About This Resource

View sample pages
(in PDF format):

From Chapter 2: Directory of Health Insurance Companies

From Chapter 3: Directory of Preferred Provider Networks

From Chapter 4: Health Plan Enrollment by State

Honors
AIS’s Directory of Health Plans is used by J.D. Power and Associates to calculate market share statistics in their annual J.D. Power and Associates National Health Insurance Plan Satisfaction Study.
For the seventh year in a row, America’s Health Insurance Plans (AHIP) — the national trade association representing health plans — has selected AIS’s Directory of Health Plans as an official directory resource of AHIP Solutions.

Table of Contents
Chapter 1: Highlights From AIS’s Database of Health Plans

Chapter 2: Directory of Health Insurance Companies

Chapter 3: Directory of Preferred Provider Networks

Chapter 4: Health Plan Enrollment by State
Index of Companies

Related Publications
Health Plan Week
Drug Benefit News
Health Plan Facts, Trends and Data
AIS’s 2003-2007 Health Plan Enrollment Statistics

AIS’s Directory of Health Plans: 2010

You can use the data in AIS’s Directory of Health Plans to:

• Discover which health plans offer certain types of plan models — and which health plans operate in each state — so you can gauge your competitors’ strengths and identify where your opportunities for market expansion lie.
• Gain insight into the increasing diversity of health plan models as benefit designs adapt to meet marketplace demands.
• Create targeted mailing lists and develop call lists to network and generate leads for prospective new partners.
• Determine which PPO networks may best serve your benefit design offerings.
• Track shifts in branding as organizations have started to position themselves as national brands versus state or local entities, and as integrations, mergers and acquisitions change the competitive landscape.
• Develop benchmarks for determining the prevalence of certain type of plan models and create projections about which areas are likely to grow.

AIS’s Directory of Health Plans not only provides enrollment data, but also gives you charts, graphs, and tables to help you answer these vital questions:

• Where do you and your competitors stand nationwide in regards to enrollment and market share?
• Who are the largest PPO networks and where do they operate?
• What are the top health plans by plan model type, market sector and risk type?
• Which plans have gained NCQA accreditation status for quality of care and service?
• What PBMs are contracted or affiliated with which health plans?

Also Available as a Convenient CD Database

AIS’s Directory of Health Plans comes in two versions — a printed book version and a CD Database version (which comes with a free copy of the book).

• The CD contains all of the data in the book in multiple file formats (Excel, Access, dBase and ASCII), so you can easily create the specific kind of analysis best suited to your needs.
• The directory contains verified contact names in 16 different job functions – and the CD has all of this information electronically in mailing lists so you can quickly sort and create targeted lists based on job function, company or state.
• The CD Database’s capabilities make it perfect for marketing research and developing prospects lists, as well as creating detailed company profiles and prospective client lists for your sales force.
• And if more than one person in your organization would benefit from having access to this data, multi-user licenses are available to save you money.

Plus, when you purchase the CD version, you’ll have access to these exclusive features not found in the printed book version:

• A new enhancement that allows users to view enrollment for large national companies in spreadsheet format — at the subsidiary level. This data is independently researched by AIS staff to supplement primary survey research.
• A special report allowing easy analysis of health insurers by state containing the full listing of each company operating in each state.
• Full listings of parent organizations with corporate headquarters executives, total enrollment data and more.
• Data on health plans found only on the CD include total physicians, total hospitals and executives by two job functions — claims management and reimbursement.
  

