Enrollment for most leading U.S. health insurers continued to decline through 2009, according to a new study.

The latest Healthcare Business Strategy report from Mark Farrah Associates found between December 2008 and December 2009 top plans saw an aggregate decline of 2.2 million members. Losses continue to be experienced in both the fully-insured and administrative services only (ASO) segments.

Mark Farrah Associates reports "the difficult economy continues to take a toll in terms of rising medical expenses and declining membership for most plans." Total membership for the eight leading companies decreased by more than 2.2 million members in 2009. ASO enrollment decreased 0.9 percent and risk enrollment declined 2.5 percent for these plans between December 2008 and December 2009.

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