Highmark Inc. is facing its first real competition in the Western Pennsylvania health insurance market.

But the extent to which that competition has resulted in lower costs for employers and lots of new business for four national, for-profit insurance companies has been limited so far, said Elliott Dinkin, CEO of Downtown benefits consulting company Cowden Associates Inc.

"They have their toes in the water, but they're cautious," Dinkin said of the approach to the market by Aetna Inc., Cigna Corp., HealthAmerica and United HealthCare.

The four companies for the first time last year could offer plans with full access to UPMC, but it's likely at the same cost as Highmark, Dinkin said on Wednesday at a meeting of the Western Pennsylvania Diversity Initiative in the City-County Building. If UPMC is charging the four nationals the same rates for medical procedures as it charges Highmark, the state's largest health insurer, then it makes competing on price difficult, he said. Read more