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 20, 2016

This week's topics: Health Insurance ExchangesHealth Plan BusinessLegal/Regulatory IssuesProvider ContractingValue-Based Care

Health Insurance Exchanges

Cigna to Offer Individual and Family Plans in Chicago Area
Company press release, Oct. 19, 2016
Cigna Corp. is introducing new individual and family medical plans in the Chicago area, both on and off the federal public marketplace.

NC Blue Cross announces rate increase of 24.3 percent for ACA marketplace plans
Charlotte Observer, Oct. 17, 2016
Blue Cross and Blue Shield of North Carolina said it will raise premiums for Affordable Care Act plans on the individual market by an average 24.3%, up from its original rate request of 18.8%, filed in May.

With Blue Cross' exit, Nebraskans can expect even higher health premiums through Obamacare
World-Herald, Oct. 13, 2016
About 82,000 Nebraskans will see premium rate hikes on for individual health insurance next year because Blue Cross Blue Shield withdrew from the Affordable Care Act’s exchange.

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Health Plan Week

Health Plan Business

UnitedHealth raises 2016 forecast, again
Post-Bulletin, Oct. 19, 2016
UnitedHealth Group officials said third-quarter 2016 profits rose 23 percent to nearly $2 billion.

Horizon Blue Cross Blue Shield Launches Integrated Mental-Physical Pilot
NJ Spotlight, Oct. 19, 2016
Horizon Blue Cross Blue Shield of New Jersey launched a new episode-of-care  program for patients with Crohn’s disease that will integrate mental and physical care.

Blue Cross Of Montana Opens New Headquarters
Helena Independent Record, Oct. 19, 2016
Blue Cross and Blue Shield of Montana moved to new Helena headquarters.

Centene subsidiary awarded expanded Medicaid contract in Missouri
St. Louis Post-Dispatch, Oct. 18, 2016
Centene Corp. won a contract to expand its presence in the Missouri Medicaid program starting in May 2017, when it will manage care for Medicaid recipients statewide.

WellCare of Georgia Offers 2017 Medicare Advantage Options That Promote Preventive and Maintenance Care
Company press release, Oct. 17, 2016
WellCare of Georgia, a subsidiary of WellCare Health Plans, Inc., will offer Medicare beneficiaries an expanded variety of Medicare Advantage plans for 2017.

WellCare of Louisiana Offers 2017 Medicare Advantage Options to Help Seniors Achieve and Maintain Optimal Health
Company press release, Oct. 17, 2016
WellCare of Louisiana, a subsidiary of WellCare Health Plans, Inc., will offer Medicare Advantage plans in 2017 designed to help older adults get and stay healthy.

Kaiser to Raise Senior Health Plan Premiums, Oct. 14, 2016
Effective Jan. 1, 2017, Kaiser Permanente is closing two of its Medicare Advantage plans, and the remaining offering will represent a rate hike for some Medicare-eligible Hawai‘i Island residents.

Invitae Signs Lab Services Agreement With UnitedHealthcare, Oct. 14, 2016
Invitae told investors that it entered into a national provider agreement for laboratory services with UnitedHealthcare, effective Jan. 1, 2017.

Competition Fuels Aetna, Merck Deal
Investopedia, Oct. 14, 2016
Aetna Inc. said it reached a value-based reimbursement agreement with Merck for Januvia and Janumet, the company’s blockbuster diabetes drugs.

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AIS’s Medicare and Medicaid Market Data: 2016

Legal/Regulatory Issues

Tom Daschle Pushed Hillary Clinton To Back Aetna Merger While Refusing To Register As Aetna Lobbyist
International Business Times, Oct. 19, 2016
Former Democratic Senate Majority Leader Tom Daschle lobbied aides to Hillary Clinton to support Aetna’s proposed purchase of Humana Inc. in fall 2015, but did not register as a lobbyist until spring 2016.

Clayton leaders mulling Centene expansion have ties to company
St. Louis Post-Dispatch, Oct. 15, 2016
Some Clayton, Mo., city leaders charged with approving Centene’s proposed expansion have ties to the insurer.

Cigna Accused Of Cheating Prescription Drug Buyers
Hartford Courant, Oct. 14, 2016
A West Hartford, Conn., law firm filed a proposed class action lawsuit against insurer Cigna Corp. and UnitedHealth Group that charge the insurers with imposing prescription drug copays higher than actual drug costs.

Anthem and Cigna must unveil alleged merger breaches, judge says
Modern Healthcare, Oct. 14, 2016
U.S. District Judge Amy Berman Jackson ruled that the Anthem and Cigna must disclose documents alleging they breached the terms of their merger agreement.

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From the AIS Blogs

What do you think is likely to contribute to member enrollment shifts this Annual Election Period? Join the conversation at the AIS Blogs.

Provider Contracting

SRHS, UnitedHealthcare reach agreement
Greenville Online, Oct. 19, 2016
Spartanburg Regional Healthcare System reached a two-year agreement with UnitedHealthcare for the insurer’s commercial and Medicare Advantage plans.

Blue Cross of Idaho awards ISU grant to help screen for traumatic brain injury
Idaho Business Review, Oct. 18, 2016
Blue Cross of Idaho is making available $50 vouchers for additional treatment after being screened for traumatic brain injury through Idaho State University’s Traumatic Brain Injury Program.

Nearly 750,000 South Floridians affected by Tenet, Humana Dispute
Sun-Sentinel, Oct. 17, 2016
Starting Oct. 1, almost 750,000 Humana customers in South Florida will no longer have access to Tenet's hospitals in-network.

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The AIS Guide to Blue Cross and Blue Shield Plans

Value-Based Care

Highmark working with health systems on plans with lower expenses
Pittsburgh Post-Gazette, Oct. 14, 2016
Highmark is working with Conemaugh Health System in Johnstown and Lehigh Valley Health Network in Allentown to offer health insurance plans that come with lower out-of-pocket expenses for members.

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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

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Health Plan Facts, Trends and Data: 2016-2017
Health Insurance Exchange Database