Massachusetts' eight health insurers finished 2008 with a total surplus of $2.5 billion, a more than four-fold increase from 1999, according to an executive summary of a report from the Division of Health Care Finance and Policy. However, when the report uses a more complete accounting measurement to examine the companies, one that also takes into account each firm's liabilities and investments, the state's largest insurer, Blue Cross and Blue Shield of Massachusetts, ended the period on a significantly less firm financial footing. That measurement, known as a risk-based capital ratio, shows Blue Cross's health slipping by about a third. By the same measurement, the financial strength of the state's second-largest insurer, Harvard Pilgrim Health Care, more than doubled, and the state's third-largest, Tufts Health Plan, more than tripled, the Boston Globe reports.
