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

July 17, 2014

This week's topics: Accountable Care OrganizationsExchangesHealth Plan BusinessPersonnel AnnouncementsProvider Contracting

Accountable Care Organizations

Optimus Healthcare Partners, UnitedHealthcare Helping to Transform Health Care Delivery in New Jersey
UnitedHealthcare Press Release, July 16, 2014
UnitedHealthcare and Optimus Healthcare Partners LLC on July 1 initiated an accountable care model for New Jersey residents enrolled in UnitedHealthcare's employer-sponsored and Medicare health plans.

Independence Blue Cross Announces Results of Its Accountable Care Organization (ACO) Payment Model
Independence Blue Cross Press Release, July 14, 2014
Independence Blue Cross has released results from its accountable care organization payment model, which the insurer says is used by more than 90% of health care systems in the Philadelphia region.

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ACO Business News


BCBS of Alabama Could Face Greater Competition in Second Year of Exchanges
Birmingham Business Journal, July 16, 2014
UnitedHealthcare has begun procedures to offer individual plans in all 67 counties of Alabama, providing more competition for Blue Cross and Blue Shield of Alabama.

Tenn. Blue Cross Requests Rate Increase of 19% in 2015
The Tennesseean, July 16, 2014
BlueCross BlueShield of Tennessee has requested to increase its rates by an average of 19% for marketplace plans in 2015; Cigna and Humana have requested increases of 7.5% and 14.4%, respectively.

UnitedHealthcare to Be Fourth Company to Offer Insurance in Georgia Exchange Next Year
The Augusta Chronicle, July 14, 2014
UnitedHealthcare is applying to sell plans statewide in Georgia’s exchange 2015, joining Coventry, Time Insurance Co. and Blue Cross and Blue Shield of Georgia.

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Medicare Star Ratings: Key Steps to Prepare for Changes in 2014 and 2015

Health Plan Business

Blue Cross Appeals Rate Decision on Its Vermont Health Plan
Bennington Banner Region, July 15, 2014
Blue Cross Blue Shield of Vermont and its subsidiary The Vermont Health Plan are appealing the Green Mountain Care Board’s decision to reduce a rate increase request, stating that a lower increase would threaten the company’s solvency.

UnitedHealth Group Sues California Over Fine
Los Angeles Times, July 11, 2014
UnitedHealth Group Inc. has sued California Insurance Commissioner Dave Jones because of his attempt to fine the insurer $173.6 million for violations resulting from a failed 2005 acquisition.

Blue Shield, DMHC of Calif. Release Social Security Numbers
California Healthline, July 10, 2014
Blue Shield of California inadvertently sent 18,000 doctors’ Social Security numbers, along with other information, to the California Department of Managed Health Care, which failed to catch the error.

New Cigna Individual Supplemental Health Products Pay Lump Sums from $5k to $100k for Those Diagnosed with Cancer, Heart Attack or Stroke
Cigna Press Release, July 10, 2014
Cigna has launched Flexible Choice, a suite of supplemental health insurance products that provide lump-sum payments for policyholders diagnosed with a heart attack, stroke or cancer.

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From the AIS Blogs

Are private insurance exchanges the future of employer-sponsored benefits? Health insurers appear to think so. Do you agree? Will private exchanges become the model for employee benefits in the future, or will they remain just one more option for employers? Join the conversation at the AIS Blogs.

Personnel Announcements

NMIC Board Names Tim Huckle as CEO and President
Blue Cross Blue Shield of North Dakota Press Release, July 14, 2014
The Noridian Mutual Insurance Company’s board has appointed Tim Huckle as president and CEO, effective immediately.

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Health Plan Week

Provider Contracting

Tenet and Humana Sign New Multi-Year National Agreement
Tenet Press Release, July 14, 2014
Tenet Healthcare Corporation and Humana Inc. have signed a multi-year contract extension agreement that expands members’ network access.

Highmark Inc. and Armstrong County Memorial Hospital Reach Agreement on Multi-year Contract
Highmark Inc. Press Release, July 14, 2014
Highmark Inc. and Armstrong County Memorial Hospital signed a multi-year contract extension granting Highmark members continued access to the Kittanning, Penn., hospital.

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Have breaking news or an editorial question? Email Erin Trompeter, editor of SPOTLIGHT ON HEALTH INSURERS, at If you are interested in sponsoring SPOTLIGHT ON HEALTH INSURERS please contact Bailey Sterrett at

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