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Visit AISEducation.com for more news and strategic information for today's business leaders
 
AIS's Directory of Health Plans: 2009

Table of Contents
Sample Pages
Field Lists
Methodology
Photo of Book
Written By
Written For
AIS Guarantee
Shipping Information
Related Publications
 
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Place an order or get more information at 800-521-4323

Print Edition Price: $622
CD Database Price: $1,695
Pages: 577
ISBN: 1-933801-52-2

©2009
Pub Code: GDHP6


AIS's Directory of Health Plans is the most effective resource available to track all of the health plan players and new business trends. The new 2009 Directory of Health Plans contains several data enhancements in addition to the most up-to-date enrollment data and contact information for health plans and primary care preferred provider networks operating in the U.S.

The 2009 Directory of Health Plans contains several data enhancements, based upon customer feedback and input from industry experts. Enrollment will be broken down by risk type, with additional enrollment breakdowns by individual vs. group business and members enrolled in HRA and HSA-based CDH plans. Medicare enrollment data will be refined to more fully capture membership in all types of Medicare Advantage Coordinated Care plans, Private Fee for Service plans, and more.

Whether you’re a health care provider, health plan, health care supplier or vendor, this directory will help you:

  • See how the economic downturn has affected your competitors and partners…by tracking changes in commercial and public-sector membership
  • Conduct accurate market share analysis
  • Find out who does what –– and who to contact –– at health care companies
  • Quickly look up any health plan or provider network and find out what they do, where they are and how big they are
  • Get enrollment benchmarks for comparison to your own business
  • Identify potential business partners and clients
  • Compare network access fees and identify PPO networks that provide the services you need
  • Get the latest data available on recent mergers, acquisitions and other shifts in the industry

AIS’s Directory of Health Plans is used by J.D. Power and Associates to calculate market share statistics in their annual J.D. Power and Associates National Health Insurance Plan Satisfaction Study. And, for the sixth year in a row, America’s Health Insurance Plans (AHIP) — the national trade association representing health plans — has selected AIS’s Directory of Health Plans as an official directory resource of AHIP Solutions.

The listings cover:

  • National and state-level enrollment data by company
  • National enrollment by type of product
  • Company contact information
  • Types of primary care products offered
  • Key executives
  • Complete NCQA accreditation status for all accredited commerical, Medicare and Medicaid plans
Each company record lists contact and ownership information. In addition, key executives at each company are listed by job function. Enrollment is also included for each record, broken out by category. (See below for lists of fields in each section.)

AIS’s Directory of Health Plans: 2009 CD Database
Is Perfect for Marketing, Market Research and Analysis!

  • MCO and PPO network files in multiple file formats for easy data manipulation
  • Easy-to-pull mailing lists with complete job function and contact information
  • On-screen field definitions so that you can quickly identify the information you need to find, along with detailed table relationships
  • Health insurers by state containing the full listing of each company operating in each state — only on the CD
  • Parent organizations with full listings for corporate headquarters executives, enrollment data and more — only on the CD
(CD buyers also get a free copy of the print edition. Multi-user licenses also are available — call Bailey Sterrett, (202) 775-9008, ext. 3034, for details.)

 

Table of Contents

Preface

Introduction

  • Field Lists and Definitions
  • Methodology
  • NCQA Accreditation

Chapter 1: Highlights From AIS’s Database of Health Plans: 2009

  • U.S. Health Plans Ranked by Total Medical Enrollment
  • Top 50 PPO Networks by Number of Lives with Access
  • Health Plan and Network Subsidiaries and Affiliates, by Owner
  • Health Plan Enrollment by Risk, Sector and Program
    • Percentage of Health Plan Enrollment by Risk Type
    • Percentage of Risk Enrollment by Sector
    • Percentage of Commercial Risk-Based Enrollment by Plan Model
    • Percentage of Public-Sector (Government-Sponsored) Health Plan Enrollment by Program Type
    • Percentage of Non-Risk (ASO) Enrollment by Sector
    • Percentage of Medical Enrollment in Consumer-Directed Health Care Plans
    • Individual (Commercial Non-Group) Risk Enrollment as a Percentage of Total Medical Enrollment
    • Percentage of Health Plan Enrollment by Network Capitation Status
    • Number of Health Plans and Enrollment by Tax Status
    • Top 10 Health Plans by Total Medical Risk Enrollment (Fully Funded)
    • Top 10 Health Plans by Total Medical Non-Risk Enrollment (Self-Insured or ASO)
    • Top 10 Health Plans by Total Commercial Risk Enrollment
    • Top 10 Commercial HMOs by Enrollment
    • Top 10 Commercial PPOs by Enrollment
    • Top 10 Plans by Total Medicare Advantage Enrollment
    • Top 10 Plans by Medicare PFFS Enrollment
    • Top 10 Plans by Total Medicaid HMO Enrollment
    • Top 10 Plans by Total Consumer-Directed Health Plan Enrollment
    • Top 10 Not-for-Profit Health Plans by Enrollment
    • Top 10 Health Plans Owned by Publicly Traded Companies
    • Top 10 Privately-Owned Health Plans by Enrollment
  • Health Plans Listed by Contracted or Affiliated PBM

Chapter 2: Directory of Health Insurance Companies

Chapter 3: Directory of Preferred Provider Networks

Chapter 4: Health Plan Enrollment by State

Index of Companies

View sample pages (in PDF format):

Field Lists

Health Insurance Companies (463 Records)

