
H3158    HIP of New Jersey          1/0        27    \a    \a     4,513   6.8  41.2   2.1

Barnstable-Yarmouth, MA NECMA
-----------------------------------------------------------------------------------------
H2255    U.S. Healthcare, Inc.      2/6     1,055  10.6  92.0    10,143  12.6  57.6   4.4
          MASS
H2258    Pilgrim Health Care,        1/       163    \a    \a     8,065   6.8  45.8   2.0
          Inc.                       11
H2261    HMO BLUE, Inc.              0/       101    \a    \a     9,759   5.2  44.4   2.0
                                     10

Bergen-Passaic, NJ PMSA
-----------------------------------------------------------------------------------------
H3154    Medigroup, Inc.             0/       609  22.1  72.3     3,994  22.4  75.9   6.9
                                     10
H3152    HMO of New Jersey, Inc.    3/2     1,057  15.3  71.6    32,261  11.0  55.4   5.1
H3155    First Option Health Plan    0/       760  12.6  92.0     2,996  11.2  84.4   3.7
          of NJ, Inc.                11
H3158    HIP of New Jersey          1/0       635   5.5  42.9     4,513   6.8  41.2   2.1
H3107    Oxford Health Plans (New    4/     5,425   4.7  67.6     9,417   8.1  65.5   3.6
          Jersey), Inc.              10
H3157    Aetna Health Plans of       0/       216    \a    \a    11,688   9.1  51.2   1.9
          New Jersey                 11

Binghamton, NY MSA
-----------------------------------------------------------------------------------------
H3371    Community Health Plan      0/2       158    \a    \a       159    \a    \a    \a

Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH NECMA
-----------------------------------------------------------------------------------------
H2255    U.S. Healthcare, Inc.      2/6     8,274  12.4  53.6    10,143  12.6  57.6   4.4
          MASS
H3049    U.S. HealthCare of New     2/6       848  12.0  96.1       967  13.3  91.5   6.4
          Hampshire, Inc.
H4102    United Health Plans of      8/     3,062   9.8  30.1    14,317   4.8  49.4   2.0
          New England                11
H2261    HMO BLUE, Inc.              0/     4,805   7.0  37.3     9,759   5.2  44.4   2.0
                                     10
H2258    Pilgrim Health Care,        1/     7,707   6.5  44.6     8,065   6.8  45.8   2.0
          Inc.                       11
H2256    Tufts Associated HMO,      2/3    31,276   4.7  59.8    32,787   4.9  61.0   2.1
          Inc.
H2206    Harvard Community Health   11/    20,207   2.6  54.6    23,881   2.9  53.2   1.2
          Plan                        6
H9001    Fallon Community Health    11/    26,105   1.3  50.3    27,811   1.5  49.9   0.8
          Plan, Inc.                  9
H2204    Harvard Community Health   11/       193    \a    \a       217    \a    \a    \a
          Plan of N.E.                4
H4153    United Health Plans of     0/3        40    \a    \a       174    \a    \a    \a
          New England

Buffalo-Niagara Falls, NY MSA
-----------------------------------------------------------------------------------------
H3362    Independent Health Assn.   0/8     1,548   8.8  93.4     1,608   9.4  94.1   2.8
H3351    Health Care Plan, Inc.     7/0     9,343   4.4  63.9     9,565   4.4  63.3   3.4

Dutchess County, NY PMSA
-----------------------------------------------------------------------------------------
H3361    WellCare of New York,      1/3       419  23.1  34.0     2,878  11.7  57.9   2.5
          Inc.
H3366    Physicians Health SVC of    0/         1    \a    \a       679  16.8  71.6   3.7
          NY, Inc.                   10
H3312    U.S. HealthCare, Inc.      10/       110    \a    \a    15,096  12.9  57.3   5.8
                                      1
H3373    Capital Area Community     0/2       147    \a    \a       214    \a    \a    \a
          HP

Erie, PA MSA
-----------------------------------------------------------------------------------------
H3957    Keystone Health Plan       1/8     1,800    \a    \a    48,663   5.2  83.0   2.1
          West

Harrisburg-Lebanon-Carlisle, PA MSA
-----------------------------------------------------------------------------------------
H3962    Keystone Health Plan       0/7       429  25.2  79.4     1,863  19.5  82.1   4.3
          Central, Inc.
H3931    U.S. Health Care Systems   11/     1,167  12.3  75.5    63,494   5.3  62.1   3.3
          of PA                       2
H3956    Aetna Health Plans of      2/6     3,120   8.4  79.8     9,065  16.6  39.0   4.2
          Central/East PA
H3960    HealthAmerica of Central   0/5       108    \a    \a       153    \a    \a    \a
          PA

Hartford, CT NECMA
-----------------------------------------------------------------------------------------
H0751    U.S. Healthcare, Inc.      2/6     3,123  10.8  93.8     6,712  12.0  86.1   4.4
H0752    Oxford Healthplan           0/       126    \a    \a     1,390  13.7  50.3   4.2
                                     10

Jamestown, NY MSA
-----------------------------------------------------------------------------------------
H3362    Independent Health Assn.   0/8        45    \a    \a     1,608   9.4  94.1   2.8
H3351    Health Care Plan, Inc.     7/0        33    \a    \a     9,565   4.4  63.3   3.4

Jersey City, NJ PMSA
-----------------------------------------------------------------------------------------
H3152    HMO of New Jersey, Inc.    3/2       450  23.4  72.4    32,261  11.0  55.4   5.1
H3107    Oxford Health Plans (New    4/       670  12.1  80.2     9,417   8.1  65.5   3.6
          Jersey), Inc.              10
H3154    Medigroup, Inc.             0/       241    \a    \a     3,994  22.4  75.9   6.9
                                     10
H3155    First Option Health Plan    0/        46    \a    \a     2,996  11.2  84.4   3.7
          of NJ, Inc.                11
H3157    Aetna Health Plans of       0/        40    \a    \a    11,688   9.1  51.2   1.9
          New Jersey                 11
H3158    HIP of New Jersey          1/0       218    \a    \a     4,513   6.8  41.2   2.1

Johnstown, PA MSA
-----------------------------------------------------------------------------------------
H3957    Keystone Health Plan       1/8     1,498  10.9  98.5    48,663   5.2  83.0   2.1
          West
H3954    Geisinger Health Plan      2/9        28    \a    \a    15,028   3.0  73.6   1.8

Lancaster, PA MSA
-----------------------------------------------------------------------------------------
H3956    Aetna Health Plans of      2/6       427  14.8  79.4     9,065  16.6  39.0   4.2
          Central/East PA
H3931    U.S. Health Care Systems   11/     1,743   5.9  89.2    63,494   5.3  62.1   3.3
          of PA                       2
H3960    HealthAmerica of Central   0/5        30    \a    \a       153    \a    \a    \a
          PA

Middlesex-Somerset-Hunterdon, NJ PMSA
-----------------------------------------------------------------------------------------
H3154    Medigroup, Inc.             0/       386  21.5  76.8     3,994  22.4  75.9   6.9
                                     10
H3157    Aetna Health Plans of       0/     2,032  11.2  46.9    11,688   9.1  51.2   1.9
          New Jersey                 11
H3152    HMO of New Jersey, Inc.    3/2     2,507  10.4  72.1    32,261  11.0  55.4   5.1
H3107    Oxford Health Plans (New    4/       342   8.2  71.4     9,417   8.1  65.5   3.6
          Jersey), Inc.              10
H3158    HIP of New Jersey          1/0     1,634   4.4  63.9     4,513   6.8  41.2   2.1
H3155    First Option Health Plan    0/       214    \a    \a     2,996  11.2  84.4   3.7
          of NJ, Inc.                11

Monmouth-Ocean, NJ PMSA
-----------------------------------------------------------------------------------------
H3154    Medigroup, Inc.             0/       982  21.1  76.9     3,994  22.4  75.9   6.9
                                     10
H3107    Oxford Health Plans (New    4/       319  20.3  60.0     9,417   8.1  65.5   3.6
          Jersey), Inc.              10
H3152    HMO of New Jersey, Inc.    3/2     4,779  13.5  60.0    32,261  11.0  55.4   5.1
H3158    HIP of New Jersey          1/0       399  13.0  25.0     4,513   6.8  41.2   2.1
H3157    Aetna Health Plans of       0/     1,020  12.7  47.9    11,688   9.1  51.2   1.9
          New Jersey                 11
H3155    First Option Health Plan    0/     1,423  11.0  78.5     2,996  11.2  84.4   3.7
          of NJ, Inc.                11
H3156    Amerihealth HMO, Inc.       0/        65    \a    \a     2,056   9.1  66.8   2.7
                                     11

Nassau-Suffolk, NY PMSA
-----------------------------------------------------------------------------------------
H3354    NYL Care                   4/9     9,227  18.3  20.5    12,794  18.0  24.8   6.8
H3359    Managed Health, Inc.       2/6       560  10.9  24.6     1,344  10.3  24.5   3.3
H3312    U.S. HealthCare, Inc.      10/     4,852   9.3  47.5    15,096  12.9  57.3   5.8
                                      1
H3360    ChoiceCare Long Island,    1/4     4,192   6.8  55.9     4,449   7.9  57.3   2.2
          Inc.
H3307    Oxford Health Plans (New   5/0    25,669   5.8  48.2    88,850   7.0  59.8   3.6
          York), Inc.
H3330    HIP of Greater New York    9/5    12,285   4.2  41.6    51,339   5.2  47.6   4.2
H3366    Physicians Health SVC of    0/       136    \a    \a       679  16.8  71.6   3.7
          NY, Inc.                   10
H3365    Cigna HealthCare of New    0/3        46    \a    \a       259    \a    \a    \a
          York
H3370    Empire Blue Cross Blue     0/4        16    \a    \a       904    \a    \a    \a
          Shield

New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT NECMA
-----------------------------------------------------------------------------------------
H0751    U.S. Healthcare, Inc.      2/6     3,185  12.0  83.6     6,712  12.0  86.1   4.4
H0752    Oxford Healthplan           0/     1,197   8.3  73.5     1,390  13.7  50.3   4.2
                                     10

New London-Norwich, CT NECMA
-----------------------------------------------------------------------------------------
H0752    Oxford Healthplan           0/        44    \a    \a     1,390  13.7  50.3   4.2
                                     10
H0751    U.S. Healthcare, Inc.      2/6       130    \a    \a     6,712  12.0  86.1   4.4

New York, NY PMSA
-----------------------------------------------------------------------------------------
H3366    Physicians Health SVC of    0/       553  16.9  73.1       679  16.8  71.6   3.7
          NY, Inc.                   10
H3354    NYL Care                   4/9     3,456  16.5  34.9    12,794  18.0  24.8   6.8
H3312    U.S. HealthCare, Inc.      10/     9,018  13.4  60.9    15,096  12.9  57.3   5.8
                                      1
H3359    Managed Health, Inc.       2/6       751   9.0  25.0     1,344  10.3  24.5   3.3
H3307    Oxford Health Plans (New   5/0    62,281   6.3  72.9    88,850   7.0  59.8   3.6
          York), Inc.
H3363    Kaiser Foundation HP of    1/1     1,015   4.7  31.3     1,086   4.8  28.8   1.7
          New York
H3330    HIP of Greater New York    9/5    38,126   4.1  57.2    51,339   5.2  47.6   4.2
H3361    WellCare of New York,      1/3       169    \a    \a     2,878  11.7  57.9   2.5
          Inc.
H3360    ChoiceCare Long Island,    1/4       244    \a    \a     4,449   7.9  57.3   2.2
          Inc.
H3365    Cigna HealthCare of New    0/3       212    \a    \a       259    \a    \a    \a
          York
H3370    Empire Blue Cross Blue     0/4       880    \a    \a       904    \a    \a    \a
          Shield

Newark, NJ PMSA
-----------------------------------------------------------------------------------------
H3154    Medigroup, Inc.             0/       956  24.5  84.1     3,994  22.4  75.9   6.9
                                     10
H3152    HMO of New Jersey, Inc.    3/2     2,293  12.8  75.5    32,261  11.0  55.4   5.1
H3155    First Option Health Plan    0/       297   9.5  96.2     2,996  11.2  84.4   3.7
          of NJ, Inc.                11
H3157    Aetna Health Plans of       0/       721   9.2  39.3    11,688   9.1  51.2   1.9
          New Jersey                 11
H3107    Oxford Health Plans (New    4/     2,298   9.2  75.5     9,417   8.1  65.5   3.6
          Jersey), Inc.              10
H3158    HIP of New Jersey          1/0       193    \a    \a     4,513   6.8  41.2   2.1

Newburgh, NY-PA PMSA
-----------------------------------------------------------------------------------------
H3361    WellCare of New York,      1/3       301  13.0  53.8     2,878  11.7  57.9   2.5
          Inc.
H3312    U.S. HealthCare, Inc.      10/       824  10.1  81.9    15,096  12.9  57.3   5.8
                                      1
H3366    Physicians Health SVC of    0/         1    \a    \a       679  16.8  71.6   3.7
          NY, Inc.                   10
H3307    Oxford Health Plans (New   5/0       159    \a    \a    88,850   7.0  59.8   3.6
          York), Inc.
H3953    HMO of Northeastern PA,    2/6        12    \a    \a    11,504   6.3  84.8   1.9
          Inc.

