B
UPMC Health Options Inc
Rating Date
September 2025
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 (3.4 on a scale of 0 to 10) based on a decline in the number of member physicians during 2022. Rating is significantly influenced by the strong financial results of UPMC. Good quality investment portfolio (5.4) containing junk bond exposure equal to 96.2% of capital. Good liquidity (6.4) with sufficient resources (cash flows and marketable investments) to handle a spike in claims.
Other Rating Factors: Excellent capitalization (7.2) based on excellent current risk-adjusted capital (severe loss scenario) reflecting improvement over results in 2021. Weak profitability index (2.5) with operating losses during 2021. Return on equity has been low, averaging 0.3% over the last five years.
Principal Lines of Business: --
Licensed in: PA
Principal Enrollment Breakdown: --
Other Highlights
Medical Loss Ratio
Medical Expense
Per Member Per Month ($)
938
Provider Compensation ($000)
Capitation Pay
0
Fee For Service
0
Contractual Pay
Salary
0
Bonus
0
Other
--
Member Physicians
Enrollment
Total Patient Encounters
Physician
Non-Physician
Corporate Info
Group Affiliation
UPMC
Investment Rating
--
Company Address
U.S. Steel Building
Pittsburgh, PA 15219
Phone Number
(412) 434-1200
NAIC Number
15345
Largest Affiliates
A
Pittsburgh, PA - Health
B
Pittsburgh, PA - Health
B
Pittsburgh, PA - Health
B
Pittsburgh, PA - Health
B
Pittsburgh, PA - Health