Spotlight on Health Insurers
A weekly scan of actions taken by individual health plans
Spotlight on Health Insurers is a weekly review of news from the nation's leading health insurers, including coverage of exchanges, value-based health care arrangements, provider contracting and personnel changes. Subscribe now to get an issue delivered to your inbox every Thursday!

October 1, 2015

This week's topics: Health Plan BusinessPeople on the MoveProvider Contracting Value-Based Care

Health Plan Business

Minn. Braces for Major Rate Hikes
CBSMinnesota, Oct. 1, 2015
Consumers are awaiting the state’s final approval on insurance premium increases, with Blue Cross and Blue Shield of Minnesota asking for an increase of more than 50%.

United Says Most Minn. MA Members Won’t See Increase
United press release, Oct. 1, 2015
UnitedHealth Group said 90% of UnitedHealthcare members in Minnesota won’t see a premium hike for 2016.

Man Sentenced to 4 Years for Selling Faulty Wheelchairs
The Indianapolis Star, Sept. 30, 2015
A man who sold old and sometimes faulty wheelchairs to insurers like Anthem, Inc. as well as Medicare and Medicaid, was sentenced to four years in prison.

BCBSA Study Reveals Gender Disparities in Cardiac Treatment
BCBSA press release, Sept. 29, 2015
A new report from the Blue Cross Blue Shield Association finds that women are far less likely to receive aggressive treatment following a heart attack, even though women are more likely to die or become disabled from the episode.

Ala. Law Makes Insurance Exec Salaries Secret, Sept. 28, 2015
A new Alabama law makes insurance executive compensation confidential, effectively sealing the salaries of execs like Blue Cross Blue Shield of Alabama CEO Terry Kellogg, who made $4.84 million last year.

Anthem Says It Doesn’t Anticipate Cigna Layoffs
4-traders, Sept. 25, 2015
Anthem said in a new regulatory filing that it’s not planning on cutting Cigna Corp. employees once a proposed acquisition takes place.

Horizon Reveals Breach Resulting From Fraud
Horizon press release, Sept. 25, 2015
Horizon Blue Cross Blue Shield of New Jersey notified members that their PHI was exposed after uncovering a fraudulent billing scam.

Court Says Calif. BCBS Plans Should Pay Premium Taxes
Law360, Sept. 25, 2015
A California appellate court reversed a lower court’s decision, finding that Anthem Blue Cross in California and Blue Shield of California should pay a gross tax on premiums like other state insurers.

-back to top-

Commercial Health Plan Market Metrics: 2014 Performance Measures for Individual, Small-Group and Large-Group Risk-Based Plans

People on the Move

Aetna Hires Former Casino Leader
Las Vegas Sun, Sept. 30, 2015
Aetna Inc. named former Caesars Entertainment Corp. CEO Gary Loveman president of its Healthagen unit, as he retains his position as Caesar’s chairman.

-back to top-

Dual-Eligibles Demos: Early Results and Their Implications

Provider Contracting

Catholic Hospital Leader Accuses Horizon of Prejudice, Sept. 29, 2015
Horizon Blue Cross Blue Shield of New Jersey “schemed in secret” to keep seven of eight Catholic hospitals out of its new tiered network, the leader of the Catholic Healthcare Partnership alleged.

Court Rules Insurer Can Settle Malpractice Suit Without Doctor
Law360, Sept. 28, 2015
A Louisiana appellate court affirmed that Louisiana Medical Mutual Insurance Co. (LAMMICO) didn’t breach its contract with a physician when it settled a malpractice lawsuit after she was terminated.

-back to top-

From the AIS Blogs

The big issue that some MA trade groups have with the results CMS recently outlined of its own new research into the link between serving a highly disadvantaged population and poor plan star ratings seems to be the word "small." Does size matter? Join the conversation at the AIS Blogs.

Value-Based Care

Cigna Inks Value-Based Deal With UCSF
Cigna press release, Oct. 1, 2015
Cigna is teaming with University of California, San Francisco in a collaborative care deal, making it Cigna’s eighth in the state.

-back to top-

Health Plan Facts, Trends and Data: 2015-2016



Have breaking news or an editorial question? Email Executive Editor Jill Brown at If you are interested in advertising in SPOTLIGHT ON HEALTH INSURERS please contact Bailey Sterrett at

SPOTLIGHT ON HEALTH INSURERS is copyrighted and protected by federal law. The re-use of its content is restricted (see below). However, you are permitted to forward this email to as many of your friends and colleagues as you wish, or better yet have them sign up for their own copy at atlantic_subscription.cfm, where you can also sign up for AIS's Health Business Daily and AIS's Goverment News of the Week.

Copyright © 2015 Atlantic Information Services, Inc. (AIS). All rights reserved. It is not permissible to include all or any portion of this content on any website, intranet or electronic network or in any print publication, without AIS's written permission in advance. Permission requests should be directed to

With archives of AIS's Spotlight on Health Insurers, features like the News Archives, AIS Blogs and more! (Free registration required)

AISHealth  Follow AISHealth on Twitter  Follow AISHealth on Facebook  Follow AISHealth on LinkedIn


 Be a part of the health care consumerism conversation at IHC FORUM West, and learn cost-saving strategies, empowering tools, top-quality solutions and a clear understanding of the changing landscape in health and benefits. As a benefit of AIS Health Insurer News partnership with The IHC, we would like to offer you a free, complimentary registration to attend IHC FORUM West. Just use the VIP code: AISVIP when registering. Register here.

Upcoming Webinars

The 340B Drug Pricing Program: What Proposed Changes Would Mean for Your Organization
Wed., Oct. 7, 2015
Click here for details

2016 Medicare Star Ratings: Translating Trends Into Strategies
Thurs., Oct. 22, 2015
Click here for details

Self-Funding Strategies for Insurers: Emerging Opportunities in the Small-Group Market
Thurs., Oct. 29, 2015
Click here for details

Enhanced CMS Oversight of Network Adequacy: Strategies for Medicare Advantage Plans
Tues., Nov. 17, 2015
Click here for details

Missed a Live Event?
Listen at your convenience to recent webinars with On-Demand or CD options!
Inside Health Insurance Exchanges

FREE webinar!
Open Enrollment Preview: How Lessons Learned Can Help Insurers and Brokers Win on Exchanges

Tuesday, Oct. 6, 2015

Learn what strategies will be most effective in the upcoming open enrollment. Click here to sign up!


AIS's Rx Benefit  Data - Easy-to-Use Database - Free Demo