Philadelphia, PA-NJ PMSA
-----------------------------------------------------------------------------------------
H3107    Oxford Health Plans (New    4/       251  23.9  47.3     9,417   8.1  65.5   3.6
          Jersey), Inc.              10
H3154    Medigroup, Inc.             0/       466  18.5  59.7     3,994  22.4  75.9   6.9
                                     10
H3949    Greater Atlantic Health    4/7    13,077  12.0  34.7    13,195  12.3  36.2   7.9
          Service, Inc.
H3157    Aetna Health Plans of       0/     2,718  10.2  37.3    11,688   9.1  51.2   1.9
          New Jersey                 11
H3956    Aetna Health Plans of      2/6     1,962  10.0  59.7     9,065  16.6  39.0   4.2
          Central/East PA
H3152    HMO of New Jersey, Inc.    3/2    14,901   8.7  46.4    32,261  11.0  55.4   5.1
H3156    Amerihealth HMO, Inc.       0/     1,309   8.0  61.9     2,056   9.1  66.8   2.7
                                     11
H3158    HIP of New Jersey          1/0     1,261   6.5  23.2     4,513   6.8  41.2   2.1
H3952    Keystone Health Plan        3/    67,789   4.7  77.4    68,163   4.9  76.9   2.6
          East, Inc.                 10
H3931    U.S. Health Care Systems   11/    51,048   4.2  58.0    63,494   5.3  62.1   3.3
          of PA                       2
H3155    First Option Health Plan    0/        99    \a    \a     2,996  11.2  84.4   3.7
          of NJ, Inc.                11

Pittsburgh, PA MSA
-----------------------------------------------------------------------------------------
H3951    U.S. Health Care Systems   5/5    21,009   8.0  44.7    22,537   8.5  46.3   4.4
          of PA
H3957    Keystone Health Plan       1/8    42,661   4.7  80.1    48,663   5.2  83.0   2.1
          West
H3959    HealthAmerica               0/     3,519   2.3  52.5     3,613   2.5  53.7   0.7
          Pennsylvania, Inc.         10

Pittsfield, MA NECMA
-----------------------------------------------------------------------------------------
H2261    HMO BLUE, Inc.              0/         8    \a    \a     9,759   5.2  44.4   2.0
                                     10

Providence-Warwick-Pawtucket, RI NECMA
-----------------------------------------------------------------------------------------
H4149    Harvard Community Health   1/5     3,980   4.4  70.5     4,002   4.7  69.3   3.8
          Plan of N.E.
H4102    United Health Plans of      8/    10,679   3.2  69.2    14,317   4.8  49.4   2.0
          New England                11

Reading, PA MSA
-----------------------------------------------------------------------------------------
H3956    Aetna Health Plans of      2/6     2,040  21.7  23.7     9,065  16.6  39.0   4.2
          Central/East PA
H3962    Keystone Health Plan       0/7       448   9.9  84.6     1,863  19.5  82.1   4.3
          Central, Inc.
H3931    U.S. Health Care Systems   11/     2,311   9.0  63.9    63,494   5.3  62.1   3.3
          of PA                       2
H3960    HealthAmerica of Central   0/5         6    \a    \a       153    \a    \a    \a
          PA

Rochester, NY MSA
-----------------------------------------------------------------------------------------
H3305    Rochester Area HMO, Inc.   11/    14,908   3.2  45.8    15,118   3.2  46.5   0.7
                                      1
H3362    Independent Health         0/8         8    \a    \a     1,608   9.4  94.1   2.8
          Assoc.
H3351    Health Care Plan, Inc.     7/0        27    \a    \a     9,565   4.4  63.3   3.4

Scranton--Wilkes-Barre--Hazleton, PA MSA
-----------------------------------------------------------------------------------------
H3953    HMO of Northeastern PA,    2/6     7,256   5.2  74.1    11,504   6.3  84.8   1.9
          Inc.
H3954    Geisinger Health Plan      2/9     4,658   2.7  66.1    15,028   3.0  73.6   1.8
H3960    HealthAmerica of Central   0/5        36    \a    \a       153    \a    \a    \a
          PA

Sharon, PA MSA
-----------------------------------------------------------------------------------------
H3957    Keystone Health Plan       1/8       762  11.6  100.    48,663   5.2  83.0   2.1
          West                                              0

Springfield, MA NECMA
-----------------------------------------------------------------------------------------
H2255    U.S. Healthcare, Inc.      2/6       588  15.0  60.2    10,143  12.6  57.6   4.4
          MASS
H2256    Tufts Associated HMO,      2/3     1,350   6.4  76.7    32,787   4.9  61.0   2.1
          Inc.
H2261    HMO BLUE, Inc.              0/     4,732   2.8  47.7     9,759   5.2  44.4   2.0
                                     10
H9001    Fallon Community Health    11/        70    \a    \a    27,811   1.5  49.9   0.8
          Plan, Inc.                  9

State College, PA MSA
-----------------------------------------------------------------------------------------
H3954    Geisinger Health Plan      2/9     1,912   2.2  69.8    15,028   3.0  73.6   1.8
H3961    HealthAmerica of Central   0/3        13    \a    \a        13    \a    \a    \a
          PA

Trenton, NJ PMSA
-----------------------------------------------------------------------------------------
H3152    HMO of New Jersey, Inc.    3/2     2,125   7.1  60.9    32,261  11.0  55.4   5.1
H3157    Aetna Health Plans of       0/     1,214   4.0  56.8    11,688   9.1  51.2   1.9
          New Jersey                 11
H3154    Medigroup, Inc.             0/       126    \a    \a     3,994  22.4  75.9   6.9
                                     10
H3155    First Option Health Plan    0/         9    \a    \a     2,996  11.2  84.4   3.7
          of NJ, Inc.                11
H3156    Amerihealth HMO, Inc.       0/        90    \a    \a     2,056   9.1  66.8   2.7
                                     11
H3107    Oxford Health Plans (New    4/        23    \a    \a     9,417   8.1  65.5   3.6
          Jersey), Inc.              10
H3158    HIP of New Jersey          1/0        92    \a    \a     4,513   6.8  41.2   2.1

Vineland-Millville-Bridgeton, NJ PMSA
-----------------------------------------------------------------------------------------
H3152    HMO of New Jersey, Inc.    3/2     1,283  11.0  39.0    32,261  11.0  55.4   5.1
H3157    Aetna Health Plans of       0/     1,097   5.0  82.0    11,688   9.1  51.2   1.9
          New Jersey                 11
H3154    Medigroup, Inc.             0/         3    \a    \a     3,994  22.4  75.9   6.9
                                     10
H3155    First Option Health Plan    0/        27    \a    \a     2,996  11.2  84.4   3.7
          of NJ, Inc.                11
H3156    Amerihealth HMO, Inc.       0/       162    \a    \a     2,056   9.1  66.8   2.7
                                     11
H3107    Oxford Health Plans (New    4/        11    \a    \a     9,417   8.1  65.5   3.6
          Jersey), Inc.              10

Williamsport, PA MSA
-----------------------------------------------------------------------------------------
H3953    HMO of Northeastern PA,    2/6     4,050   8.1  98.5    11,504   6.3  84.8   1.9
          Inc.
H3954    Geisinger Health Plan      2/9       254   5.5  71.4    15,028   3.0  73.6   1.8

York, PA MSA
-----------------------------------------------------------------------------------------
H3956    Aetna Health Plans of      2/6       943  52.4  16.6     9,065  16.6  39.0   4.2
          Central/East PA
H3962    Keystone Health Plan       0/7       413  17.4  92.9     1,863  19.5  82.1   4.3
          Central, Inc.
H3931    U.S. Health Care Systems   11/       550  16.9  67.7    63,494   5.3  62.1   3.3
          of PA                       2

Others, Not in an MSA
-----------------------------------------------------------------------------------------
H3931    U.S. Health Care Systems   11/       627  14.5  81.3    63,494   5.3  62.1   3.3
          of PA                       2
H3951    U.S. Health Care Systems   5/5     1,299  12.1  65.6    22,537   8.5  46.3   4.4
          of PA
H3957    Keystone Health Plan       1/8     2,601   7.8  86.6    48,663   5.2  83.0   2.1
          West
H3361    WellCare of New York,      1/3     1,501   6.5  81.6     2,878  11.7  57.9   2.5
          Inc.
H3954    Geisinger Health Plan      2/9     7,425   3.1  83.0    15,028   3.0  73.6   1.8
H3962    Keystone Health Plan       0/7       115    \a    \a     1,863  19.5  82.1   4.3
          Central, Inc.
H0752    Oxford Healthplan           0/         4    \a    \a     1,390  13.7  50.3   4.2
                                     10
H3049    U.S. HealthCare of New     2/6        54    \a    \a       967  13.3  91.5   6.4
          Hampshire, Inc.
H0751    U.S. Healthcare, Inc.      2/6       183    \a    \a     6,712  12.0  86.1   4.4
H3953    HMO of Northeastern PA,    2/6        95    \a    \a    11,504   6.3  84.8   1.9
          Inc.
H2261    HMO BLUE, Inc.              0/        36    \a    \a     9,759   5.2  44.4   2.0
                                     10
H3351    Health Care Plan, Inc.     7/0       118    \a    \a     9,565   4.4  63.3   3.4
H3305    Rochester Area HMO, Inc.   11/       122    \a    \a    15,118   3.2  46.5   0.7
                                      1
H3959    HealthAmerica               0/        85    \a    \a     3,613   2.5  53.7   0.7
          Pennsylvania, Inc.         10
H9001    Fallon Community Health    11/        13    \a    \a    27,811   1.5  49.9   0.8
          Plan, Inc.                  9
H0851    Amerihealth HMO, Inc.      0/2        18    \a    \a        38    \a    \a    \a
H3373    Capital Area Community     0/2        66    \a    \a       214    \a    \a    \a
          HP
H3960    HealthAmerica of Central   0/5         2    \a    \a       153    \a    \a    \a
          PA
-----------------------------------------------------------------------------------------
\a This plan either had an average enrollment of less than 250 or was
in operation 6 months or less. 



                                        Table II.2
                         
                            Voluntary Disenrollment Rates for
                           Medicare Risk HMOs, Southern Region

                                         Within metropolitan        Overall contract
                                                areas                  statistics
                                         --------------------  --------------------------
                                   Plan
                                    age   Average         FFS   Average         FFS
HCFA                               yrs.   monthly        as %   monthly        as %  Rapi
contrac                               /  enrollme  Vol.    of  enrollme  Vol.    of     d
t #      Plan name                 mos.        nt  rate  vol.        nt  rate  vol.  rate
-------  ------------------------  ----  --------  ----  ----  --------  ----  ----  ----
Atlanta, GA MSA
-----------------------------------------------------------------------------------------
H1155    United Healthcare of       0/8     2,274  18.9  97.6     2,335  18.9  96.6   4.4
          Georgia, Inc.
H1156    USHC of Georgia, Inc.      0/1        18    \a    \a        19    \a    \a    \a

Austin-San Marcos, TX MSA
-----------------------------------------------------------------------------------------
H4557    PCA Health Plans of         3/     4,438   6.6  96.6    18,517  35.1  53.6  13.8
          Texas, Inc.                10
H4558    NYLCARE Health Plans,      3/6        15    \a    \a    28,994   8.6  55.3   3.4
          Inc.

Baltimore, MD PMSA
-----------------------------------------------------------------------------------------
H2153    Optimum Choice, Inc.       2/5     2,332  29.2  22.9    11,611  59.9  40.2   6.0
H2101    HealthCare Corp. of the    10/     3,327  14.4  75.6     4,966  14.7  79.5   4.8
          Mid-Atlantic                7
H2154    U.S. HealthCare Delaware   2/2     2,863  11.4  67.7     4,026  12.0  65.5   4.2
H2152    NYLCARE Health Plans,      2/5       672  10.3  60.9     4,804   8.1  60.9   2.5
          Inc.
H2151    Chesapeake Health Plan,    2/7     5,386   7.6  73.1     5,829   8.5  70.0   3.0
          Inc.
H0951    Humana Group Health         1/        36    \a    \a     7,497  23.0  77.0   8.1
          Plan, Inc.                 11

Baton Rouge, LA MSA
-----------------------------------------------------------------------------------------
H1956    Advantage Health Plan,      0/       461  32.3  66.1     3,028  26.7  76.5   8.8
          Inc.                       10
H1954    Community Health Network   2/2     5,037  13.7  64.7    14,825  24.8  63.0  10.8
          of Louisiana
H1951    Ochsner Health Plan        2/1     4,301  10.3  33.5    21,558   9.5  42.9   4.2
H1955    Gulf South Health Plans,   1/9     2,597   5.7  46.9     3,686   8.3  51.1   3.0
          Inc.

