WellPoint is the leading health plan in the U.S. with more than 33 million medical members.
One in nine Americans receives coverage for their medical care through WellPoint's affiliated health plans.
WellPoint is a Blue Cross or Blue Cross Blue Shield licensee in 14 states: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin.
WellPoint offers a broad range of medical and specialty products.
WellPoint's mission is to improve the health of the people they serve. The WellPoint Companies provide health security by offering a choice of quality branded health and related financial services designed to meet the changing expectations of individuals, families and their sponsors throughout a lifelong relationship.
WellPoint’s vision is to transform the industry, becoming the most valued health plan through a new generation of consumer-friendly products that put individuals back in control of their health and financial future.
The Patient Protection and Affordable Care Act (PPACA) was signed into law on March 23, 2010, followed by the Health Care and Educational Reconciliation Act (HCERA) signed on March 30, 2010. Together, this legislation makes up the federal health care reform law which mandates many changes to our health care system over the next several years.
Donut hole coverage gap in Medicare prescription benefit is fully phased out. Seniors continue to pay the standard 25% of their drug costs until they reach the threshold for Medicare catastrophic coverage .
Specialty products are viewed by industry leaders as a way to shore up revenues under HCR.
WellPoint has seen strong growth in specialty products popular with consumers.
Going global where there are opportunities in the growing Asian middle class market and fewer regulatory hurdles is also an option for WellPoint and other national carriers.
WellPoint 4Q2009 PMPM Financials for the Individual Market Segment MLR minimum will be 85% under HCR. WellPoint is well over the new MLR in ME, well under it in NH. Will have to raise it slightly in its best market, VA. It might consider exiting markets where MLR is extremely low or high AND enrollment is very low.
WellPoint 2009 PMPM Financials for the Medicaid Segment
The role of brokers is being hotly debated. Many carriers are reducing what they pay brokers, changing how they pay brokers or eliminating commissions altogether to meet the new MLR standards.
The broker community is absolutely critical and important to health care system. One of the primary reasons many who qualify for Medicaid are not enrolled is because no one is financially incented to get them enrolled.
WellPoint, Inc. has not announced what the new broker commission structure will be.
The rules are going to vary very dramatically by state. Some states have credibility rules based on the size of the carrier’s market share, and then there are phase-ins. Some states might allow legal entity consolidations. So there's a variety of things to understand further before WellPoint announces the broker commission rates.
WellPoint anticipates that it will be aligned with the key competitors in terms of having commission structures that are somewhat similar. There's been huge outliers in the past, but essentially the playing field has been leveled on that by creating an MLR floor.
Additional Information about Employment-Based Coverage
The changes in employment-based coverage shown in Table 3 of the cost estimate for the Patient Protection and Affordable Care Act are themselves the net result of several flows, which can be illustrated using the estimates for 2019. For that year, under the proposal, CBO and the JCT staff estimate that about 157 million non-elderly people would have their primary insurance coverage through an employer, or about 5 million fewer than under current law .
We estimate that about 6 million people would be covered by an employment-based plan who would not be covered by one under current law (largely because the mandate for individuals to be insured would increase workers’ demand for insurance coverage through their employers).
Additional Information about Employment-Based Coverage
We estimate that between 9 million and 10 million other people who would be covered by an employment-based plan under current law would not have an offer of such coverage under the proposal. Firms that would choose not to offer coverage as a result of the proposal would tend to be smaller employers and employers that predominantly employ lower-wage workers—people who would be eligible for subsidies through the exchanges—although some workers who would not have employment-based coverage because of the proposal would not be eligible for such subsidies. Whether those changes in coverage would represent the dropping of existing coverage or a lack of new offers of coverage is difficult to determine.
In addition, between 1 million and 2 million people who could be covered by their employer’s plan (or a plan offered to a family member) would instead obtain coverage in the exchanges , either because the employer’s offer would be deemed unaffordable and they would therefore be eligible to receive subsidies in the exchanges, or because the “firewall” for those with an offer of employer coverage would be imperfectly enforced. (Those people are counted as enrollees in the exchanges.)
$195 Grant to Non-profit to run country’s only uninsured help line
With the implementation of Health Care Reform Legislation set to roll out over the next three years, current efforts to educate uninsured Americans will continue.
The number of health plan outlets is small but is expected to grow as more consumers look to buy individual policies. The Colorado plan is the first among subsidiaries of Indianapolis-based WellPoint to open a retail store. The Anthem store is in the Denver suburb of Littleton, Colo., in the Southwest Plaza mall. Other plans have opened retail outlets, but experts said more might consider stores as a way to reach potential customers -- especially to build a customer base for 2014, when most U.S. residents will be required to have health coverage or pay a tax penalty.