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!

February 4, 2016

Note: Spotlight on Health Insurers will not be published next week. The next issue will be sent on Feb. 18.

This week's topics: Health Plan BusinessPeople on the MoveProvider Contracting

Health Plan Business

BCBSMA Adopts Text Reminders to Members
Boston Business Journal, Feb. 2, 2016
Blue Cross Blue Shield of Massachusetts is teaming up with a Philadelphia vendor to provide health and bill reminders to members via text message. 

United Projects Doom, but Subsidiary Markets ACA Products
Forbes, Feb. 2, 2016
After UnitedHealth Group infamously said it is considering leaving the exchange market, its subsidiary Harken Health has begun marketing new ACA products.

Aetna: ‘Serious Concerns’ Over Exchange Business
The Hill, Feb. 1, 2016
In a departure from its earlier declaration that it is committed to the exchanges, Aetna Inc. CEO Mark Bertolini said the company is deeply concerned over the market’s sustainability.

United Challenges Medicare Payment Policy
Law360, Feb. 1, 2016
UnitedHealth Group is suing CMS in D.C. federal court, arguing that the agency’s policy of returning overpayments for Medicare services is unfair.

WellCare Continues Fight for Iowa Contract
The Gazette, Feb. 1, 2016
WellCare Health Plans, Inc. appealed the state’s decision to toss its Medicaid contract to a district court judge in the latest development in an ongoing battle in Iowa’s transition to managed care.

Aetna Still Pondering Post-Merger Leadership Structure
Louisville Business First, Feb. 1, 2016
Aetna CEO Mark Bertolini said in an investor’s call that the company is still hammering out the details of how the company’s management will be structured after the acquisition of Humana Inc.

Hoosier Health Plan Cuts Majority of Workers
Indianapolis Business Journal, Jan. 31, 2016
Advantage Health Solutions Inc. is slashing 78 of its 130 staffers, following the termination of its Medicare Advantage business last year and its placement under state supervision.

HHS Rules United Must Cover Transgender Surgery
Yahoo! News, Jan. 29, 2016
An HHS panel said UnitedHealth Group must cover the sex reassignment surgery for a Texas Air Force veteran who initially asked for coverage under her Medicare Advantage plan in November 2014.

BCBSNC Halts ACA Ads After $400M Loss
The News & Observer, Jan. 29, 2016
Blue Cross and Blue Shield of North Carolina is eliminating commissions and suspending advertising and online applications for exchange policies after taking a major financial beating.

BCBSM Questions Tribe’s Legal Reasoning in ERISA Suit
Law360, Jan. 29, 2016
Blue Cross Blue Shield of Michigan asked a judge to toss a lawsuit from the Little River Band of Ottawa Indians, claiming the group did not prove that ERISA applies to the tribe.

Oregon Takes Control of Moda Health
KOIN, Jan. 28, 2016
Oregon is halting the sale and renewal of Moda Health policies, citing serious concerns over the insurer’s financial solvency.

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Save When You Reserve AIS’s Directory of Health Plans: 2016 & Get a FREE Report!

People on the Move

Independence Promotes Tandigm Leader
Philadelphia Business Journal, Feb. 2, 2016
Independence Blue Cross is expanding the role Tandigm head Anthony Coletta, naming him executive vice president of the company and president of facilitated health networks.

Horizon Boosts Govt. Staff Amid OMNIA Controversy
NJBIZ, Jan. 31, 2016
Horizon Blue Cross Blue Shield of New Jersey hired Gov. Chris Christie’s deputy chief of staff and other state players as it battles pushback on its tiered-network health plans.

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The AIS Guide to Blue Cross and Blue Shield Plans: 2015

Provider Contracting

Texas Blues Settles Dispute With Hendrick
KTXS, Jan. 29, 2016
Health Care Service Corp. subsidiary Blue Cross Blue Shield of Texas has resolved a year-long contract fight with Hendrick Health System, saying the two will partner again on March 1.

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Innovative Plan-Provider Ventures: Case Studies From Anthem and Aetna



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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