Beaumont-Port Arthur, TX MSA
-----------------------------------------------------------------------------------------
H4558    NYLCARE Health Plans,      3/6     1,980  11.5  92.5    28,994   8.6  55.3   3.4
          Inc.
H4565    HMO Texas, L.C.            0/3       534    \a    \a       634    \a    \a    \a

Birmingham, AL MSA
-----------------------------------------------------------------------------------------
H0151    United Healthcare of       1/9     5,303  10.7  91.4     5,384  11.0  90.5   4.5
          Alabama
H0150    Health Partners of         2/8     5,807   8.0  70.1     5,924   8.2  71.2   3.8
          Alabama

Brazoria, TX PMSA
-----------------------------------------------------------------------------------------
H4557    PCA Health Plans of         3/       276  57.3  48.7    18,517  35.1  53.6  13.8
          Texas, Inc.                10
H4562    FHP of Texas, Inc.         1/7       292  35.9  68.6     3,381  36.6  47.3  10.7
H4510    Humana HP of Texas         8/7       358  25.2  74.4    19,813  22.2  49.2  10.0
H4558    NYLCARE Health Plans,      3/6     1,061   8.3  45.5    28,994   8.6  55.3   3.4
          Inc.
H4563    Prudential Health Care      1/        74    \a    \a     5,392  29.8  47.0   9.5
          Plan, Inc.                 11
H4565    HMO Texas, L.C.            0/3         3    \a    \a       634    \a    \a    \a

Bryan-College Station, TX MSA
-----------------------------------------------------------------------------------------
H4557    PCA Health Plans of         3/        10    \a    \a    18,517  35.1  53.6  13.8
          Texas, Inc.                10
H4590    Pacificare of Texas,       9/0        16    \a    \a    58,034  12.7  45.0   4.9
          Inc.
H4558    NYLCARE Health Plans,      3/6         3    \a    \a    28,994   8.6  55.3   3.4
          Inc.

Charleston-North Charleston, SC MSA
-----------------------------------------------------------------------------------------
H4249    Companion HealthCare        0/       432   5.9  100.     1,343   8.5  98.8   2.6
          Corporation                10                     0

Clarksville-Hopkinsville, TN-KY MSA
-----------------------------------------------------------------------------------------
H4452    Health 1*2*3               0/9        38    \a    \a       915  13.0  100.   3.4
                                                                                  0

Columbia, SC MSA
-----------------------------------------------------------------------------------------
H4249    Companion HealthCare        0/       718   8.7  97.9     1,343   8.5  98.8   2.6
          Corporation                10

Corpus Christi, TX MSA
-----------------------------------------------------------------------------------------
H4504    Humana HP of Texas         11/     8,551  12.0  98.6     8,747  12.3  98.0   7.5
                                      0
H4557    PCA Health Plans of         3/         3    \a    \a    18,517  35.1  53.6  13.8
          Texas, Inc.                10
H4558    NYLCARE Health Plans,      3/6         2    \a    \a    28,994   8.6  55.3   3.4
          Inc.

Cumberland, MD-WV MSA
-----------------------------------------------------------------------------------------
H2153    Optimum Choice, Inc.       2/5       194    \a    \a    11,611  59.9  40.2   6.0
H2101    HealthCare Corp. of the    10/       156    \a    \a     4,966  14.7  79.5   4.8
          Mid-Atlantic                7
H2151    Chesapeake Health Plan,    2/7         3    \a    \a     5,829   8.5  70.0   3.0
          Inc.

Dallas, TX PMSA
-----------------------------------------------------------------------------------------
H4507    NYLCARE Health Plans,      10/    11,521   9.3  70.0    19,289   9.2  64.5   3.7
          Inc.                        0
H4590    Pacificare of Texas,       9/0     7,606   8.9  83.1    58,034  12.7  45.0   4.9
          Inc.

Daytona Beach, FL MSA
-----------------------------------------------------------------------------------------
H1061    AV-MED Health Plan, Inc.   3/3       739  150.  30.1     5,641  54.1  21.0   9.5
                                                      3
H1036    Humana Medical Plan,       11/    21,158  10.0  53.7   216,043  17.5  32.5   8.4
          Inc.                        9
H1035    Florida Health Care        11/    13,096   4.9  49.8    13,399   5.0  49.2   2.6
          Plan, Inc.                  2

Dover, DE MSA
-----------------------------------------------------------------------------------------
H0850    U.S. HealthCare Delaware   2/6       323  11.5  73.0     2,053  13.3  62.4   5.4
H2153    Optimum Choice, Inc.       2/5        50    \a    \a    11,611  59.9  40.2   6.0
H0851    Amerihealth HMO, Inc.      0/2         2    \a    \a        38    \a    \a    \a

Florence, SC MSA
-----------------------------------------------------------------------------------------
H4249    Companion HealthCare        0/        50    \a    \a     1,343   8.5  98.8   2.6
          Corporation                10

Fort Lauderdale, FL PMSA
-----------------------------------------------------------------------------------------
H1056    PCA Health Plans of        5/2     7,995  33.3  18.0    17,278  40.5  20.0  19.9
          Florida, Inc.
H1076    HIP Health Plan of         1/9     4,956  29.2  21.6    11,869  29.7  24.2  13.5
          Florida, Inc.
H1013    Foundation Health, A       9/7    11,115  27.4  17.2    26,070  34.6  21.6  22.5
          Florida Health Plan
H9011    United HealthCare of       11/     9,110  22.3  21.4    49,307  16.6  41.2  11.3
          Florida, Inc.               9
H1073    Prudential Health Care     2/3     3,916  14.9  32.0    11,706  16.1  31.3   5.0
          Plan, Inc.
H1036    Humana Medical Plan,       11/    40,057  14.0  25.5   216,043  17.5  32.5   8.4
          Inc.                        9
H1026    Health Options, Inc.       11/    15,352  11.7  29.6    45,247  12.3  34.4   6.1
                                      9
H1016    AV-MED Health Plan, Inc.   11/     9,161   9.1  31.3    21,614  10.9  31.9   6.6
                                      9
H1078    Neighborhood Health        1/6       206    \a    \a     3,378  19.6  35.1   6.7
          Partnership, Inc.

Fort Myers-Cape Coral, FL MSA
-----------------------------------------------------------------------------------------
H1036    Humana Medical Plan,       11/     1,850  15.2  97.5   216,043  17.5  32.5   8.4
          Inc.                        9
H1068    PCA Health Plans of        2/3         9    \a    \a    10,304  51.7  18.7  11.6
          Florida, Inc.

Fort Pierce-Port St. Lucie, FL MSA
-----------------------------------------------------------------------------------------
H1036    Humana Medical Plan,       11/     2,808  13.2  96.2   216,043  17.5  32.5   8.4
          Inc.                        9

Fort Worth-Arlington, TX PMSA
-----------------------------------------------------------------------------------------
H4590    Pacificare of Texas,       9/0     1,476  14.8  52.1    58,034  12.7  45.0   4.9
          Inc.
H4507    NYLCARE Health Plans,      10/     6,441   8.6  54.1    19,289   9.2  64.5   3.7
          Inc.                        0
H4559    Harris Health Plan, Inc.   2/0    18,171   7.8  80.9    18,585   7.9  80.6   4.3

Gainesville, FL MSA
-----------------------------------------------------------------------------------------
H1057    AV-MED Health Plan, Inc.   3/2     3,011   7.6  96.9    11,106  20.5  97.6   4.5

Galveston-Texas City, TX PMSA
-----------------------------------------------------------------------------------------
H4557    PCA Health Plans of         3/       660  52.3  42.0    18,517  35.1  53.6  13.8
          Texas, Inc.                10
H4510    Humana HP of Texas         8/7       768  23.8  75.4    19,813  22.2  49.2  10.0
H4590    Pacificare of Texas,       9/0     2,159  11.6  65.6    58,034  12.7  45.0   4.9
          Inc.
H4558    NYLCARE Health Plans,      3/6     1,570   9.7  32.9    28,994   8.6  55.3   3.4
          Inc.
H4562    FHP of Texas, Inc.         1/7        79    \a    \a     3,381  36.6  47.3  10.7
H4563    Prudential Health Care      1/       105    \a    \a     5,392  29.8  47.0   9.5
          Plan, Inc.                 11
H4565    HMO Texas, L.C.            0/3         3    \a    \a       634    \a    \a    \a

Greensboro--Winston-Salem--High Point, NC MSA
-----------------------------------------------------------------------------------------
H3449    Partners National Health   1/0       847   5.4  91.3       863   5.4  91.5   1.4
          Plans of NC
H3455    QualChoice of North        0/1        20    \a    \a        20    \a    \a    \a
          Carolina, Inc.
H4250    Companion HealthCare       0/9        91    \a    \a        92    \a    \a    \a
          Corporation

Hagerstown, MD PMSA
-----------------------------------------------------------------------------------------
H2153    Optimum Choice, Inc.       2/5       313   5.8  38.9    11,611  59.9  40.2   6.0
H2101    HealthCare Corp. of the    10/       188    \a    \a     4,966  14.7  79.5   4.8
          Mid-Atlantic                7
H2151    Chesapeake Health Plan,    2/7         7    \a    \a     5,829   8.5  70.0   3.0
          Inc.

Houma, LA MSA
-----------------------------------------------------------------------------------------
H1954    Community Health Network   2/2       261  112.  95.9    14,825  24.8  63.0  10.8
          of Louisiana                                4
H1951    Ochsner Health Plan        2/1       828  15.3  56.7    21,558   9.5  42.9   4.2
H1956    Advantage Health Plan,      0/         5    \a    \a     3,028  26.7  76.5   8.8
          Inc.                       10
H1958    SMA HMO, Inc.              0/2        51    \a    \a       105    \a    \a    \a

Houston, TX PMSA
-----------------------------------------------------------------------------------------
H4557    PCA Health Plans of         3/     7,183  55.7  57.6    18,517  35.1  53.6  13.8
          Texas, Inc.                10
H4510    Humana HP of Texas         8/7     3,126  43.6  50.3    19,813  22.2  49.2  10.0
H4562    FHP of Texas, Inc.         1/7     2,930  36.4  45.2     3,381  36.6  47.3  10.7
H4563    Prudential Health Care      1/     5,119  29.5  46.4     5,392  29.8  47.0   9.5
          Plan, Inc.                 11
H4590    Pacificare of Texas,       9/0    16,584  18.6  38.3    58,034  12.7  45.0   4.9
          Inc.
H4558    NYLCARE Health Plans,      3/6    23,441   8.1  51.0    28,994   8.6  55.3   3.4
          Inc.
H4565    HMO Texas, L.C.            0/3        90    \a    \a       634    \a    \a    \a

Jacksonville, FL MSA
-----------------------------------------------------------------------------------------
H1069    PCA Health Plans of        2/3     6,929  71.6  16.4     7,331  71.1  17.1  15.6
          Florida, Inc.
H1059    AV-MED Health Plan, Inc.   3/2     7,420  42.6  21.1     7,728  42.9  22.0   9.4
H1036    Humana Medical Plan,       11/     2,988  42.1  41.8   216,043  17.5  32.5   8.4
          Inc.                        9
H1071    Health Options, Inc.       2/7     4,923  32.7  20.1     5,023  33.0  21.0   8.2
H1070    Prudential Health Care     2/4     5,146  12.3  28.5     5,330  12.4  30.0   4.2
          Plan, Inc.
H1088    Principal Health Care of   0/5       406    \a    \a       415    \a    \a    \a
          Florida, Inc.

Lakeland-Winter Haven, FL MSA
-----------------------------------------------------------------------------------------
H1068    PCA Health Plans of        2/3        60    \a    \a    10,304  51.7  18.7  11.6
          Florida, Inc.

Little Rock-North Little Rock, AR MSA
-----------------------------------------------------------------------------------------
H0451    HMO Partners               0/9     1,998   9.7  87.7     2,964  10.8  92.1   3.1
H0453    HealthSource, Arkansas,    0/3        69    \a    \a        70    \a    \a    \a
          Inc.

