Published: July 08, 2011
A.M. Best Upgrades Ratings of Priority Health Government Programs
OLDWICK, N.J. - (BUSINESS WIRE) - A.M. Best Co. has upgraded the financial strength rating (FSR) to
B++ (Good) from B+ (Good) and issuer credit rating (ICR) to "bbb+" from
"bbb-" of Priority Health Government Programs (PHGP). The outlook
for both ratings has been revised to positive from stable.
A.M. Best also has affirmed the FSR of A- (Excellent) and ICR of "a-" of Priority
Health. The outlook for these ratings is stable. PHGP is a
wholly-owned subsidiary of Priority Health. All companies are domiciled
in Grand Rapids, MI.
Priority Health is majority owned by Spectrum Health System
(Spectrum Health), a financially strong integrated healthcare delivery
system, which has implicitly and explicitly supported the health plan
over the years. Priority Health has been fully integrated into the
system and acts as a significant source of referral to Spectrum Health
providing payor mix stability. Priority Health also is a major
contributor to the consolidated revenue and earnings of Spectrum Health;
as such, it demonstrates the advantages of the insurance and delivery
system's integration. In return, Priority Health and PHGP receive
meaningful rating enhancement as part of Spectrum Health, which is
reflected in their current ratings.
The ratings also consider Priority Health's favorable growth in
membership and premium trends for the past several years. However, it is
noted that there are numerous offsetting factors A.M. Best will continue
to monitor, including Priority Health's 2010 underwriting losses,
pricing pressures in its core Michigan markets and its relatively low
risk-adjusted capitalization and high premium leverage. At year-end
2010, the group reported significant losses at both Priority Health and
its other wholly-owned subsidiary, Priority Health Insurance Company
(PHIC), which markets the group's preferred provider organization,
stop-loss and Medicare prescription drug products. These losses impacted
both Priority Health and PHIC's capital positions. However, management
implemented benefit design, underwriting and pricing enhancements to the
commercial product offerings; intensified medical trend management
programs to reduce the occurrence of unnecessary healthcare costs; and
created operational efficiencies to keep administrative costs low. A.M.
Best notes that these corrective measures resulted in substantive
improvement in earnings at both entities, as reported by Priority Health
through May 2011.
Additionally, the rating upgrades of PHGP acknowledge the improvement in
its level of both absolute and risk-adjusted capitalization, strong
overall performance and positive operating results in each of the last
few years, as well as its contributions to the overall group.
Priority Health provides coverage for medical, hospital and other health
care services to its members through various commercial lines and
Medicare products and provides coverage to Medicaid recipients located
in Michigan through PHGP. A.M. Best views PHGP as an integral and
growing part of the group, which has contributed favorably to Priority
Health's overall membership, revenue and earnings growth. Additionally,
the entity has both implicit and explicit support of both Priority
Health and Spectrum Health.
The principal methodology used in determining these ratings is Best's
Credit Rating Methodology -- Global Life and Non-Life Insurance Edition,
which provides a comprehensive explanation of A.M. Best's rating process
and highlights the different rating criteria employed. Additional key
criteria utilized include: "Risk Management and the Rating Process for
Insurance Companies" ; "Understanding BCAR for Life and Health Insurers" ;
"Rating Members of Insurance Groups" ; "Rating
Health Insurance Companies" ; and "Assessing Country Risk."
Methodologies can be found at www.ambest.com/ratings/methodology.
Founded in 1899, A.M. Best Company is the world's oldest and most
authoritative insurance rating and information source. For more
information, visit www.ambest.com.
Copyright (c) 2011 by A.M. Best Company, Inc. ALL RIGHTS
RESERVED.

A.M. Best Co.
Jennifer Afriyie
Financial Analyst
908-439-2200,
ext. 5203
jennifer.afriyie@ambest.com
or
Joseph
Zazzera, MBA
Managing Senior Financial Analyst
908-439-2200,
ext. 5797
joseph.zazzera@ambest.com
or
Carole
Lovell
Public Relations Associate
908-439-2200, ext. 5445
carole.lovell@ambest.com
or
Jim
Peavy
Assistant Vice President, Public Relations
908-439-2200,
ext. 5644
james.peavy@ambest.com
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