Enrollment in Illinois HMOs continues to decline with the most recent data from HealthLeaders-InterStudy showing a 14 percent decrease from the year before. HMOs now comprise about 18 percent of the commercial market in the state, despite a steady HMO membership by Blue Cross Blue Shield of Illinois. UniCare Health Plans of the Midwest is launching a new HMO for small businesses in the Chicago region that prices premiums below $100 for healthy single men. On the Medicare front, UnitedHealth Group and smaller insurers in the Part D market stand to gain low-income members as a result of 2009 bidding that takes some insurers, such as Humana, out of that segment in some states. While the low-income market represents volume, it comes with more risk as the population tends to be sicker and not use as many generic drugs. In downstate Illinois, Health Alliance is growing with its decision to purchase Peoria-based HCH Administration, a third-party administrator. And Blue Cross Blue Shield of Illinois is showing that diabetes disease management and pay for performance are working for members enrolled in broader PPO networks, which typically do not have gatekeeper primary-care physicians.