Louisville, KY-IN MSA
-----------------------------------------------------------------------------------------
H1890    Humana Health Plan, Inc.   9/1     6,606  17.2  99.6     6,872  17.3  99.3   7.9

Lynchburg, VA MSA
-----------------------------------------------------------------------------------------
H2157    Optimum Choice, Inc.        0/         2    \a    \a        32    \a    \a    \a
                                     10

Melbourne-Titusville-Palm Bay, FL MSA
-----------------------------------------------------------------------------------------
H1036    Humana Medical Plan,       11/       292  25.7  98.7   216,043  17.5  32.5   8.4
          Inc.                        9

Miami, FL PMSA
-----------------------------------------------------------------------------------------
H1076    HIP Health Plan of         1/9     1,316  55.9  21.2    11,869  29.7  24.2  13.5
          Florida, Inc.
H1056    PCA Health Plans of        5/2     5,596  49.9  22.0    17,278  40.5  20.0  19.9
          Florida, Inc.
H1013    Foundation Health, A       9/7     9,557  37.3  25.4    26,070  34.6  21.6  22.5
          Florida Health Plan
H1078    Neighborhood Health        1/6     3,104  18.1  35.2     3,378  19.6  35.1   6.7
          Partnership, Inc.
H1073    Prudential Health Care     2/3     3,299  15.4  31.8    11,706  16.1  31.3   5.0
          Plan, Inc.
H1036    Humana Medical Plan,       11/    27,529  14.9  30.3   216,043  17.5  32.5   8.4
          Inc.                        9
H1026    Health Options, Inc.       11/    10,919  14.4  33.6    45,247  12.3  34.4   6.1
                                      9
H9011    United HealthCare of       11/    34,681  11.8  46.4    49,307  16.6  41.2  11.3
          Florida, Inc.               9
H1016    AV-MED Health Plan, Inc.   11/     7,730  10.1  30.8    21,614  10.9  31.9   6.6
                                      9

Mobile, AL MSA
-----------------------------------------------------------------------------------------
H0152    United Healthcare of       1/9     5,765  15.0  99.9     5,847  15.4  98.1   6.5
          Alabama

Naples, FL MSA
-----------------------------------------------------------------------------------------
H1036    Humana Medical Plan,       11/         9    \a    \a   216,043  17.5  32.5   8.4
          Inc.                        9

Nashville, TN MSA
-----------------------------------------------------------------------------------------
H4452    Health 1*2*3               0/9       758  10.4  100.       915  13.0  100.   3.4
                                                            0                     0

New Orleans, LA MSA
-----------------------------------------------------------------------------------------
H1954    Community Health Network   2/2     9,150  27.2  55.9    14,825  24.8  63.0  10.8
          of Louisiana
H1956    Advantage Health Plan,      0/     2,151  22.8  84.1     3,028  26.7  76.5   8.8
          Inc.                       10
H1955    Gulf South Health Plans,   1/9       515  14.8  57.9     3,686   8.3  51.1   3.0
          Inc.
H1951    Ochsner Health Plan        2/1    14,993   8.5  40.7    21,558   9.5  42.9   4.2
H1958    SMA HMO, Inc.              0/2        52    \a    \a       105    \a    \a    \a

Norfolk-Virginia Beach-Newport News, VA-NC MSA
-----------------------------------------------------------------------------------------
H2153    Optimum Choice, Inc.       2/5     1,013  137.  50.5    11,611  59.9  40.2   6.0
                                                      8
H4949    Sentara Health Plans       5/9     5,058  14.0  59.2     5,131  14.1  59.7   5.4

Ocala, FL MSA
-----------------------------------------------------------------------------------------
H1057    AV-MED Health Plan, Inc.   3/2     4,084  36.5  98.3    11,106  20.5  97.6   4.5

Oklahoma City, OK MSA
-----------------------------------------------------------------------------------------
H3754    Pacificare of Oklahoma,    0/7     6,882   8.6  59.1     7,011   8.7  59.8   2.0
          Inc.
H3749    Pacificare of Oklahoma,     5/     2,841   5.0  96.5    16,652   6.6  61.1   3.0
          Inc.                       11
H3755    Community Care HMO, Inc.   0/6       204    \a    \a     1,094    \a    \a    \a
H3756    HealthCare Oklahoma,       0/3        84    \a    \a        88    \a    \a    \a
          Inc.
H3757    Bluelincs HMO, Inc.        0/2        54    \a    \a        75    \a    \a    \a

Orlando, FL MSA
-----------------------------------------------------------------------------------------
H1067    PCA Health Plans of        2/3     4,322  66.0  15.8     4,651  64.1  17.1  13.5
          Florida, Inc.
H1061    AV-MED Health Plan, Inc.   3/3     4,730  38.7  13.7     5,641  54.1  21.0   9.5
H1036    Humana Medical Plan,       11/    23,889  19.0  22.5   216,043  17.5  32.5   8.4
          Inc.                        9
H1081    Prudential Health Care     1/4     4,666   6.0  47.5     4,816   7.2  53.6   1.4
          Plan, Inc.
H1095    Health Options, Inc.       0/6     2,133    \a    \a     2,198    \a    \a    \a

Punta Gorda, FL MSA
-----------------------------------------------------------------------------------------
H1036    Humana Medical Plan,       11/       336  29.2  88.8   216,043  17.5  32.5   8.4
          Inc.                        9
H1068    PCA Health Plans of        2/3         9    \a    \a    10,304  51.7  18.7  11.6
          Florida, Inc.

Richmond-Petersburg, VA MSA
-----------------------------------------------------------------------------------------
H2153    Optimum Choice, Inc.       2/5     1,191  125.  41.2    11,611  59.9  40.2   6.0
                                                      2
H2152    NYLCARE Health Plans,      2/5       195    \a    \a     4,804   8.1  60.9   2.5
          Inc.
H4951    Cigna HealthCare of        0/2        72    \a    \a        74    \a    \a    \a
          Virginia

Roanoke, VA MSA
-----------------------------------------------------------------------------------------
H2157    Optimum Choice, Inc.        0/        17    \a    \a        32    \a    \a    \a
                                     10

San Antonio, TX MSA
-----------------------------------------------------------------------------------------
H4560    Prudential Health Care     2/1     1,441  40.3  26.2     1,452  41.0  26.2  14.6
          Plan, Inc.
H4557    PCA Health Plans of         3/     5,029  28.9  35.7    18,517  35.1  53.6  13.8
          Texas, Inc.                10
H4510    Humana HP of Texas         8/7    14,806  17.3  43.5    19,813  22.2  49.2  10.0
H4590    Pacificare of Texas,       9/0    28,966   9.8  37.5    58,034  12.7  45.0   4.9
          Inc.
H4558    NYLCARE Health Plans,      3/6         4    \a    \a    28,994   8.6  55.3   3.4
          Inc.

Sarasota-Bradenton, FL MSA
-----------------------------------------------------------------------------------------
H1068    PCA Health Plans of        2/3     2,290  27.2  35.9    10,304  51.7  18.7  11.6
          Florida, Inc.
H1036    Humana Medical Plan,       11/     2,930  25.1  91.2   216,043  17.5  32.5   8.4
          Inc.                        9

Tampa-St. Petersburg-Clearwater, FL MSA
-----------------------------------------------------------------------------------------
H1068    PCA Health Plans of        2/3     7,583  59.3  14.8    10,304  51.7  18.7  11.6
          Florida, Inc.
H1062    AV-MED Health Plan, Inc.   3/2    15,834  40.3  13.6    18,168  40.6  23.1   8.9
H1080    United Health Care of       0/     4,021  30.9  26.6     4,187  30.4  27.5   6.7
          FL, Inc.                   11
H1036    Humana Medical Plan,       11/    58,174  21.0  22.4   216,043  17.5  32.5   8.4
          Inc.                        9
H1082    Health Options, Inc.       0/9    10,003  20.5  50.8    10,319  20.9  50.8   5.9
H1087    Cigna HealthCare of        1/2     1,247  20.0  26.5     1,269  19.9  27.4   5.0
          Florida, Inc.
H1084    HIP Health Plan of         1/2     1,012  13.1  42.1     1,068  13.9  41.9   3.9
          Florida
H1074    Prudential Health Care     2/0     9,157  10.0  39.1     9,459  10.3  39.7   3.3
          Plan, Inc.

Tulsa, OK MSA
-----------------------------------------------------------------------------------------
H3749    Pacificare of Oklahoma,     5/    12,250   6.9  53.1    16,652   6.6  61.1   3.0
          Inc.                       11
H3755    Community Care HMO, Inc.   0/6       872    \a    \a     1,094    \a    \a    \a
H3757    Bluelincs HMO, Inc.        0/2        45    \a    \a        75    \a    \a    \a

Washington, DC-MD-VA-WV PMSA
-----------------------------------------------------------------------------------------
H2153    Optimum Choice, Inc.       2/5     4,203  37.5  35.0    11,611  59.9  40.2   6.0
H0951    Humana Group Health         1/     7,182  23.0  77.0     7,497  23.0  77.0   8.1
          Plan, Inc.                 11
H2154    U.S. HealthCare Delaware   2/2       446  15.0  64.2     4,026  12.0  65.5   4.2
H2152    NYLCARE Health Plans,      2/5     3,796   7.5  57.7     4,804   8.1  60.9   2.5
          Inc.
H2101    HealthCare Corp. of the    10/       230    \a    \a     4,966  14.7  79.5   4.8
          Mid-Atlantic                7
H2151    Chesapeake Health Plan,    2/7       165    \a    \a     5,829   8.5  70.0   3.0
          Inc.
H0953    U.S. HealthCare Delaware   2/5        80    \a    \a        83    \a    \a    \a

West Palm Beach-Boca Raton, FL MSA
-----------------------------------------------------------------------------------------
H1013    Foundation Health, A       9/7     4,701  44.5  15.4    26,070  34.6  21.6  22.5
          Florida Health Plan
H1056    PCA Health Plans of        5/2     2,720  43.1  15.2    17,278  40.5  20.0  19.9
          Florida, Inc.
H9011    United HealthCare of       11/     4,458  26.6  25.0    49,307  16.6  41.2  11.3
          Florida, Inc.               9
H1076    HIP Health Plan of         1/9     4,921  24.0  25.9    11,869  29.7  24.2  13.5
          Florida, Inc.
H1073    Prudential Health Care     2/3     4,376  17.1  28.9    11,706  16.1  31.3   5.0
          Plan, Inc.
H1036    Humana Medical Plan,       11/    27,168  14.2  27.8   216,043  17.5  32.5   8.4
          Inc.                        9
H1016    AV-MED Health Plan, Inc.   11/     4,313  14.0  28.9    21,614  10.9  31.9   6.6
                                      9
H1026    Health Options, Inc.       11/    17,994  10.6  36.0    45,247  12.3  34.4   6.1
                                      9
H1078    Neighborhood Health        1/6        17    \a    \a     3,378  19.6  35.1   6.7
          Partnership, Inc.

Wilmington-Newark, DE-MD PMSA
-----------------------------------------------------------------------------------------
H0850    U.S. HealthCare Delaware   2/6     1,435  12.5  63.9     2,053  13.3  62.4   5.4
H3157    Aetna Health Plans of       0/     1,364   7.5  74.5    11,688   9.1  51.2   1.9
          New Jersey                 11
H2154    U.S. HealthCare Delaware   2/2       367   5.4  60.0     4,026  12.0  65.5   4.2
H2153    Optimum Choice, Inc.       2/5        33    \a    \a    11,611  59.9  40.2   6.0
H2101    HealthCare Corp. of the    10/        45    \a    \a     4,966  14.7  79.5   4.8
          Mid-Atlantic                7
H2151    Chesapeake Health Plan,    2/7       198    \a    \a     5,829   8.5  70.0   3.0
          Inc.
H0851    Amerihealth HMO, Inc.      0/2        19    \a    \a        38    \a    \a    \a

