AIS’s Directory of Health Plans

After re-entering the Affordable Care Act exchange markets for the 2022 plan year, CVS Health Corp.’s Aetna last week said it will expand its product offerings in 12 states, in both new and existing markets. The new state markets include Arizona, California, Illinois and North Carolina. The insurer currently enrolls 27,800 exchange members, with Florida (about 10,000 members) and Texas (about 7,000 members) as its largest state markets.

UnitedHealthcare intends to offer Affordable Care Act exchange products in four new states — Kansas, Mississippi, Missouri and Ohio — for the 2023 plan year, according to a Sept. 6 report in the Star Tribune. The expansion, if approved by regulators, would bring United’s exchange presence to 22 states. UnitedHealthcare is currently the 12th-largest exchange insurer in the U.S., with 337,701 members.

Cigna Corp. will offer Affordable Care Act exchange products in three new states, while expanding its existing market to 50 new counties overall, according to an Aug. 29 press release. The new states are Indiana, South Carolina and Texas. Cigna currently ranks 11th in national ACA enrollment, with 340,000 members. Tennessee is its largest state exchange market, with 85,000 members.

California’s Department of Health Care Services last week announced the state’s intention to award Medicaid contracts to three MCOs; Molina Healthcare, Elevance Health’s Anthem Blue Cross Partnership Plan and Centene Corp.’s Health Net. All three are incumbents to the Medi-Cal program, and currently serve a combined 2.96 million lives. This is California’s first statewide managed Medicaid procurement, and the new contracts, which will require the MCOs to follow new quality and transparency requirements, will run for five years. California runs a variety of managed care initiatives throughout the state, and its programs currently serve 12,328,266 Medicaid lives.

Elevance Health’s Empire BlueCross BlueShield last week unveiled new partnerships with four virtual behavioral health providers; Alma, Headway, NOCD and Ophelia. The four providers will be in-network across all of Empire’s lines of business. Elevance is currently the largest insurer in New York, with 4,215,983 members. 10.8% of its members are enrolled in commercial risk-based plans.

UnitedHealth Group has acquired a small, Houston-based Medicare Advantage organization affiliated with Kelsey-Seybold Clinic, according to an Aug. 16 report from the Star Tribune. The firm, KS Plan Administrators, currently serves 41,536 MA members in its KelseyCare Advantage plans. United, meanwhile, is the largest MA insurer in Texas, with 1,057,563 members. Financial terms of the deal were not disclosed.

Humana Inc. last week unveiled plans to purchase Inclusa, a long-term care organization operating throughout Wisconsin. The move marks further expansion into Wisconsin for Humana, which purchased Milwaukee-based Medicaid insurer iCare in 2020. Humana is currently the fifth-largest insurer in Wisconsin, serving 223,678 members. More than half of its members are enrolled in a public-sector plan offering.

The Mississippi Department of Medicaid last week released new Medicaid contract awards to three insurers; Molina Healthcare, Centene Corp.’s Magnolia Health Plan and TrueCare. TrueCare, a provider-owned health insurer, partnered with CareSource on their bid, and will be a new entrant to the program. Anthem Inc.’s Amerigroup and incumbent UnitedHealthcare were not selected. Mississippi currently serves 440,728 Medicaid and CHIP beneficiaries via managed care plans, with 370,841 in fee-for-service.

Nonprofit Medicare Advantage insurer SCAN Health Plan on Aug. 4 unveiled plans to expand its offerings into Texas for the 2023 plan year. Its products will be available in the state’s Harris and Bexar counties, pending CMS approval. The firm also plans to expand its presence in Nevada, moving into Nye County. SCAN currently serves 271,061 Medicare Advantage and dual eligible members in California, Nevada and Arizona.

CVS Health Corp.’s Aetna last week unveiled plans to join Covered California, the state’s Affordable Care Act exchange marketplace. The insurer will offer plans in select counties in the greater Sacramento and Fresno areas. Kaiser Permanente’s Kaiser Foundation Health Plan is the exchange market leader in California with 722,000 members, about 38% of  the state’s overall enrollees. Aetna re-entered the ACA markets in 2022, and currently serves 27,800 members in seven states.