Health Insurance Companies Company information — Company Name, Company Owner, Profit Status, Private/Public, Stock Symbol, Aliases, Contracted PBM, States Served Contact information — Address, URL, Telephone, Fax Executives by job function — CEO, President, Operations, Finance, Medical, Legal, Provider Relations, Marketing, Member Relations, Pharmacy, Specialty Pharmacy, Public Relations, Information Systems, Purchasing Enrollment data — Total Medical, Total Fully Insured, Commercial Risk, Commercial Risk HMO, Commercial Risk POS, Commercial Risk PPO, Commercial Risk FFS/Indemnity, Medicare Supplement, Public Sector Risk, Total Medicare, Medicare Coordinated Care, Medicare PFFS, Medicaid HMO (Risk), SCHIP and Other Public-Sector, Other/Unspecified Risk, Total Shared-Risk, Total Self-Funded, Commercial Non-Risk, Public-Sector Non-Risk, CDH (HRA-Based Plans, HSA-Qualified Plans), Individual (non-Group), Fully Capitated, Partially Capitated, Non-Capitated, Other Enrollment Specific to Each State, the District of Columbia and Puerto Rico CD-only data — total physicians, total hospitals, claims management Executives, Reimbursement Executives

PPO Networks Company information — Network Name, Company Name, Parent/Owner, Profit Status, Private/Public, Stock Symbol, Contracted or Affiliated PBM(s) Contact information — Address, URL, Telephone, Fax Executives by job function — CEO, President, Operations, Finance, Medical, Legal, Provider Relations, Marketing, Member Relations, Pharmacy, Public Relations, Information Systems, Purchasing Network information — Lives With Network Access, Claims Processed per Year, Dependent Factor, Number of Employer Clients, Number of Payer Clients, Average Benefit In Network, Average Benefit Out-of-Network, Total Physicians, Total Hospitals, States Served, Enrollment specific to each state, the District of Columbia and Puerto Rico Services offered and fees — Utilization Management, Workers' Compensation, Disease Management, Case Management, Pharmacy Network, Claims Repricing, Claims Processing, Available for Lease, CM Fee Per Hour, UM Fee PMPM, Network Access Fee, Average Savings

From Chapter 2: Directory of Health Insurance Companies

From Chapter 3: Directory of Preferred Provider Networks

From Chapter 4: Health Plan Enrollment by State

AIS’s Directory of Health Plans is published by Atlantic Information Services, Inc. (AIS). The research and data tracking is conducted by in-house researchers who work exclusively for AIS.

All known health insurers and PPO networks operating as of Jan. 1, 2010, believed to fit the criteria of this database are included. Inclusion in the database is not optional. All companies were surveyed by AIS staff researchers between Oct. 1, 2009 and Dec. 31, 2009. Organizations were contacted by mail, fax or email and were offered options to fill out an online or paper form, or to provide information via email, fax, mail or telephone interviews. Data provided directly by the companies via survey is deemed to be the most accurate and up-to-date information on that company. For companies that do not return a survey response, or where blanks are left on survey responses, researchers endeavor to complete the company record through other available means.

Fully insured commercial HMO enrollment, when not provided by the company, is from third-quarter 2009 state insurance department filings where available. Medicare enrollment, when not provided by the company, was updated from the Centers for Medicare and Medicaid Services (CMS) records from October 2009. Medicaid enrollment, when not provided by the company, was taken from state reports ranging in date from September to December 2009. Data from company Web sites, SEC filings, company press releases and published news reports were used to supplement the records.

This item is shipped via UPS. Please give us your street address when you order (UPS does not deliver to PO boxes.) You should receive your order within 5-7 business days. Shipping cost is $5 per item.

Rush orders: Please call us at 800-521-4323 to place a rush order. We will overnight your order for an additional charge of $30, or you can give us your FedEx or UPS account number and we will charge the shipping to your account. Rush orders placed after 3:00pm EST will not be shipped out until the next business day.

Order AIS’s Directory of Health Plans for a 30-day risk-free inspection and test for yourself the value of this new data and analysis resource. If within 30 days you’re not 100% satisfied, just return it to AIS and we will send you a prompt, full refund. For CD version purchasers, please review your copy of the print version before breaking the seal on the CD package. Refunds will not be made once the seal on the CD package has been broken.

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