Others, Not in an MSA
-----------------------------------------------------------------------------------------
H2153    Optimum Choice, Inc.       2/5     2,121  71.0  39.8    11,611  59.9  40.2   6.0
H1954    Community Health Network   2/2       371  66.6  96.4    14,825  24.8  63.0  10.8
          of Louisiana
H1062    AV-MED Health Plan, Inc.   3/2     1,551  43.6  97.8    18,168  40.6  23.1   8.9
H1956    Advantage Health Plan,      0/       396  41.8  63.0     3,028  26.7  76.5   8.8
          Inc.                       10
H4557    PCA Health Plans of         3/       579  27.6  52.5    18,517  35.1  53.6  13.8
          Texas, Inc.                10
H1036    Humana Medical Plan,       11/     1,362  17.0  94.4   216,043  17.5  32.5   8.4
          Inc.                        9
H0850    U.S. HealthCare Delaware   2/6       268  15.3  58.5     2,053  13.3  62.4   5.4
H1955    Gulf South Health Plans,   1/9       548  13.3  52.1     3,686   8.3  51.1   3.0
          Inc.
H0451    HMO Partners               0/9       942  13.0  98.9     2,964  10.8  92.1   3.1
H4590    Pacificare of Texas,       9/0       831  12.4  76.7    58,034  12.7  45.0   4.9
          Inc.
H1057    AV-MED Health Plan, Inc.   3/2     3,563  12.3  96.8    11,106  20.5  97.6   4.5
H1951    Ochsner Health Plan        2/1     1,075  10.1  56.9    21,558   9.5  42.9   4.2
H2101    HealthCare Corp. of the    10/     1,079   9.7  92.4     4,966  14.7  79.5   4.8
          Mid-Atlantic                7
H4558    NYLCARE Health Plans,      3/6       814   9.6  96.2    28,994   8.6  55.3   3.4
          Inc.
H1069    PCA Health Plans of        2/3       177    \a    \a     7,331  71.1  17.1  15.6
          Florida, Inc.
H1068    PCA Health Plans of        2/3        26    \a    \a    10,304  51.7  18.7  11.6
          Florida, Inc.
H1059    AV-MED Health Plan, Inc.   3/2       164    \a    \a     7,728  42.9  22.0   9.4
H4510    Humana HP of Texas         8/7       249    \a    \a    19,813  22.2  49.2  10.0
H4452    Health 1*2*3               0/9       127    \a    \a       915  13.0  100.   3.4
                                                                                  0
H1070    Prudential Health Care     2/4        82    \a    \a     5,330  12.4  30.0   4.2
          Plan, Inc.
H4249    Companion HealthCare        0/       129    \a    \a     1,343   8.5  98.8   2.6
          Corporation                10
H2151    Chesapeake Health Plan,    2/7        24    \a    \a     5,829   8.5  70.0   3.0
          Inc.
H2152    NYLCARE Health Plans,      2/5        80    \a    \a     4,804   8.1  60.9   2.5
          Inc.
H1958    SMA HMO, Inc.              0/2         4    \a    \a       105    \a    \a    \a
H2157    Optimum Choice, Inc.        0/        10    \a    \a        32    \a    \a    \a
                                     10
H3755    Community Care HMO, Inc.   0/6        10    \a    \a     1,094    \a    \a    \a
H3756    HealthCare Oklahoma,       0/3         2    \a    \a        88    \a    \a    \a
          Inc.
H3757    Bluelincs HMO, Inc.        0/2         6    \a    \a        75    \a    \a    \a
-----------------------------------------------------------------------------------------
\a This plan either had an average enrollment of less than 250 or was
in operation 6 months or less. 



                                        Table II.3
                         
                            Voluntary Disenrollment Rates for
                            Medicare Risk HMOs, Midwest Region

                                         Within metropolitan        Overall contract
                                                areas                  statistics
                                         --------------------  --------------------------
                                   Plan
                                    age   Average         FFS   Average         FFS
HCFA                               yrs.   monthly        as %   monthly        as %  Rapi
contrac                               /  enrollme  Vol.    of  enrollme  Vol.    of     d
t #      Plan name                 mos.        nt  rate  vol.        nt  rate  vol.  rate
-------  ------------------------  ----  --------  ----  ----  --------  ----  ----  ----
Akron, OH PMSA
-----------------------------------------------------------------------------------------
H3607    Kaiser Foundation HP of    10/     2,785   7.6  54.0    21,161   4.8  62.8   2.7
          Ohio                        0
H3655    Community Insurance        2/1       173    \a    \a     6,687  12.6  62.5   4.1
          Company
H3659    United HealthCare of       0/6       110    \a    \a     5,314    \a    \a    \a
          Ohio, Inc.
H3660    SummaCare, Inc.            0/5       738    \a    \a       863    \a    \a    \a

Bloomington, IN MSA
-----------------------------------------------------------------------------------------
H1551    HealthSource Indiana       5/5        27    \a    \a       382  15.1  100.   4.8
          Managed Care Plan                                                       0

Canton-Massillon, OH MSA
-----------------------------------------------------------------------------------------
H3655    Community Insurance        2/1       150    \a    \a     6,687  12.6  62.5   4.1
          Company
H3607    Kaiser Foundation HP of    10/       116    \a    \a    21,161   4.8  62.8   2.7
          Ohio                        0
H3659    United HealthCare of       0/6       227    \a    \a     5,314    \a    \a    \a
          Ohio, Inc.
H3660    SummaCare, Inc.            0/5        69    \a    \a       863    \a    \a    \a

Chicago, IL PMSA
-----------------------------------------------------------------------------------------
H1460    FHP of Illinois, Inc.       0/     1,291  50.5  47.0     1,307  50.8  47.1  12.8
                                     11
H1461    NYLCARE, Inc.              1/2       857  29.0  58.6       868  28.9  58.6   7.7
H1458    Health Direct Insurance,   2/0     2,740  23.4  57.9     2,766  23.6  57.9   6.8
          Inc.
H1406    Humana Health Plan, Inc.   11/    39,272  13.0  57.0    41,686  13.6  60.4   7.7
                                      6
H9045    United HealthCare of       11/    45,524   9.2  49.2    45,919   9.3  49.4   4.9
          Illinois                    6

Cincinnati, OH-KY-IN PMSA
-----------------------------------------------------------------------------------------
H3658    FHP of Ohio, Inc.          0/7     2,014  14.8  90.8     3,187  23.9  72.1   5.8
H3655    Community Insurance        2/1     4,921   9.4  57.1     6,687  12.6  62.5   4.1
          Company
H3659    United HealthCare of       0/6       579    \a    \a     5,314    \a    \a    \a
          Ohio, Inc.

Cleveland-Lorain-Elyria, OH PMSA
-----------------------------------------------------------------------------------------
H3657    QualChoice Health Plan     0/9       575  15.8  70.6       583  16.2  71.8   3.8
H3654    Prudential Health Care     2/4     8,002  13.6  59.4     8,062  13.7  59.6   4.8
          Plan of N. Ohio
H3656    Aetna Health Plans of      2/1     5,919  11.0  60.1     5,959  11.1  59.7   4.7
          Ohio, Inc.
H3607    Kaiser Foundation HP of    10/    17,901   4.2  64.8    21,161   4.8  62.8   2.7
          Ohio                        0
H3655    Community Insurance        2/1       248    \a    \a     6,687  12.6  62.5   4.1
          Company
H3659    United HealthCare of       0/6       408    \a    \a     5,314    \a    \a    \a
          Ohio, Inc.
H3660    SummaCare, Inc.            0/5        72    \a    \a       863    \a    \a    \a

Columbus, OH MSA
-----------------------------------------------------------------------------------------
H3655    Community Insurance        2/1       265  32.5  75.6     6,687  12.6  62.5   4.1
          Company
H3659    United HealthCare of       0/6       978    \a    \a     5,314    \a    \a    \a
          Ohio, Inc.

Dayton-Springfield, OH MSA
-----------------------------------------------------------------------------------------
H3658    FHP of Ohio, Inc.          0/7       834  44.0  56.5     3,187  23.9  72.1   5.8
H3655    Community Insurance        2/1       292  21.2  79.0     6,687  12.6  62.5   4.1
          Company
H3659    United HealthCare of       0/6     1,189    \a    \a     5,314    \a    \a    \a
          Ohio, Inc.

Detroit, MI PMSA
-----------------------------------------------------------------------------------------
H2312    Health Alliance Plan of    10/     7,376   7.2  97.5     7,481   7.3  97.1   2.9
          Michigan                    0

Gary, IN PMSA
-----------------------------------------------------------------------------------------
H1406    Humana Health Plan, Inc.   11/     1,804  22.1  99.2    41,686  13.6  60.4   7.7
                                      6

Hamilton-Middletown, OH PMSA
-----------------------------------------------------------------------------------------
H3658    FHP of Ohio, Inc.          0/7       309  25.5  71.7     3,187  23.9  72.1   5.8
H3655    Community Insurance        2/1       588  12.4  38.4     6,687  12.6  62.5   4.1
          Company
H3659    United HealthCare of       0/6       125    \a    \a     5,314    \a    \a    \a
          Ohio, Inc.

Indianapolis, IN MSA
-----------------------------------------------------------------------------------------
H9028    Maxicare Indiana, Inc.     11/     3,027   7.1  73.5     3,076   7.3  72.9   3.2
                                      9
H1557    Anthem Health of           0/5       255    \a    \a       276    \a    \a    \a
          Indiana, Inc.

Jackson, MI MSA
-----------------------------------------------------------------------------------------
H9009    Blue Care Network-         11/       130    \a    \a     4,308   1.4  95.1   0.5
          Health Central              9

Kankakee, IL PMSA
-----------------------------------------------------------------------------------------
H9045    United HealthCare of       11/        21    \a    \a    45,919   9.3  49.4   4.9
          Illinois                    6

Kansas City, MO-KS MSA
-----------------------------------------------------------------------------------------
H2652    Total Health Care           6/     3,891  29.4  20.6     3,949  29.2  20.7   3.0
                                     10
H2656    Good Health HMO, Inc.      2/8     4,589  19.2  53.7     4,653  19.2  53.9   6.5
H2649    Humana Kansas City, Inc.   7/0    14,206  10.3  46.4    14,482  10.3  47.1   4.7
H1751    Kaiser Foundation HP of    0/5       857    \a    \a       888    \a    \a    \a
          KS City, Inc.
H2666    HealthNet                  0/5     1,299    \a    \a     1,308    \a    \a    \a

Kokomo, IN MSA
-----------------------------------------------------------------------------------------
H1557    Anthem Health of           0/5         8    \a    \a       276    \a    \a    \a
          Indiana, Inc.

Lansing-East Lansing, MI MSA
-----------------------------------------------------------------------------------------
H9009    Blue Care Network-         11/     3,858   1.3  94.1     4,308   1.4  95.1   0.5
          Health Central              9

Milwaukee-Waukesha, WI PMSA
-----------------------------------------------------------------------------------------
H5253    PrimeCare Health Plan,     1/3     2,501   6.4  98.1     2,539   6.5  97.0   1.9
          Inc.

Minneapolis-St. Paul, MN-WI MSA
-----------------------------------------------------------------------------------------
H2455    Blue Plus, Inc.            2/0       684   5.0  70.6       696   4.9  70.6   1.2
H9006    Medica                     11/    39,690   3.0  87.0    40,513   3.3  86.4   1.2
                                      9
H9005    Group Health Plan, Inc.    11/    17,126   3.0  74.0    17,473   3.1  74.9   1.8
                                      9

Omaha, NE-IA MSA
-----------------------------------------------------------------------------------------
H2802    United HealthCare of the   11/     3,865   8.5  61.9     3,922   8.5  62.1   3.1
          Midlands, Inc.              3
H2849    Exclusive HealthCare,      0/2       718    \a    \a       724    \a    \a    \a
          Inc.

St. Louis, MO-IL MSA
-----------------------------------------------------------------------------------------
H2658    Gencare Health Systems,     1/     1,764  22.4  21.3     1,781  22.6  21.7   8.4
          Inc.                       11
H2659    HMO Missouri, Inc.         1/9     4,926  12.4  51.9     4,991  12.5  51.9   5.0
H2654    Gencare Health Systems,    4/1    15,773   8.2  65.9    15,936   8.3  66.0   2.9
          Inc.
H2663    Group Health Plan, Inc.    1/0     9,993   2.9  70.8    10,212   3.0  71.0   1.1

Toledo, OH MSA
-----------------------------------------------------------------------------------------
H3649    Family Health Plan, Inc.   3/9     2,268   6.7  25.5     2,422   6.6  25.6   1.9
H3653    Paramount Care, Inc.       1/9     1,857   2.8  100.     1,937   2.8  100.   1.0
                                                            0                     0

Wichita, KS MSA
-----------------------------------------------------------------------------------------
H1750    Preferred Plus of          0/6       122    \a    \a       123    \a    \a    \a
          Kansas, Inc.

Youngstown-Warren, OH MSA
-----------------------------------------------------------------------------------------
H3655    Community Insurance        2/1       226    \a    \a     6,687  12.6  62.5   4.1
          Company
H3659    United HealthCare of       0/6       912    \a    \a     5,314    \a    \a    \a
          Ohio, Inc.

Others, Not in an MSA
-----------------------------------------------------------------------------------------
H1551    HealthSource Indiana       5/5       351  14.6  100.       382  15.1  100.   4.8
          Managed Care Plan                                 0                     0
H3655    Community Insurance        2/1       103    \a    \a     6,687  12.6  62.5   4.1
          Company
H3649    Family Health Plan, Inc.   3/9       106    \a    \a     2,422   6.6  25.6   1.9
H9006    Medica                     11/        88    \a    \a    40,513   3.3  86.4   1.2
                                      9
H9005    Group Health Plan, Inc.    11/        89    \a    \a    17,473   3.1  74.9   1.8
                                      9
H2663    Group Health Plan, Inc.    1/0       103    \a    \a    10,212   3.0  71.0   1.1
H3653    Paramount Care, Inc.       1/9        58    \a    \a     1,937   2.8  100.   1.0
                                                                                  0
H9009    Blue Care Network-         11/        95    \a    \a     4,308   1.4  95.1   0.5
          Health Central              9
H1557    Anthem Health of           0/5         7    \a    \a       276    \a    \a    \a
          Indiana, Inc.
H3659    United HealthCare of       0/6       709    \a    \a     5,314    \a    \a    \a
          Ohio, Inc.
-----------------------------------------------------------------------------------------
\a This plan either had an average enrollment of less than 250 or was
in operation 6 months or less. 



