Spotlight on Health Insurers
A weekly scan of actions taken by individual health plans

Note: AIS’s Spotlight on Health Insurers is being discontinued with today’s issue. If you don’t already subscribe to our other free email newsletter, AIS’s Health Business Daily, please click here to sign up.


November 17, 2016

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

Health Insurance Exchanges

Judge allows Anthem to continue sales of stripped-down insurance policies
Los Angeles Times, Nov. 15, 2016
A judge declined to issue a restraining order that would have kept Anthem Blue Cross from moving 500,000 enrollees to plans with no out-of-network coverage.

EIRMC to change to out-of-network provider under Blue Cross through Your Health Idaho
KIDK 3, Nov. 15, 2016
Eastern Idaho Regional Medical Center will be an out-of-network provider for Blue Cross of Idaho’s exchange plans for the 2017 benefit year.

-back to top-

Save $50 on Upcoming Webinars

Health Plan Business

Insurer WellCare Health to buy Universal American for $600 million
Reuters, Nov. 17, 2016
Well Care Health Plans said it would buy Universal American in a deal slated to close in the second quarter of 2017.

Kaiser income soars in Q3 but not every health insurer made money
Portland Business Journal, Nov. 17, 2016
Kaiser Foundation Health Plan in Oregon posted $51 million in third-quarter net income.

WellCare Offers Behavioral Health Care via Online Programs to Increase Access, Convenience and Engagement for Florida Members
Company press release, Nov. 17, 2016
WellCare of Florida, a subsidiary of WellCare Health Plans, Inc., is offering its Medicare Advantage and Staywell Medicaid members free behavioral health care services via online cognitive-based therapy programs to address common behavioral health conditions.

Clayton approves tax abatements for Centene expansion plan
KPLR St. Louis, Nov. 16, 2016
The Clayton, Mo., Board of Alderman agreed to grant Centene Corp. a 40% tax break on future property taxes as the insurer moves closer to building a new office complex in the town.

Oscar — The Health Care Startup — Continues To Lose Millions
Kaiser Health News, Nov. 16, 2016
Oscar Insurance Corp. has lost $45 million in the third quarter of 2016 on operations in California, New York and Texas.

Kaiser Permanente Hawaii reports on its third quarter
Pacific Business News, Nov. 15, 2016
Kaiser Permanente Hawaii reported “solid [results] for the third quarter,” according to Thomas Risse, the insurer’s chief financial officer.

-back to top-

12 PBM Contracting Pitfalls Health Plans Should Avoid

Legal/Regulatory Issues

Khang & Khang LLP Announces Securities Class Action Lawsuit against Centene Corp. and Encourages Investors with Losses to Contact the Firm
Company press release, Nov. 15, 2016
Khang & Khang LLP filed a proposed class action lawsuit against Centene Corporation on behalf of investors who purchased or otherwise acquired shares between April 26 and Sept. 6, 2016.

GAO greenlights $58 billion in DoD TRICARE awards, denying nine industry protests
Federal News Radio, Nov. 15, 2016
GAO denied protests filed by WellPoint, UnitedHealth Military and Veterans, and Health Net.

-back to top-

Health Insurance Exchange Database

Provider Contracting

Blue Cross and Blue Shield of Texas, Baylor Scott & White Health Announce New Agreement
Company press release, Nov. 17, 2016
Blue Cross and Blue Shield of Texas and Baylor Scott & White Health announced a new four-year network access agreement.

Health Care Concerns Raised After Blue Cross Blue Shield Cuts Off Minn. Clinics
ABC Eyewitness News, Nov. 16, 2016
Blue Cross Blue Shield of Minnesota terminated its contract with Integrity Health Network, the provider says.

Contract between Blue Cross Blue Shield, Fairview may expire
Fox 9, Nov. 15, 2016
Warnings that the contract between Blue Cross Blue Shield of Minnesota and Fairview Health Services could expire at the end of the year has raised concerns among some enrollees.

-back to top-

AIS’s Medicare and Medicaid Market Data: 2016

Value-Based Care

HealthCare Partners Saves $1.6 million in Anthem Blue Cross Enhanced Personal Health Care Program
Company press release, Nov. 17, 2016
HealthCare Partners said it achieved $1.6 million in savings from participation in the Enhanced Personal Health Care program, a commercial ACO formed by Anthem Blue Cross.

Cigna, Northwest Indiana’s Community Healthcare System Form New Collaborative Care Relationship
Company press release, Nov. 16, 2016
Cigna has entered into a collaborative care relationship with Northwest Indiana’s Community Healthcare System.

CharterCARE and UnitedHealthcare to Improve Medicaid Patients' Health and Health Care in Rhode Island
Company press release, Nov. 16, 2016
CharterCARE Health Partners, CharterCARE Provider Group RI, LLC, and UnitedHealthcare Community Plan of Rhode Island have launched a Medicaid ACO program.

-back to top-



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 © 2016 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


Advertise with AIS
Free webinar on AIS’s Online Directory of Health Plans
Specialty Pharmacy News
The AIS Guide to Blue Cross and Blue Shield Plans
Health Plan Facts, Trends and Data: 2016-2017