  • MCO ID Number (CD edition only)
  • Company Name
  • Company Owner
  • Owner ID (CD edition only)
  • Address
  • City
  • State
  • Zip
  • URL
  • Profit Status
  • Private/Public
  • Stock Symbol
  • Aliases
  • Business Telephone
  • Telephone (Automated)
  • Fax
  • CEO
  • President
  • Operations
  • Finance
  • Medical
  • Legal
  • Provider Relations
  • Marketing
  • Member Relations
  • Pharmacy
  • Specialty Pharmacy
  • Public Relations
  • Information Systems
  • Purchasing
  • Contracted PBM
  • Total Medical Enrollment
  • Total Fully Insured Enrollment
  • Commercial Risk Enrollment
  • Commercial Risk HMO Enrollment
  • Commercial Risk POS Enrollment
  • Commercial Risk PPO Enrollment
  • Commercial Risk FFS/Indemnity Enrollment
  • Medicare Supplement Enrollment
  • Public Sector Risk Enrollment
  • Total Medicare Enrollment
  • Medicare Coordinated Care Enrollment
  • Medicare PFFS Enrollment
  • Medicaid HMO Enrollment (Risk)
  • SCHIP and Other Public-Sector Enrollment
  • Other/Unspecified Risk Enrollment
  • Total Shared-Risk Enrollment
  • Total Self-Funded Enrollment
  • Commercial Non-Risk Enrollment
  • Public-Sector Non-Risk Enrollment
  • CDH Enrollment
  • HRA-Based Plans
  • HSA-Qualified Plans
  • Individual (non-Group) Enrollment
  • Fully Capitated Enrollment
  • Partially Capitated Enrollment
  • Non-Capitated Enrollment
  • Other Enrollment
  • States Served
  • Enrollment specific to each state, the District of Columbia and Puerto Rico
  • Blues yes/no (CD edition only)
  • Total Physicians (CD edition only)
  • Total Hospitals (CD edition only)
  • Publication Notes

PPO Networks (164 Records)

  • PPO ID Number (CD edition only)
  • Network Name
  • Company Name
  • Parent/Owner
  • Owner ID (CD edition only)
  • Address
  • City
  • State
  • Zip
  • URL
  • Profit Status
  • Private/Public
  • Stock Symbol
  • Telephone (for business office)
  • Automated Telephone
  • Fax
  • CEO
  • President
  • Operations
  • Finance
  • Medical
  • Legal
  • Provider Relations
  • Marketing
  • Member Relations
  • Pharmacy
  • Public Relations
  • Information Systems
  • Purchasing
  • Contracted or Affiliated PBM(s)
  • Lives With Network Access
  • Claims Processed per Year
  • Dependent Factor
  • Number of Employer Clients
  • Number of Payer Clients
  • Average Benefit In Network
  • Average Benefit Out-of-Network
  • Utilization Management
  • Workers' Compensation
  • Disease Management
  • Case Management
  • Pharmacy Network
  • Claims Repricing
  • Claims Processing
  • Available for Lease
  • CM Fee Per Hour
  • UM Fee PMPM
  • Network Access Fee
  • Average Savings
  • Total Physicians
  • Total Hospitals
  • States Served
  • Publication Note
  • Enrollment specific to each state, the District of Columbia and Puerto Rico

Methodology

All known health insurers and PPO networks operating as of Jan. 1, 2009, believed to fit the criteria of this database are included. Inclusion in the database is not optional. All companies were surveyed by AIS staff researchers between Oct. 1, 2008 and Dec. 31, 2008. Organizations were contacted by mail, fax or email and were offered options to fill out an online or paper form, or to provide information via email, fax, mail or telephone. Data provided directly by the companies via survey is deemed to be the most accurate and up-to-date information on that company. For companies that do not return a survey response, or where blanks are left on survey responses, researchers endeavor to complete the company record through other available means.

Fully insured HMO enrollment, when not provided by the company, is from third-quarter 2008 state department of insurance filings where available. In the few states that do not release quarterly statements, annual statements for 2007 were used to supplement the survey research for HMOs operating in those states.

Medicare enrollment, when not provided by the company, was updated from the Centers for Medicare and Medicaid Services (CMS) records from October 2008.

Medicaid enrollment, when not provided by the company, was taken from state reports ranging in date from September to December 2008.

Data from company Web sites, SEC filings, company press releases and published news reports were used to supplement the records.

 

Written By

AIS's Directory of Health Plans is published by Atlantic Information Services, Inc. (AIS), an objective publisher of news, data and information for health care managers. The research is conducted by in-house researchers who work exclusively for AIS.

 

Written For

Providers, suppliers, vendors, sales reps, market researchers, and anyone else who needs to keep an eye on health care players and business trends.

 

AIS Guarantee

Order this comprehensive resource for a 30-day risk-free inspection and see its value for yourself. If within 30 days you are not 100% satisfied, you may return it to AIS and receive a full, prompt refund. For CD purchasers, refunds will not be made once the seal on the CD package has been broken. Please review your copy of the print edition prior to breaking the seal.

 

Shipping Information

This item is shipped via UPS. Please give us your street address when you order (UPS does not deliver to PO boxes.) You should receive your order within 5-7 business days. Shipping cost is $5 per item.

Rush orders: Please call us at 800-521-4323 to place a rush order. We will overnight your order for an additional charge of $30, or you can give us your FedEx or UPS account number and we will charge the shipping to your account. Rush orders placed after 3:00pm EST will not be shipped out until the next business day.

 

For further information call 800-521-4323 or e-mail customerserv@aispub.com

 

Print an order form:
If you do not wish to place your order online, click here to download a printable order form (PDF file), then submit your order via fax or mail, as directed on the form.

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Consumer-Directed Health Care: Facts, Trends and Data

HSA Directory and Resource Guide

 



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