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!

July 21, 2016

This week's topics: Health Plan BusinessHealth Insurance ExchangesLegal/Regulatory IssuesPeople on the MoveProvider Contracting

Health Plan Business

Ky. Identity Theft Victims Blame Anthem Breach
Bowling Green Daily News, July 20, 2016
Two victims of identity theft in Kentucky are blaming the 2015 Anthem, Inc. breach for leaking their personal data to thieves.

United Beats 2Q Estimates Despite Exchange Losses
The Hill, July 19, 2016
UnitedHealth Group topped investor expectations for second quarter earnings, increasing profits 28% year-over-year, in spite of its highly publicized exit from the majority of the individual exchanges.

City of Clayton Holds Hearing on Centene Campus Expansion
St. Louis Business Journal, July 14, 2016
Clayton, Mo., officials are planning a public hearing on Centene Corp.’s proposed $770 million expansion, which would require rezoning.

Anthem Expands Medicaid Plans to Six Wis. Counties
Anthem press release, July 14, 2016
Anthem Blue Cross and Blue Shield in Wisconsin on July 1 began offering Medicaid coverage to Dane, Florence, Marquette, Menominee, Polk and Taylor counties.

-back to top-

AIS’s Medicare and Medicaid Market Data: 2016

Health Insurance Exchanges

Covered Calif. Plans Hike Rates by More Than 13%
California Healthline, July 19, 2016
The increase is driven by double-digit hikes from Blue Shield of California and Anthem Blue Cross in California, while Kaiser Permanente filed an increase of only 6%.

Oregon’s Failed CO-OP Members Can Apply Deductibles to New Plan
Oregon press release, July 18, 2016
Oregon’s Health CO-OP members won’t be penalized for money already spent toward deductibles and out-of-pocket maximums when they switch to new plans, the state government said Monday.

-back to top-

Inside Health Insurance Exchanges

Legal/Regulatory Issues

Feds Block Multibillion-Dollar Insurance Mergers
U.S. News and World Report, July 21, 2016
The Department of Justice filed separate suits against Anthem, Inc. and Cigna Corp., and Aetna Inc. and Humana Inc. to block the companies’ proposed mergers, citing concerns about the competitive impact on consumers.

Anthem Donations Throw Another Wrench in Cigna Deal
International Business Times, July 18, 2016
Anthem’s donations to the Republican and Democratic governors’ associations are posing more questions as the company fends off conflict-of-interest allegations regarding the Connecticut insurance commissioner.

Calif. Blue Shield Faces $35M Class Action Over ACA Rebates
Modern Healthcare, July 14, 2016
Blue Shield of California was hit with a lawsuit from members claiming the insurer failed to reimburse them after they say the company included improper payments in its medical loss ratio calculations.  

Judge Greenlights Mental Health Suit Against Kaiser
Law360, July 14, 2016
A California judge concluded there was sufficient evidence of discrimination in a proposed class-action that accuses Kaiser of forcing certain psychiatric patients to cancel their plans.

Calif. Blue Shield Accuses County of Dumping Sickest Patients
Law360, July 14, 2016
Blue Shield of California sued San Luis Obispo Regional Health Authority for shifting its sickest patients to Blue Shield plans, costing the insurer upwards of $12 million.

-back to top-

AIS's Rx Benefit Data - Sophisticated Database from AIS - Free Demo

People on the Move

Arkansas Blues Promotes Two Staffers Up the Ranks
Arkansas Business, July 18, 2016
Arkansas Blue Cross & Blue Shield promoted Dan Petroff, lead systems analyst, to manager of customer service applications and Rhonda Carroll, customer service supervisor, to manager of BlueCard and regular business claims.

-back to top-

Advertise With AIS

Provider Contracting

Montana Blues Inks Deal With Benefis
NBC Montana, July 16, 2016
Health Care Service Corp. unit Blue Cross and Blue Shield of Montana struck an agreement with Benefis Health Systems for large group plans in 2017.

Providence Health Severs Ties With Premera
KIRO7, July 14, 2016
Providence Health Services is ending its contract with Premera Blue Cross at the end of the year, displacing more than 500,000 patients.

-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


World Congress
Source Media
AIS's Directory of Health Plans: 2016 Is Shipping Now!
Specialty Pharmacy Trends and Strategies: 2016-2017 Edition

New from AIS: Online Training
Train your workforce on two of the most important issues in health care business today!

(1) Value-Based Payment Models

(2) Oncology Management Strategies