B
UPMC Health Options Inc
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 quality investment portfolio (3.3 on a scale of 0 to 10). Good overall results on stability tests (5.2) despite a decline in enrollment during 2023. Potentially strong support from affiliation with UPMC. Excellent capitalization (7.1) based on excellent current risk-adjusted capital (severe loss scenario) reflecting improvement over results in 2021.
Other Rating Factors: Excellent liquidity (6.9) with sufficient resources (cash flows and marketable investments) to handle a spike in claims. Weak profitability index (1.1) with operating losses during 2021 and 2023. Average return on equity over the last five years has been poor at -1.7%.
Principal Lines of Business: --
Licensed in: PA
Principal Enrollment Breakdown: --
Other Highlights
Medical Loss Ratio
Medical Expense
Per Member Per Month ($)
452
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