AIS’s Directory of Health Plans: 2012

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

Methodology

All known health insurers and PPO networks operating as of Jan. 1, 2012, 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, 2011, and Dec. 31, 2011. Organizations were contacted individually and 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 companies via survey is deemed the most accurate and up-to-date information on that company. For companies that do not return a survey, or where blanks are left on responses, researchers endeavor to complete the record through other means. Survey data is audited against public records as available.

Fully insured commercial HMO enrollment, when not provided by the company, is from third-quarter 2011 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 November 2011.

Medicaid enrollment, when not provided by the company, was taken from state reports ranging in date from September to December 2011.

Data from company websites, SEC filings, company press releases and published news reports were used to supplement the records.

Data Fields

• Executives by job function — CEO, President, Operations, Finance, Medical, Legal, Provider Relations, Marketing, Member Relations, Pharmacy, Specialty Pharmacy, Public Relations, Information Systems, Purchasing, Claims Management, Reimbursement, DM/Wellness
• Company information — Company Name, Network Name, Parent/Owner, Profit Status, Private/Public, Stock Symbol, Aliases, Contracted PBM(s), States Served, Address, URL, Telephone, Fax
• Enrollment data — Total Medical, Total Fully Funded, 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, PACE Program, Medicaid HMO, SCHIP and Other Public-Sector, Unspecified Risk, Total Shared-Risk, Total Self-Funded, Commercial Non-Risk, Public-Sector Non-Risk, Individual (non-Group), Other, Enrollment specific to each state, D.C. and Puerto Rico, Total Physicians (CD only), Total Hospitals (CD only)
• Enrollment Specific to Each State
• Network information (PPO networks) — Lives With Network Access, Claims Processed per Year, Dependent Factor, No. Employer Clients, No. Payer Clients, Avg. Benefit In Network, Avg. Benefit Out-of-Network, Total Physicians, Total Hospitals, States Served
• Services offered and fees (PPO networks) — 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, Avg. Savings

Honors

For the ninth 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: 2012 as an official directory resource.

Written By

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.

To produce AIS’s Directory of Health Plans, AIS’s on-staff researchers personally interview or survey a knowledgeable person at each health plan — including subsidiaries and parent companies — to get a clear picture of product offerings, contracts and markets. We work hard to ensure that each covered life is counted only once, and is categorized by plan models that are defined in a consistent and meaningful manner which reflect the current industry. By maintaining our impeccable research standards and strict methodology through nine annual editions, AIS’s health plan data offers true year-over-year comparisons and extremely accurate and sensitive insight into developing trends.

AIS is proud to maintain this extensive, proprietary database of information and to consistently publish reliable and practical information that can help you in evaluating market trends and succeeding in the health care market.

Written For

• Health plan executives, managed care and managed markets directors
• Analysts, market researchers and business development managers
• Network directors, contract and payer relations managers
• Health care policy makers
• Sales and marketing directors, brand managers
• Account executives, product managers
• Benefits advisors

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Shipping Information

This item will begin shipping, via UPS, in February 2012. Please give us your street address when you order (UPS does not deliver to PO boxes.) Shipping cost is $12.

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• Chapter 2: Directory of Health Insurance Companies
• Chapter 3: Directory of Preferred Provider Networks
• Chapter 4: Health Plan Enrollment by State