                                        Table II.4
                         
                            Voluntary Disenrollment Rates for
                            Medicare Risk HMOs, Western Region

                                         Within metropolitan        Overall contract
                                                areas                  statistics
                                         --------------------  --------------------------
                                   Plan
                                    age   Average         FFS   Average         FFS
HCFA                               yrs.   monthly        as %   monthly        as %  Rapi
contrac                               /  enrollme  Vol.    of  enrollme  Vol.    of     d
t #      Plan name                 mos.        nt  rate  vol.        nt  rate  vol.  rate
-------  ------------------------  ----  --------  ----  ----  --------  ----  ----  ----
Albuquerque, NM MSA
-----------------------------------------------------------------------------------------
H3249    QualMed, New Mexico        4/9     1,830   9.7  35.0     1,953  11.7  34.5   4.2
H3204    FHP of New Mexico, Inc.    10/    16,039   4.9  43.3    17,491   5.4  48.6   3.8
                                      9
H3250    Presbyterian Health        3/0     1,548   4.6  45.1     1,571   4.7  47.3   1.3
          Plan, Inc.
H3251    Lovelace Health Plan,      3/0     9,785   2.8  59.3    13,106   4.0  56.8   2.0
          Inc.

Bakersfield, CA MSA
-----------------------------------------------------------------------------------------
H0523    Aetna HP of California,    10/       563  17.6  34.3    55,036  11.5  26.5   5.0
          Inc.                        5
H9030    FHP, Inc.                  11/     4,873  17.2  35.4   200,230  12.6  26.7   6.7
                                      9
H0563    Health Net                 4/1     1,901   9.0  31.4    50,913  13.6  22.0   5.1
H0543    Pacificare of CA, Inc.     11/    14,345   8.2  23.3   284,714   7.3  33.1   4.0
                                      4
H0526    Kaiser Foundation HP,      9/0     2,918   4.6  50.0     3,142   4.8  48.3   3.4
          Inc.
H0564    CaliforniaCare Health      3/4        92    \a    \a     1,303  32.5  37.1  10.1
          Plans
H0576    Prudential Health Care     2/6       189    \a    \a     2,698  22.7  35.5   8.6
          Plan of CA
H0554    CareAmerica Health Plans   6/2         2    \a    \a    38,358  17.1  27.5   9.0

Bellingham, WA MSA
-----------------------------------------------------------------------------------------
H5050    Group Health Coop. of      8/0     1,162   4.6  55.6    50,900   4.0  36.1   1.9
          Puget Sound
H5063    Options Health Care,       0/4        18    \a    \a       974    \a    \a    \a
          Inc.

Boulder-Longmont, CO PMSA
-----------------------------------------------------------------------------------------
H0609    FHP of Colorado, Inc.      10/     1,098   5.7  52.4    40,369   7.0  44.1   3.0
                                      6
H0630    Kaiser Foundation HP of    11/     3,881   4.2  41.5    32,721   4.4  31.3   2.3
          Colo.                       1
H0603    HMO Colorado, Inc.         11/        59    \a    \a     2,347  16.4  16.8   3.3
                                      0
H0615    Qual-Med, Inc., Denver     8/5       146    \a    \a     7,383  14.0  21.6   3.6

Bremerton, WA PMSA
-----------------------------------------------------------------------------------------
H5050    Group Health Coop. of      8/0     2,349   5.4  37.3    50,900   4.0  36.1   1.9
          Puget Sound
H5055    Qual-Med Washington         2/        18    \a    \a       275  10.9  46.7   2.8
          Health Plan, Inc.          11
H5063    Options Health Care,       0/4       108    \a    \a       974    \a    \a    \a
          Inc.

Chico-Paradise, CA MSA
-----------------------------------------------------------------------------------------
H0562    Health Net                 4/1     3,209  29.9  19.4    58,588  11.2  23.3   3.7
H0598    PacifiCare of CA, Inc.     1/4     3,026   8.1  80.8     3,074   8.4  78.4   2.8

Colorado Springs, CO MSA
-----------------------------------------------------------------------------------------
H0609    FHP of Colorado, Inc.      10/     6,845   4.2  92.3    40,369   7.0  44.1   3.0
                                      6

Denver, CO PMSA
-----------------------------------------------------------------------------------------
H0659    Cigna HealthCare of        2/2     3,175  24.8  17.6     3,246  24.9  18.0   6.2
          Colorado, Inc.
H0603    HMO Colorado, Inc.         11/     2,021  15.2  17.2     2,347  16.4  16.8   3.3
                                      0
H0615    Qual-Med, Inc., Denver     8/5     7,145  13.0  20.6     7,383  14.0  21.6   3.6
H0609    FHP of Colorado, Inc.      10/    26,780   8.5  33.6    40,369   7.0  44.1   3.0
                                      6
H0630    Kaiser Foundation HP of    11/    25,555   4.2  27.6    32,721   4.4  31.3   2.3
          Colo.                       1
H0660    Mutual of Omaha of         0/2       229    \a    \a       232    \a    \a    \a
          Colorado

Eugene-Springfield, OR MSA
-----------------------------------------------------------------------------------------
H3805    Pacificare of Oregon       10/       700   6.9  45.8    35,938   8.2  43.3   2.7
                                     11
H3858    SelectCare Health Plans    1/3     4,609   6.5  58.2     8,353   4.9  64.1   2.6

Flagstaff, AZ-UT MSA
-----------------------------------------------------------------------------------------
H0303    FHP, Inc.                  10/        52    \a    \a    86,650   7.0  34.6   2.9
                                      9
H0356    Premier HealthCare, Inc.   0/5        72    \a    \a     1,255    \a    \a    \a

Fort Collins-Loveland, CO MSA
-----------------------------------------------------------------------------------------
H0630    Kaiser Foundation HP of    11/       293   3.4  80.0    32,721   4.4  31.3   2.3
          Colo.                       1

Fresno, CA MSA
-----------------------------------------------------------------------------------------
H0570    Health Net                 3/2     3,995  49.2  19.1     4,248  47.7  19.5   4.9
H0590    CaliforniaCare Health      1/3       326  44.4  64.1       332  44.3  63.9  10.5
          Plans
H0559    Pacificare of              4/9     7,371   9.4  41.8    89,360   8.9  40.0   3.5
          California, Inc.
H0584    Kaiser Foundation HP,       1/     5,355   3.6  67.2     5,790   4.0  64.7   2.0
          Inc.                       11

Greeley, CO PMSA
-----------------------------------------------------------------------------------------
H0630    Kaiser Foundation HP of    11/       327   3.1  70.0    32,721   4.4  31.3   2.3
          Colo.                       1

Honolulu, HI MSA
-----------------------------------------------------------------------------------------
H1230    Kaiser Foundation HP,      10/    10,191   1.9  85.1    13,795   2.0  81.1   1.2
          Inc.                        8

Las Vegas, NV-AZ MSA
-----------------------------------------------------------------------------------------
H2931    Health Plan of Nevada,     11/    22,964  57.8   6.6    24,892  55.5   8.5   8.3
          Inc.                        6
H2959    Humana Health Plan, Inc.   1/2     2,928  21.1  38.9     3,035  21.3  38.6   5.3
H2949    FHP, Inc.                  4/2    20,120  13.0  22.3    21,374  13.1  23.4   3.5
H0303    FHP, Inc.                  10/        19    \a    \a    86,650   7.0  34.6   2.9
                                      9
H0356    Premier HealthCare, Inc.   0/5       429    \a    \a     1,255    \a    \a    \a

Los Angeles-Long Beach, CA PMSA
-----------------------------------------------------------------------------------------
H0557    Foundation Health, A       4/7     3,491  33.7  38.1     8,344  28.8  33.9   9.7
          California Plan
H0576    Prudential Health Care     2/6       820  26.6  44.5     2,698  22.7  35.5   8.6
          Plan of CA
H0564    CaliforniaCare Health      3/4       384  25.8  33.3     1,303  32.5  37.1  10.1
          Plans
H9016    Watts Foundation Health,   11/     9,680  20.5  48.3    12,334  22.0  49.7  18.6
          Inc./United Health Plan     9
H0558    MaxiCare, A California     5/1     1,780  19.0  55.0     2,864  23.7  46.8  10.0
          Corporation
H0523    Aetna HP of California,    10/     7,450  17.8  32.3    55,036  11.5  26.5   5.0
          Inc.                        5
H0554    CareAmerica Health Plans   6/2    25,111  15.0  31.1    38,358  17.1  27.5   9.0
H0581    Cigna Healthcare of        2/6     9,705  14.5  36.2    13,496  15.9  32.6   8.6
          California
H0563    Health Net                 4/1    11,876  13.4  26.7    50,913  13.6  22.0   5.1
H9030    FHP, Inc.                  11/    86,171  11.1  28.5   200,230  12.6  26.7   6.7
                                      9
H0543    Pacificare of CA, Inc.     11/    71,399   8.0  31.3   284,714   7.3  33.1   4.0
                                      4
H0545    Inter Valley Health        10/     7,695   5.7  23.4    13,112  10.4  15.2   3.7
          Plan, Inc.                  7
H0524    Kaiser Foundation HP,      9/4    82,382   2.7  62.3   169,003   2.9  55.5   2.8
          Inc.
H0504    California Physicians'     0/5       112    \a    \a       204    \a    \a    \a
          Services Corp.

Medford-Ashland, OR MSA
-----------------------------------------------------------------------------------------
H3805    Pacificare of Oregon       10/     1,299   5.9  63.6    35,938   8.2  43.3   2.7
                                     11
H3855    Providence Health Plans    2/8     3,168   4.4  61.9     3,240   4.6  63.1   2.1

Merced, CA MSA
-----------------------------------------------------------------------------------------
H0568    National Med, Inc.         3/1     1,002   5.4  63.0    11,152   5.1  33.9   1.7
H0559    Pacificare of              4/9       104    \a    \a    89,360   8.9  40.0   3.5
          California, Inc.

Modesto, CA MSA
-----------------------------------------------------------------------------------------
H0559    Pacificare of              4/9     6,674  13.8  20.2    89,360   8.9  40.0   3.5
          California, Inc.
H0580    FHP, Inc.                   1/     2,751   6.6  36.5    13,124  14.4  43.8   5.8
                                     10
H0568    National Med, Inc.         3/1     7,858   5.0  24.9    11,152   5.1  33.9   1.7
H0586    Foundation Health, A       2/9        20    \a    \a    12,319  11.6  30.6   4.5
          California Plan

Oakland, CA PMSA
-----------------------------------------------------------------------------------------
H0580    FHP, Inc.                   1/     2,296  18.9  50.7    13,124  14.4  43.8   5.8
                                     10
H0594    Lifeguard, Inc.            1/3       460  13.7  22.2     2,930  12.5  40.1   3.8
H0577    Prudential Health Care     2/6       973  12.4  36.4     2,711  15.6  29.8   7.1
          Plan of CA
H0547    Aetna Health Plan of       10/     3,478   9.1  30.2    26,859   5.4  37.2   3.1
          California, Inc.           11
H0562    Health Net                 4/1    15,718   9.1  25.9    58,588  11.2  23.3   3.7
H0559    Pacificare of              4/9    17,371   7.2  39.3    89,360   8.9  40.0   3.5
          California, Inc.
H0583    Kaiser Foundation HP,      2/6    41,836   1.2  40.2   142,719   1.8  47.3   0.9
          Inc.
H0591    CaliforniaCare Health      1/3       202    \a    \a       650  43.9  35.8  10.2
          Plans
H0588    Cigna Healthcare of        1/4       136    \a    \a       859  21.9  40.4   7.9
          California
H0568    National Med, Inc.         3/1         2    \a    \a    11,152   5.1  33.9   1.7
H0599    California Physicians'     0/6        27    \a    \a       133    \a    \a    \a
          Services Corp.

Olympia, WA PMSA
-----------------------------------------------------------------------------------------
H5005    Pacificare of              9/2     1,811   6.5  65.0    43,797   6.6  47.5   2.7
          Washington, Inc.
H5050    Group Health Coop. of      8/0     4,031   3.4  40.9    50,900   4.0  36.1   1.9
          Puget Sound
H5055    Qual-Med Washington         2/        39    \a    \a       275  10.9  46.7   2.8
          Health Plan, Inc.          11
H5063    Options Health Care,       0/4        73    \a    \a       974    \a    \a    \a
          Inc.

