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September 30, 2005
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MHMR September 30, 2005; Volume 13, Number 16
SPECIAL REPORT: Medicare Part D...MCOs, PBMs get Part D O.K...Aetna sets Part D premiums...Cigna option covers donut hole...Coventry monthly rates: $18-50...Humana cleared for Part D...United, PacifiCare offer options...WellPoint to buy WellChoice...HIP, GHI to merge...2Q05 BCBS HMO/POS lives...Chart: 2Q05 BCBS lives...Chart: BCBS M&A valuations...’04 NY HMO profits fall...Chart: ’04 NY HMO financials...’04 MD HMO net climbs 47%...Chart: MD HMO financials...MCO stocks fall 3%...Services stocks fall 0.2%...Matria to acquire WinningHabits...and more...
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WELLCHOICE SOLD FOR 11 TIMES CASH FLOW
It has become self-evident that the conversion of a Blue Cross Blue Shield plan to for-profit status is nothing more than a precursor to the eventual sale of the company.
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HIP, GHI TO MERGE
HIP Health Plan of New York and Group Health Inc. (New York) announced an agreement to merge under the leadership of a governing foundation including an equal number of directors from both companies. The combined company will have more than 4 million members and $7 billion in annual revenues. No further details were released.
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7 MCOs, 3 PBMs GET NATIONAL PART D O.K.
Seven managed care organizations and three pharmacy benefit management companies have received approval to offer stand-alone Medicare Part D drug plans in all 50 states and Washington, DC, the Centers for Medicare & Medicaid announced.
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NY HMO PROFITS DECLINE 15.5% IN 2004
New York HMOs reported net income of $846.6 million in 2004, down 15.5%, on revenues of $18.16 billion, up 4.3%, according to an MHMR tally of state insurance department data.
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MD HMO NET INCOME CLIMBS 47% IN ’04
HMOs in Maryland boosted net income 47% to $241.5 million and grew revenues 10.9% to $5.681 billion in 2004, according to an MHMR tally of state insurance department data on 10 leading plans.
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AETNA PART D PREMIUMS RANGE FROM $27-68 MONTHLY
Aetna Inc. (Hartford, CT), which has received approval to offer national Medicare Part D drug plans, will offer three plan options with individual premiums ranging from $27 to $68 per month.
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CIGNA PART D OPTION COVERS GENERICS IN DONUT HOLE
Cigna Corp. (Philadelphia), which has received approval to offer national Medicare Part D drug plans, will offer an enhanced plan option that provides coverage of generic drugs through the donut hole or coverage gap.
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COVENTRY PART D RATES RANGE FROM $18-50 MONTHLY
Coventry Health Care (Bethesda, MD) will offer national stand-alone Medicare Part D plans with individual monthly premium rates ranging from $18.24 to $25.19 for standard options and $30 to $50.48 for enhanced options.
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HUMANA CLEARED TO OFFER PART D PLANS IN 46 STATES
Humana Inc. (Louisville, KY) has received approval to offer a stand-alone Part D prescription drug plan in 46 states and Washington, DC, representing all of the states in which the company applied. Humana had previously announced that it was the low bidder in each regional area for all of its Part D bids submitted to the Centers for Medicare & Medicaid.
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UNITED, PACIFICARE OFFER RANGE OF PART D OPTIONS
UnitedHealth Group (Minnetonka, MN) and PacifiCare Health Systems (Cypress, CA), which are expected to complete their merger by early 2006 (MHMR, July 31), have received approval to offer national Medicare Part D drug plans at a variety of price points.
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MATRIA TO ACQUIRE WINNINGHABITS FOR $15 MILLION
Matria Healthcare (Marietta, GA) announced a definitive agreement to acquire WinningHabits Inc. (Dallas), a provider of corporate wellness programs, for $15 million in cash plus earn-outs. The acquisition is expected to be completed on Oct. 1 and will be slightly dilutive to Matria’s fourth-quarter earnings.
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