CIGNA

News & Analysis as of

Covered California Approves New Agent Compensation Standards

Covered California, the state’s Patient Protection and Affordable Care Act (PPACA) public exchange program, will now include greater detail with respect to payments made to insurance agents. The board of Covered California...more

IREG Update - Department of Health and Human Services and the Centers for Medicare and Medicaid Services take action to change the...

Department of Health and Human Services and the Centers for Medicare and Medicaid Services take action to change the risk adjustment methodology - In February, we wrote about the controversial effect of the federal risk...more

Proposed Aetna-Humana Merger Passes Another Hurdle in Antitrust Review

The proposed merger between major health insurers Aetna Inc. and Humana Inc. continues to inch closer to finalization. In a recent press release, Aetna announced that 10 states have now signed off on its proposed acquisition...more

What Ever Happened To….The Pension Lawsuit Against CIGNA?

One of the cases I’ve covered on this blog since the beginning, was a lawsuit challenging CIGNA’s change from a traditional defined benefit plan to a cash balance plan. In plain English, it was basically (and I’m...more

A Culture of Inclusion: Transgender-Friendly Workplaces on the Rise

American Airlines, The Coca-Cola Co., Humana, Macy’s and Ford. All among the best-known brands in the world, each a stalwart of American business. All of them are among the most transgender-inclusive companies in the country...more

M&A Team News - January 2016

Here is a look back at the top M&A developments that affected deal-making last year and a look forward to our expectations for 2016....more

Supreme Court Limits ERISA Healthcare Plan’s Reimbursement Rights: What Montanile Really Means

Last week, the United States Supreme Court held that an ERISA healthcare benefit plan with reimbursement rights can only obtain “appropriate equitable relief” when enforcing its lien against a third-party settlement, thus...more

IREG Update - FHFA cuts off FHLB access to captives

FHFA cuts off FHLB access to captives - After considering input received in more than 1,300 comment letters submitted in response to a proposed rule issued in 2014, the Federal Housing Finance Agency (FHFA) issued its...more

Day Two Notes – JP Morgan Healthcare Conference, San Francisco

It was another interesting day at JP Morgan, the healthcare conference that never disappoints. Surprising declarations of war and peace, partnering that really works and strong growth stories all were heard today....more

Laboratories – 2015 Year in Review [VIDEO]

Over the past year, significant regulatory changes began to take shape that will have lasting effects on the laboratory industry for years to come. After publishing draft guidance regarding the regulation of laboratory...more

Payers Embracing Telemedicine Cost Savings, Ramping Up Reimbursement in 2016

Often considered the primary obstacle to telemedicine implementation, reimbursement changes are now better viewed as one of the most prominent drivers of telemedicine expansion. Payers are finally beginning to realize what...more

Congress Takes Long Look at Proposed Health Insurance Mergers

While the Department of Justice Antitrust Division is responsible for reviewing the proposed Anthem/Cigna and Aetna/Humana mergers for any potential competitive concerns, Congress jumped into the process with both feet in...more

Health Care Mergers Come Under Scrutiny

In July, 2015, Aetna struck a deal to buy Humana for $37 billion, which would cover 33 million members. Merging with Humana would give Aetna more than one-quarter of the total Medicare Advantage market, analysts say. In...more

IREG Update - October 2015 #2

Hot Topic - The FIO's criticism of state regulators regarding captive reinsurance framework - The Federal Insurance Office in its September 2015 "Annual Report on the Insurance Industry" criticizes state insurance...more

Inevitable Disclosure Doctrine Held Inapplicable To Failed Business Transaction

An Illinois appellate court recently rejected applying the inevitable disclosure doctrine in a trade secret misappropriation spat arising out of a failed business transaction....more

Send Lawyers, Guns and Money:* Providers Lining Up Against Anthem/Cigna and Aetna/Humana Mergers

In the wake of Anthem’s proposed acquisition of Cigna and Aetna’s proposed acquisition of Humana, providers are lining up to be heard. Take the American Medical Association (AMA), for example, which is urging federal and...more

Health Insurers Announce Merger Plans; Congress Announces Intention to Review

In the last few months, several of the largest commercial health insurers in the nation have announced their intentions to merge. First, Aetna (currently the nation’s third largest health insurer by revenue) announced its...more

IREG Update - August 2015 #2

Hot Topic: New York Emergency Medical Services and Surprise Bills Law - Earlier this year, New York’s Emergency Medical Services and Surprise Bills Law went into effect (the full text of the bill is available on the...more

Anthem-Cigna Mega Merger Likely Problematic for Providers

Anthem announced on July 24, 2015 that it would purchase Cigna, just three weeks after Aetna agreed to buy Human for $37 billion. The deal is valued at $54.2 billion, and would create the United States’ largest health insurer...more

Health Care Providers Lacked Standing to Sue as ERISA Beneficiaries: Rojas v. Cigna Health and Life Insurance Company

The U. S. Court of Appeals for the Second Circuit has affirmed a dismissal of claims by two physicians and their medical practice asserting standing under ERISA to enjoin an insurer from removing them from its coverage...more

Will Increased Consolidation in the Insurance Industry Yield Opportunities or Challenges for Investors?

A recent flurry of activity in the health insurance industry would seem to indicate that investors can expect significant consolidation in the managed care sector....more

Impact of the Cigna Health Decision on the Use of the Merger Structure in Private Acquisitions

When buying a private company controlled by a private equity sponsor but with a substantial number of other shareholders, a common technique to avoid the need to obtain signatures from all the shareholders to a stock purchase...more

Insurance Antitrust Legal News: Volume 4, Number 3

Auto Insurers Again Seek Dismissal of In Re Auto Body Shop Antitrust Litigation - In early March, the auto insurer defendants in the In re Auto Body Shop Antitrust Litigation renewed their motions seeking the dismissal...more

Fifth Circuit Finds Out-Of-Network Medical Provider Has Standing To Sue Health Plan

The Fifth Circuit recently addressed an out-of-network provider’s right to sue and whether coverage may be conditioned on collections of patient’s out of pocket costs. North Cypress Medical Ctr. Operating Co., et al. v. Cigna...more

The ERISA Litigation Newsletter - April 2015

Editor's Overview - In this month's Newsletter, Robert Rachal discusses recent "church plan" rulings where some federal judges have declined to give deference to long-standing, consistent guidance from the Internal...more

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