A federal appeals court recently ruled that former Cigna Group executive Amy Bricker cannot join rival CVS Health Corp. due to a noncompete agreement, upholding a preliminary injunction from last year. While the case involving Bricker suggests companies can effectively prohibit employees from switching jobs, firms may no longer be able to do so later this year.

A Federal Trade Commission (FTC) final rule published in the Federal Register in May would ban most firms from enforcing or signing noncompetes with their workers. However, two attorneys tell AIS Health, a division of MMIT, the rule may not go into effect as planned on Sept. 4 due to multiple appeal. Moreover, it may never be implemented, especially if Donald Trump is elected president in November.

In recent years, publicly traded managed care organizations have jumped on a growing corporate trend of publishing annual environmental, social and governance (ESG) reports designed to spotlight the larger impact their company is having on society. Alignment Healthcare Inc., for one, in 2022 released its inaugural ESG report highlighting efforts from the previous year that focused on delivering high-quality care at a lower cost compared to fee-for-service Medicare and addressing social determinants of health (SDOH). In 2023, The Cigna Group’s 98-page ESG report categorized similar efforts into four “pillars” — healthy society, healthy workforce, healthy company and healthy environment — and included efforts to reduce greenhouse gas emissions in the latter category.

In a 2022 podcast hosted by law firm K&L Gates LLP, speakers suggested that the health care industry by nature is “mission-driven…focused on the improvement of the human condition” and “is particularly well suited to address ESG issues.” And insurers’ efforts in recent years to address health inequities mirror the increased focus from the Biden administration and CMS on tying health equity to reimbursement, such as the CMS Innovation Center incorporating health equity into models that drive value-based care.

A group of lawmakers is urging federal regulators to investigate UnitedHealth executives’ sale of company stock right after learning that the health care firm was the target of a Dept. of Justice (DOJ) investigation concerning its provider-acquisition spree. As for the investigation itself, one antitrust lawyer says it could take years before the DOJ files a case — but if it does, regulators could try to force the health care giant to spin off all or part of its Optum division.

Meanwhile, the DOJ’s antitrust division on May 9 announced a new Task Force on Health Care Monopolies and Collusion, which it said will “guide the division’s enforcement strategy and policy approach in health care, including by facilitating policy advocacy, investigations and, where warranted, civil and criminal enforcement in health care markets.” Some of the competition concerns the task force will examine include “issues regarding payer-provider consolidation” and “serial acquisitions.”

Although NeueHealth Inc. — formerly known as Bright Health Group Inc. — still owes a substantial sum of money to health insurers and is struggling to stay afloat, its CEO received a $1.95 million cash bonus last year, according to a new regulatory filing.

“It really is just a mockery of good governance and fairness at this point,” remarks Ari Gottlieb, principal of A2 Strategies and a prominent critic of Bright and other startup "insurtech" firms.

NeueHealth did not respond to AIS Health’s questions about the basis for the bonus earned by G. Mike Mikan, who has served as the firm’s president and CEO since April 2020.

CEOs of health insurance companies have received increasing pay packages over the past few years, AIS Health’s Executive Compensation Database shows. The database includes major health insurers’ executive compensation from 2019 to 2022 — collected from individual companies, state insurance documents and U.S. Securities and Exchange Commission filings — and their national membership information as of the third quarter of 2023, per AIS’s Directory of Health Plans. The database will be updated annually.

Several states do not disclose compensation data for specific executives at health insurance companies or do not collect compensation data. Some insurance companies made leadership changes over the years.

In the latest round of health insurer executive compensation data collected by AIS Health, there were once again intriguing stories to tell — such as why an insurtech CEO appeared to outearn the heads of the industry’s largest insurers, or what led a Blue Cross Blue Shield affiliate to nearly double its CEO’s compensation year over year.

However, finance experts who spoke to AIS Health, a division of MMIT, say that the biggest story might just be a recent court decision involving none other than Tesla, Inc. CEO Elon Musk, as the ruling could influence how all types of companies — including health insurers — determine their chief executives’ compensation going forward.

In recent letters sent to seven major publicly traded health insurers, two U.S. senators take aim at the industry’s fierce lobbying campaign against proposed Medicare Advantage rate adjustments — saying insurers are responding to the proposal by threatening to cut benefits for seniors despite spending billions on executive compensation and stock buybacks.

Corporate finance experts say there are valid criticisms to be made about both rising CEO pay and buybacks, but they argue that larger, systemic issues are driving such behavior across all types of industries.

Struggling health insurer Bright Health Group Inc. raised eyebrows with its recent announcement that CEO George Mikan III and other top executives earned more than $3.7 million in performance bonuses — despite posting a net loss of more than $600 million last year. The troubled startup insurer is under supervision by at least two state regulators, and one persistent critic of the firm’s executives tells AIS Health, a division of MMIT, that the bonuses are “outrageous.”

Bright’s 2022 Form 10-K, an annual filing all publicly traded companies are required to submit to the Securities and Exchange Commission (SEC), revealed that Mikan received $1.69 million, with other notable officers of the company receiving between $190,115 and $765,000 in bonuses. Each of the executives who were awarded a bonus received the full amount they could have received based on performance incentives. Bright added in the filing that Mikan’s total compensation was $9,993,169, while the median compensation for a Bright employee was $71,500, meaning Mikan earned 140 times the average Bright employee.

Cigna Corp. filed a lawsuit on Jan. 26 against Amy Bricker, the former president of the company’s Express Scripts PBM, and CVS Health Corp., which hired Bricker last month to a C-suite position.

The complaint in the U.S. District Court for the Eastern District of Missouri alleges that Bricker should not be allowed to join CVS due to a non-compete agreement that “prohibits her from working for any Cigna competitor.” It came three weeks after the Federal Trade Commission (FTC) proposed a rule that would ban employers from imposing non-compete agreements and as some states look more closely at such arrangements.

See a full list of director compensation for Presidents and/or CEOs of Blue Cross and Blue Shield Affiliates at https://bit.ly/3GPOdyK, compiled by AIS Health.

N/A = Not Available.

Compensation data for Jared Short includes payments allocated to Regence insurance operations in Washington state, Oregon and Utah but not Idaho.

SOURCE/METHODOLOGY: All data is compiled from individual health insurance companies, state insurance department documents and U.S. Securities and Exchange Commission filings.

Health plans selected based on commercial medical risk enrollment as of the beginning of 2022, per AIS’s Directory of Health Plans.