Health Plan Business

From Health Plan Week - There is no hiding the fact health insurers are in a state of flux when it comes to strategizing over Affordable Care Act (ACA) exchanges. Major plans like UnitedHealth Group and Humana Inc. are exiting most marketplaces for 2017, and once staunch exchange supporter Aetna Inc. is rethinking its level of participation as the losses from individual policies grow to the hundreds of millions of dollars per year (story, p. 1). Read more

From Health Plan Week - The Blue Cross Blue Shield Association (BCBSA) on July 28 unveiled a suite of newly branded products to serve what it says is a thriving international private medical insurance business for multinational employers and people traveling overseas. The move comes at a time health insurers doing business in the international market segment say employers are looking to tighten their budgets for overseas benefits even as the demand for the products… Read more

Health Plan Business Blog

By Patrick Connole - June 6, 2016
If you were in charge of a U.S. health insurer, what issue would make you lose sleep as you peer ahead to the rest of 2016 and into next year? When a pair of consultants and a noted lawyer were asked that question, they produced a list of challenges for health insurers that amounted to a virtual...
By Patrick Connole - May 31, 2016
When the Missouri insurance regulator came out on May 24 with a preliminary finding declaring its opposition to the pending Aetna Inc. acquisition of Humana Inc., industry watchers and stakeholders immediately took to form and either said (1) this spells doom for the deal’s overall approval, or (2...
By Steve Davis - April 28, 2016
CMS is considering several tweaks to its risk-adjustment program established by the Affordable Care Act (ACA) including a high-risk pool, partial-year enrollments and the inclusion of prescription drug claims as predictors of diagnoses or severity of illness. On April 11, I moderated a well-...

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