Orange County, CA PMSA
-----------------------------------------------------------------------------------------
H0558    MaxiCare, A California     5/1       895  33.0  39.3     2,864  23.7  46.8  10.0
          Corporation
H9016    Watts Foundation Health,   11/       509  31.3  45.3    12,334  22.0  49.7  18.6
          Inc./United Health Plan     9
H0576    Prudential Health Care     2/6       327  22.6  40.5     2,698  22.7  35.5   8.6
          Plan of CA
H0523    Aetna HP of California,    10/     2,439  20.3  23.6    55,036  11.5  26.5   5.0
          Inc.                        5
H0554    CareAmerica Health Plans   6/2     4,257  16.0  24.5    38,358  17.1  27.5   9.0
H0563    Health Net                 4/1     6,678  13.8  18.1    50,913  13.6  22.0   5.1
H0581    Cigna Healthcare of        2/6     1,796  11.3  20.7    13,496  15.9  32.6   8.6
          California
H9030    FHP, Inc.                  11/    33,450  10.2  18.7   200,230  12.6  26.7   6.7
                                      9
H0543    Pacificare of CA, Inc.     11/    39,566   6.4  37.0   284,714   7.3  33.1   4.0
                                      4
H0524    Kaiser Foundation HP,      9/4    13,610   3.3  52.2   169,003   2.9  55.5   2.8
          Inc.
H0564    CaliforniaCare Health      3/4       117    \a    \a     1,303  32.5  37.1  10.1
          Plans
H0557    Foundation Health, A       4/7        12    \a    \a     8,344  28.8  33.9   9.7
          California Plan
H0545    Inter Valley Health        10/       127    \a    \a    13,112  10.4  15.2   3.7
          Plan, Inc.                  7
H0504    California Physicians'     0/5        42    \a    \a       204    \a    \a    \a
          Services Corp.

Phoenix-Mesa, AZ MSA
-----------------------------------------------------------------------------------------
H0307    Humana Health Plan, Inc.   8/7    17,575  16.4  26.1    18,273  17.1  28.2   7.1
H0350    Maricopa County Health     3/0     2,017  11.2  63.1     2,105  11.4  65.3   2.7
          Plan
H0351    Intergroup Prepaid         4/8    21,629   9.4  36.5    39,571   8.5  44.0   3.2
          Health Serv of AZ, Inc.
H0352    Partners Health Plan of    4/5       386   9.3  47.2    18,974   5.1  50.1   2.1
          Arizona, Inc.
H0303    FHP, Inc.                  10/    61,837   6.9  29.9    86,650   7.0  34.6   2.9
                                      9
H0354    Cigna HealthCare of        4/0    27,002   6.0  41.2    29,459   6.8  40.3   3.4
          Arizona, Inc.
H0355    Blue Cross/Blue Shield     0/5       455    \a    \a       600    \a    \a    \a
          of Ariz.
H0356    Premier HealthCare, Inc.   0/5        13    \a    \a     1,255    \a    \a    \a

Portland-Vancouver, OR-WA PMSA
-----------------------------------------------------------------------------------------
H3805    Pacificare of Oregon       10/    25,316   7.4  28.1    35,938   8.2  43.3   2.7
                                     11
H3856    HMO Oregon                 3/0    16,460   6.0  57.6    16,876   6.3  57.5   4.3
H9003    Kaiser Foundation HP of    11/    22,063   5.2  50.5    32,390   5.1  52.6   2.9
          the NW                      9
H9047    Providence Health Plans     9/    22,683   3.5  47.6    24,208   3.8  49.9   2.7
                                     10
H5005    Pacificare of              9/2     4,743   3.0  81.1    43,797   6.6  47.5   2.7
          Washington, Inc.
H3857    SelectCare Health Plans    2/2       176    \a    \a     1,800   8.2  61.9   2.3
H9049    HMO Oregon, Inc.            8/        16    \a    \a        22    \a    \a    \a
                                     10

Provo-Orem, UT MSA
-----------------------------------------------------------------------------------------
H4653    FHP of Utah, Inc.          0/4     1,014    \a    \a     5,647    \a    \a    \a

Pueblo, CO MSA
-----------------------------------------------------------------------------------------
H0609    FHP of Colorado, Inc.      10/     4,876   2.1  94.2    40,369   7.0  44.1   3.0
                                      6

Redding, CA MSA
-----------------------------------------------------------------------------------------
H0593    National Med, Inc.         0/9       415   7.7  100.       523   6.6  100.   2.6
                                                            0                     0

Reno, NV MSA
-----------------------------------------------------------------------------------------
H2931    Health Plan of Nevada,     11/       739  18.3  54.1    24,892  55.5   8.5   8.3
          Inc.                        6
H2960    Hometown Health Plan       1/1     3,445   5.8  64.2     3,550   6.0  65.7   1.6

Riverside-San Bernardino, CA PMSA
-----------------------------------------------------------------------------------------
H0554    CareAmerica Health Plans   6/2     6,333  25.2  18.2    38,358  17.1  27.5   9.0
H0576    Prudential Health Care     2/6       661  22.1  28.1     2,698  22.7  35.5   8.6
          Plan of CA
H0557    Foundation Health, A       4/7     2,254  22.0  29.4     8,344  28.8  33.9   9.7
          California Plan
H0581    Cigna Healthcare of        2/6       418  18.4  16.9    13,496  15.9  32.6   8.6
          California
H0545    Inter Valley Health        10/     4,761  17.3   9.2    13,112  10.4  15.2   3.7
          Plan, Inc.                  7
H9030    FHP, Inc.                  11/    31,051  14.0  21.0   200,230  12.6  26.7   6.7
                                      9
H0563    Health Net                 4/1     7,239  13.3  21.3    50,913  13.6  22.0   5.1
H0523    Aetna HP of California,    10/    36,394   9.2  21.0    55,036  11.5  26.5   5.0
          Inc.                        5
H0543    Pacificare of CA, Inc.     11/    42,470   8.0  28.0   284,714   7.3  33.1   4.0
                                      4
H0524    Kaiser Foundation HP,      9/4    26,840   3.0  44.3   169,003   2.9  55.5   2.8
          Inc.
H0564    CaliforniaCare Health      3/4       163    \a    \a     1,303  32.5  37.1  10.1
          Plans
H0558    MaxiCare, A California     5/1       113    \a    \a     2,864  23.7  46.8  10.0
          Corporation
H0504    California Physicians'     0/5        40    \a    \a       204    \a    \a    \a
          Services Corp.

Sacramento, CA PMSA
-----------------------------------------------------------------------------------------
H0577    Prudential Health Care     2/6       716  21.4  18.3     2,711  15.6  29.8   7.1
          Plan of CA
H0562    Health Net                 4/1     9,352  19.9  11.5    58,588  11.2  23.3   3.7
H0580    FHP, Inc.                   1/     1,842  18.5  38.8    13,124  14.4  43.8   5.8
                                     10
H0586    Foundation Health, A       2/9    11,555  11.2  28.4    12,319  11.6  30.6   4.5
          California Plan
H0559    Pacificare of              4/9    10,990   7.5  32.6    89,360   8.9  40.0   3.5
          California, Inc.
H0583    Kaiser Foundation HP,      2/6    22,169   1.8  31.6   142,719   1.8  47.3   0.9
          Inc.
H0591    CaliforniaCare Health      1/3       205    \a    \a       650  43.9  35.8  10.2
          Plans
H0599    California Physicians'     0/6        57    \a    \a       133    \a    \a    \a
          Services Corp.

Salem, OR PMSA
-----------------------------------------------------------------------------------------
H3805    Pacificare of Oregon       10/     2,244  14.3  57.6    35,938   8.2  43.3   2.7
                                     11
H9003    Kaiser Foundation HP of    11/     5,251   4.0  54.2    32,390   5.1  52.6   2.9
          the NW                      9
H3858    SelectCare Health Plans    1/3     1,680   2.6  81.8     8,353   4.9  64.1   2.6
H9047    Providence Health Plans     9/       140    \a    \a    24,208   3.8  49.9   2.7
                                     10

Salinas, CA MSA
-----------------------------------------------------------------------------------------
H0559    Pacificare of              4/9     3,287   7.2  95.7    89,360   8.9  40.0   3.5
          California, Inc.

Salt Lake City-Ogden, UT MSA
-----------------------------------------------------------------------------------------
H4651    IHC Care, Inc.             0/8     1,822   7.2  54.5     1,855   7.4  53.8   1.7
H4653    FHP of Utah, Inc.          0/4     4,383    \a    \a     5,647    \a    \a    \a

San Diego, CA MSA
-----------------------------------------------------------------------------------------
H0581    Cigna Healthcare of        2/6     1,109  30.5  26.9    13,496  15.9  32.6   8.6
          California
H9030    FHP, Inc.                  11/    26,731  14.8  25.9   200,230  12.6  26.7   6.7
                                      9
H0563    Health Net                 4/1     8,370  12.4  22.8    50,913  13.6  22.0   5.1
H0543    Pacificare of CA, Inc.     11/    68,771   5.8  32.6   284,714   7.3  33.1   4.0
                                      4
H0524    Kaiser Foundation HP,      9/4    26,080   2.0  58.6   169,003   2.9  55.5   2.8
          Inc.
H0564    CaliforniaCare Health      3/4       130    \a    \a     1,303  32.5  37.1  10.1
          Plans
H0557    Foundation Health, A       4/7        15    \a    \a     8,344  28.8  33.9   9.7
          California Plan
H0576    Prudential Health Care     2/6       178    \a    \a     2,698  22.7  35.5   8.6
          Plan of CA

San Francisco, CA PMSA
-----------------------------------------------------------------------------------------
H0580    FHP, Inc.                   1/     1,750  23.7  50.8    13,124  14.4  43.8   5.8
                                     10
H0588    Cigna Healthcare of        1/4       521  23.0  40.0       859  21.9  40.4   7.9
          California
H0577    Prudential Health Care     2/6       430  14.2  29.5     2,711  15.6  29.8   7.1
          Plan of CA
H0559    Pacificare of              4/9     6,585  11.4  30.4    89,360   8.9  40.0   3.5
          California, Inc.
H0562    Health Net                 4/1    18,216   5.9  31.3    58,588  11.2  23.3   3.7
H0547    Aetna Health Plan of       10/    20,424   3.6  39.6    26,859   5.4  37.2   3.1
          California, Inc.           11
H0583    Kaiser Foundation HP,      2/6    28,830   1.3  47.9   142,719   1.8  47.3   0.9
          Inc.
H0591    CaliforniaCare Health      1/3        44    \a    \a       650  43.9  35.8  10.2
          Plans
H0594    Lifeguard, Inc.            1/3       173    \a    \a     2,930  12.5  40.1   3.8
H0571    Chinese Community Health   0/8       169    \a    \a       174    \a    \a    \a
          Plan
H0599    California Physicians'     0/6        36    \a    \a       133    \a    \a    \a
          Services Corp.

San Jose, CA PMSA
-----------------------------------------------------------------------------------------
H0577    Prudential Health Care     2/6       553  13.4  39.2     2,711  15.6  29.8   7.1
          Plan of CA
H0594    Lifeguard, Inc.            1/3     2,216  12.2  45.4     2,930  12.5  40.1   3.8
H0547    Aetna Health Plan of       10/     2,575  12.2  31.9    26,859   5.4  37.2   3.1
          California, Inc.           11
H0580    FHP, Inc.                   1/     3,847  11.1  34.2    13,124  14.4  43.8   5.8
                                     10
H0559    Pacificare of              4/9    20,098   7.6  37.5    89,360   8.9  40.0   3.5
          California, Inc.
H0562    Health Net                 4/1     3,920   7.2  31.7    58,588  11.2  23.3   3.7
H0583    Kaiser Foundation HP,      2/6    18,221   1.1  42.6   142,719   1.8  47.3   0.9
          Inc.
H0591    CaliforniaCare Health      1/3       164    \a    \a       650  43.9  35.8  10.2
          Plans
H0588    Cigna Healthcare of        1/4       191    \a    \a       859  21.9  40.4   7.9
          California
H0599    California Physicians'     0/6        19    \a    \a       133    \a    \a    \a
          Services Corp.

San Luis Obispo-Atascadero-Paso Robles, CA MSA
-----------------------------------------------------------------------------------------
H0563    Health Net                 4/1     3,674  20.4  10.9    50,913  13.6  22.0   5.1
H0595    Lifeguard, Inc.            2/0       834  20.0  25.7     1,036  19.7  29.9   6.4
H0576    Prudential Health Care     2/6       338   8.9  40.0     2,698  22.7  35.5   8.6
          Plan of CA
H0543    Pacificare of CA, Inc.     11/     6,036   7.6  44.8   284,714   7.3  33.1   4.0
                                      4
H0564    CaliforniaCare Health      3/4       127    \a    \a     1,303  32.5  37.1  10.1
          Plans

Santa Barbara-Santa Maria-Lompoc, CA MSA
-----------------------------------------------------------------------------------------
H9030    FHP, Inc.                  11/       551  19.4  53.3   200,230  12.6  26.7   6.7
                                      9
H0563    Health Net                 4/1     6,679  12.3  13.5    50,913  13.6  22.0   5.1
H0543    Pacificare of CA, Inc.     11/     9,712   7.3  35.0   284,714   7.3  33.1   4.0
                                      4
H0564    CaliforniaCare Health      3/4       220    \a    \a     1,303  32.5  37.1  10.1
          Plans

Santa Cruz-Watsonville, CA PMSA
-----------------------------------------------------------------------------------------
H0559    Pacificare of              4/9     3,363   3.9  94.7    89,360   8.9  40.0   3.5
          California, Inc.

