C
Seton Health Plan Inc
AustinTX
Rating Date
January 2026
NAIC
Classification
Risk Adjusted
Capital Ratio #1
Risk Adjusted
Capital Ratio #2
Total
Assets
Capital
Health
Premiums
Net
Income
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Major Rating Factors: Fair overall results on stability tests (3.6 on a scale of 0 to 10) based on a significant -25% decrease in enrollment during the period, rapid premium growth over the last five years and a steep decline in capital during 2023. Weak profitability index (0.9) with 15.9 million in losses in the current year. Average return on equity over the last five years has been poor at -2.8%. Good quality investment portfolio (5.9).
Other Rating Factors: Good liquidity (6.3) with sufficient resources (cash flows and marketable investments) to handle a spike in claims. Excellent overall capitalization (7.4) based on excellent current risk-adjusted capital (severe loss scenario) despite some fluctuation in capital levels.
Principal Lines of Business: --
Licensed in: TX
Principal Enrollment Breakdown: --
Other Highlights
Medical Loss Ratio
Medical Expense
Per Member Per Month ($)
227
Provider Compensation ($000)
Capitation Pay
654
Fee For Service
Contractual Pay
Salary
0
Bonus
Other
--
Member Physicians
Enrollment
Total Patient Encounters
Physician
Non-Physician
Corporate Info
Group Affiliation
Ascension Health Alliance
Investment Rating
--
Company Address
1345 Philomena Street
Austin, TX 78723
Phone Number
(512) 324-3350
NAIC Number
95240
Largest Affiliates
D
Troy, MI - Health
U
Austin, TX - Health