WellPoint, Cigna Balance Medical Bills, Profits

California-based Scan Health Plan, a Medicare specialist, leads the way, spending 94% of its $1.2 billion in premium income on medical expenses while returning 8.6% in net income. That's possible because health insurers have other income, including investments.

In second place is Partnership HealthPlan of California, a public-private coalition, spent 92% of its premiums on medical expenses and returned 2.9% in net income.

Third-best goes to UPMC Health Benefits of Pennsylvania, spent 91.3% of premium income on medical expenses and returned 8.5% in net income.

-- Reported by Gavin Magor in Jupiter, Fla.

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