Santa Fe, NM MSA
-----------------------------------------------------------------------------------------
H3204    FHP of New Mexico, Inc.    10/     1,038   8.3  68.6    17,491   5.4  48.6   3.8
                                      9
H3251    Lovelace Health Plan,      3/0     1,688   8.1  30.1    13,106   4.0  56.8   2.0
          Inc.
H3249    QualMed, New Mexico        4/9        96    \a    \a     1,953  11.7  34.5   4.2

Santa Rosa, CA PMSA
-----------------------------------------------------------------------------------------
H0562    Health Net                 4/1       840  23.2  13.8    58,588  11.2  23.3   3.7
H0559    Pacificare of              4/9     1,362  18.4  32.3    89,360   8.9  40.0   3.5
          California, Inc.
H0566    Health Plan of the         3/4     9,602   6.5  33.7     9,773   6.5  34.5   2.5
          Redwoods
H0583    Kaiser Foundation HP,      2/6     7,870   1.3  52.0   142,719   1.8  47.3   0.9
          Inc.
H0580    FHP, Inc.                   1/         3    \a    \a    13,124  14.4  43.8   5.8
                                     10

Seattle-Bellevue-Everett, WA PMSA
-----------------------------------------------------------------------------------------
H5052    Providence Good Health     3/7     9,381   9.4  33.9    16,004   7.9  39.8   2.4
          Plan of Washington
H5005    Pacificare of              9/2    25,735   4.4  50.5    43,797   6.6  47.5   2.7
          Washington, Inc.
H5050    Group Health Coop. of      8/0    34,040   3.6  29.5    50,900   4.0  36.1   1.9
          Puget Sound
H5055    Qual-Med Washington         2/       117    \a    \a       275  10.9  46.7   2.8
          Health Plan, Inc.          11
H5063    Options Health Care,       0/4       603    \a    \a       974    \a    \a    \a
          Inc.

Spokane, WA MSA
-----------------------------------------------------------------------------------------
H5053    Qual-Med, Inland           3/7     1,852   8.9  31.1     2,250   8.2  33.7   1.6
          Northwest Division
H5066    Medical Service            0/7       667   6.9  85.2       669   6.9  85.2   2.0
          Corporation of E. WA
H5005    Pacificare of              9/2     1,258   6.9  49.4    43,797   6.6  47.5   2.7
          Washington, Inc.
H5052    Providence Good Health     3/7     2,828   4.5  37.0    16,004   7.9  39.8   2.4
          Plan of Washington
H5069    Group Health Northwest      0/       698   2.8  43.8       709   2.9  41.2   0.7
                                     10

Stockton-Lodi, CA MSA
-----------------------------------------------------------------------------------------
H0559    Pacificare of              4/9     6,810   7.9  48.8    89,360   8.9  40.0   3.5
          California, Inc.
H0583    Kaiser Foundation HP,      2/6     3,454   4.3  33.1   142,719   1.8  47.3   0.9
          Inc.
H0568    National Med, Inc.         3/1     1,618   3.5  29.8    11,152   5.1  33.9   1.7
H0586    Foundation Health, A       2/9       152    \a    \a    12,319  11.6  30.6   4.5
          California Plan

Tacoma, WA PMSA
-----------------------------------------------------------------------------------------
H5005    Pacificare of              9/2     6,432  16.9  30.3    43,797   6.6  47.5   2.7
          Washington, Inc.
H5052    Providence Good Health     3/7       586  16.2  45.3    16,004   7.9  39.8   2.4
          Plan of Washigton
H5050    Group Health Coop. of      8/0     4,162   4.0  38.8    50,900   4.0  36.1   1.9
          Puget Sound
H5055    Qual-Med Washington         2/        93    \a    \a       275  10.9  46.7   2.8
          Health Plan, Inc.          11
H5063    Options Health Care,       0/4        86    \a    \a       974    \a    \a    \a
          Inc.

Tucson, AZ MSA
-----------------------------------------------------------------------------------------
H0354    Cigna HealthCare of        4/0     1,827  15.5  25.4    29,459   6.8  40.3   3.4
          Arizona, Inc.
H0351    Intergroup Prepaid         4/8    10,010   7.3  38.3    39,571   8.5  44.0   3.2
          Health Serv of AZ, Inc.
H0303    FHP, Inc.                  10/    22,144   5.6  37.0    86,650   7.0  34.6   2.9
                                      9
H0352    Partners Health Plan of    4/5    16,005   4.4  45.8    18,974   5.1  50.1   2.1
          Arizona, Inc.
H0307    Humana Health Plan, Inc.   8/7        97    \a    \a    18,273  17.1  28.2   7.1
H0355    Blue Cross/Blue Shield     0/5       128    \a    \a       600    \a    \a    \a
          of Ariz.
H0356    Premier HealthCare, Inc.   0/5         4    \a    \a     1,255    \a    \a    \a

Vallejo-Fairfield-Napa, CA PMSA
-----------------------------------------------------------------------------------------
H0562    Health Net                 4/1     1,086  15.7  13.5    58,588  11.2  23.3   3.7
H0559    Pacificare of              4/9     3,677  11.7  41.9    89,360   8.9  40.0   3.5
          California, Inc.
H0583    Kaiser Foundation HP,      2/6     8,836   1.3  58.8   142,719   1.8  47.3   0.9
          Inc.
H0580    FHP, Inc.                   1/        12    \a    \a    13,124  14.4  43.8   5.8
                                     10

Ventura, CA PMSA
-----------------------------------------------------------------------------------------
H0557    Foundation Health, A       4/7     2,468  27.3  27.5     8,344  28.8  33.9   9.7
          California Plan
H9030    FHP, Inc.                  11/     3,666  20.1  19.4   200,230  12.6  26.7   6.7
                                      9
H0523    Aetna HP of California,    10/       960  16.4  33.8    55,036  11.5  26.5   5.0
          Inc.                        5
H0563    Health Net                 4/1     2,999  12.1  28.7    50,913  13.6  22.0   5.1
H0543    Pacificare of CA, Inc.     11/    13,726   6.1  37.4   284,714   7.3  33.1   4.0
                                      4
H0524    Kaiser Foundation HP,      9/4     2,104   2.3  52.1   169,003   2.9  55.5   2.8
          Inc.
H0564    CaliforniaCare Health      3/4        31    \a    \a     1,303  32.5  37.1  10.1
          Plans
H0576    Prudential Health Care     2/6       131    \a    \a     2,698  22.7  35.5   8.6
          Plan of CA
H0554    CareAmerica Health Plans   6/2        49    \a    \a    38,358  17.1  27.5   9.0
H0581    Cigna Healthcare of        2/6       187    \a    \a    13,496  15.9  32.6   8.6
          California
H0545    Inter Valley Health        10/         3    \a    \a    13,112  10.4  15.2   3.7
          Plan, Inc.                  7

Visalia-Tulare-Porterville, CA MSA
-----------------------------------------------------------------------------------------
H0559    Pacificare of              4/9       385  19.0  98.6    89,360   8.9  40.0   3.5
          California, Inc.
H0570    Health Net                 3/2       141    \a    \a     4,248  47.7  19.5   4.9
H9030    FHP, Inc.                  11/        76    \a    \a   200,230  12.6  26.7   6.7
                                      9
H0584    Kaiser Foundation HP,       1/        35    \a    \a     5,790   4.0  64.7   2.0
          Inc.                       11

Yolo, CA PMSA
-----------------------------------------------------------------------------------------
H0586    Foundation Health, A       2/9       343   9.3  34.4    12,319  11.6  30.6   4.5
          California Plan
H0562    Health Net                 4/1     3,111   3.4  65.7    58,588  11.2  23.3   3.7
H0583    Kaiser Foundation HP,      2/6     1,348   1.5   5.0   142,719   1.8  47.3   0.9
          Inc.

Yuba City, CA MSA
-----------------------------------------------------------------------------------------
H0562    Health Net                 4/1     1,126   7.0  79.7    58,588  11.2  23.3   3.7
H0583    Kaiser Foundation HP,      2/6        96    \a    \a   142,719   1.8  47.3   0.9
          Inc.

Yuma, AZ MSA
-----------------------------------------------------------------------------------------
H0303    FHP, Inc.                  10/        27    \a    \a    86,650   7.0  34.6   2.9
                                      9
H0352    Partners Health Plan of    4/5         9    \a    \a    18,974   5.1  50.1   2.1
          Arizona, Inc.
H0356    Premier HealthCare, Inc.   0/5       532    \a    \a     1,255    \a    \a    \a

Others, Not in an MSA
-----------------------------------------------------------------------------------------
H0303    FHP, Inc.                  10/       539  24.3  55.7    86,650   7.0  34.6   2.9
                                      9
H2931    Health Plan of Nevada,     11/       575  12.5  94.4    24,892  55.5   8.5   8.3
          Inc.                        6
H0609    FHP of Colorado, Inc.      10/       461  10.8  98.0    40,369   7.0  44.1   3.0
                                      6
H0562    Health Net                 4/1       651   9.5  93.5    58,588  11.2  23.3   3.7
H3805    Pacificare of Oregon       10/     5,833   8.6  87.6    35,938   8.2  43.3   2.7
                                     11
H3857    SelectCare Health Plans    2/2     1,566   7.9  63.7     1,800   8.2  61.9   2.3
H9047    Providence Health Plans     9/       912   7.7  67.1    24,208   3.8  49.9   2.7
                                     10
H5005    Pacificare of              9/2     3,225   6.6  80.3    43,797   6.6  47.5   2.7
          Washington, Inc.
H0352    Partners Health Plan of    4/5     2,314   6.3  51.7    18,974   5.1  50.1   2.1
          Arizona, Inc.
H5050    Group Health Coop. of      8/0     2,950   6.0  47.8    50,900   4.0  36.1   1.9
          Puget Sound
H0568    National Med, Inc.         3/1       448   5.1  87.0    11,152   5.1  33.9   1.7
H0351    Intergroup Prepaid         4/8     6,924   4.7  73.5    39,571   8.5  44.0   3.2
          Health Serv of AZ, Inc.
H5052    Providence Good Health     3/7     3,084   4.2  71.5    16,004   7.9  39.8   2.4
          Plan of Washington
H9003    Kaiser Foundation HP of    11/     3,780   3.6  51.8    32,390   5.1  52.6   2.9
          the NW                      9
H3251    Lovelace Health Plan,      3/0       741   3.1  52.2    13,106   4.0  56.8   2.0
          Inc.
H3858    SelectCare Health Plans    1/3     1,952   2.8  80.0     8,353   4.9  64.1   2.6
H1230    Kaiser Foundation HP,      10/     3,370   1.1  81.6    13,795   2.0  81.1   1.2
          Inc.                        8
H0570    Health Net                 3/2         1    \a    \a     4,248  47.7  19.5   4.9
H0581    Cigna Healthcare of        2/6        36    \a    \a    13,496  15.9  32.6   8.6
          California
H0615    Qual-Med, Inc, Denver      8/5         9    \a    \a     7,383  14.0  21.6   3.6
H9030    FHP, Inc.                  11/       137    \a    \a   200,230  12.6  26.7   6.7
                                      9
H0559    Pacificare of              4/9       139    \a    \a    89,360   8.9  40.0   3.5
          California, Inc.
H4651    IHC Care, Inc.             0/8         6    \a    \a     1,855   7.4  53.8   1.7
H0593    National Med, Inc.         0/9       101    \a    \a       523   6.6  100.   2.6
                                                                                  0
H3204    FHP of New Mexico, Inc.    10/        53    \a    \a    17,491   5.4  48.6   3.8
                                      9
H0630    Kaiser Foundation HP of    11/       192    \a    \a    32,721   4.4  31.3   2.3
          Colo.                       1
H0584    Kaiser Foundation HP,       1/       103    \a    \a     5,790   4.0  64.7   2.0
          Inc.                       11
H0583    Kaiser Foundation HP,      2/6       141    \a    \a   142,719   1.8  47.3   0.9
          Inc.
H0356    Premier HealthCare, Inc.   0/5       348    \a    \a     1,255    \a    \a    \a
H4653    FHP of Utah, Inc.          0/4       202    \a    \a     5,647    \a    \a    \a
H5063    Options Health Care,       0/4        47    \a    \a       974    \a    \a    \a
          Inc.
-----------------------------------------------------------------------------------------
\a This plan either had an average enrollment of less than 250 or was
in operation 6 months or less. 


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