Timely Health Plan News and Commentary
A small number of national carriers insure a large share of Americans. UnitedHealthcare, Elevance Health, Aetna (part of CVS Health), Cigna, Humana, Centene and Molina Healthcare operate across commercial, Medicare and Medicaid markets, while regional plans such as Kaiser Permanente, Cambia Health Solutions, Oscar Health and Clover Health compete in specific states. Their decisions determine which plans are sold, which providers are in network, and how much members pay.
This section covers carrier strategy and corporate news: market entries and exits, Medicare Advantage expansions, Medicaid managed care contract awards, provider network agreements, mergers and acquisitions, quarterly results, leadership changes, regulatory settlements and litigation. When a carrier changes its approach to prior authorization, claims processing or pharmacy benefits, we report what it means for members.
For a directory of carriers and their websites, see our List of Health Insurance Companies. The independent Blue plans have their own section, Blue Cross Blue Shield, because each Blue company makes its own decisions in its own markets.
Carrier news touches almost every other section of the site. Plan-year changes appear in Health Insurance Coverage, Medicare Advantage news appears in Medicare, and state contracts appear in Medicaid and CHIP. Deals, earnings and executive appointments across the wider industry are covered in Healthcare Business, and pharmacy benefit manager (PBM) developments, including those at Express Scripts, CVS Caremark and Optum Rx, appear in Prescription Drugs and Pharmacy.
The latest health insurance company news appears below, newest first.
A single health insurer controls at least half of the commercial health insurance market in 15 states, and a Blue Cross Blue Shield company is the largest insurer in 43 of 50 states and the District of Columbia, according to the latest American Medical Association (AMA) study of insurer competition. In Alabama, Blue Cross and Blue Shield of Alabama holds 84% of the market.
Cigna is leaving the ACA individual market in all 11 states where it sells Marketplace plans for 2027, and several other insurers are pulling out of individual states, from UnitedHealthcare in Georgia to Molina in Florida, Illinois and Ohio, according to KFF’s tracking of insurer participation and state regulators.
Health insurers are returning about $759 million to customers in 2026 under the Affordable Care Act’s medical loss ratio rule, less than half the $1.64 billion they paid in 2025, according to a preliminary KFF estimate based on insurer filings.
Nearly 68 million Medicaid enrollees, 78.2% of the program, got their care through a comprehensive managed care plan in 2024, according to federal enrollment data from the Centers for Medicare & Medicaid Services (CMS). Counting dental, behavioral health and other limited plans, 84.8% of Medicaid’s 86.9 million enrollees were in some form of managed care.
Insurers selling Affordable Care Act (ACA) plans on HealthCare.gov denied 18.7% of the in-network claims they received in 2024, according to federal data analyzed by Health Plan News. That is 84.5 million denied claims out of 451 million, and the rate ran from 2.7% at the best insurer to 35.7% at the worst.
CVS Health plans to split into two publicly traded companies. Aetna, the CVS Caremark pharmacy benefit manager, CVS Specialty, Oak Street Health and Signify Health will stay together under the CVS Health name. The roughly 9,000 CVS stores, the mail pharmacy and MinuteClinic will become a separate company called CVS Pharmacy. The company announced the plan on November 4, 2026 and expects to finish it in the first half of 2028.
A hospital admission can feel stressful even when you already have health insurance. Many families assume that a policy automatically removes every upfront payment, but hospital billing and claim approval often follow a step-by-step process. A deposit is usually taken to begin treatment, secure admission, or manage expenses until approval arrives. Understanding this helps you plan better and choose the best health insurance plans for your needs. [Read more…]
Wellcare, the Medicare brand of Centene Corporation, has announced the start of the 2026 Medicare Annual Enrollment Period for Florida. From October 15, 2025 through December 7, 2025, Medicare beneficiaries can review their coverage and switch to a plan that fits how they live now, not how they lived three years ago. Coverage for new enrollments and changes will begin on January 1, 2026.
As summer wraps up and backpacks start appearing by the door, Fidelis Care is reminding New York families that a smooth start to the school year begins with a focus on health, safety, and emotional readiness. With more than 2.4 million members statewide, the health plan — part of Centene Corporation — is using the back-to-school season to share practical advice that can help set children up for success both inside and outside the classroom. [Read more…]
Getting health insurance is supposed to provide peace of mind. But for many, it turns into a nightmare when insurers reject claims for critical treatments. Pegasus Legal Capital is stepping in to help, offering financial assistance to patients whose insurers refuse to pay for necessary medical care. [Read more…]
The Bowen Homes community in Atlanta is getting a much-needed revival, thanks to a partnership between Peach State Health Plan, the Centene Foundation, and city leaders. A groundbreaking ceremony on March 5 marked the start of a project that will bring affordable housing, health services, and community resources to the area. [Read more…]
In a chilling incident that has shaken the corporate world, Brian Thompson, CEO of UnitedHealthcare, was fatally shot early Wednesday morning outside the Hilton Hotel in Midtown Manhattan. Authorities have described the attack as premeditated, with the masked gunman lying in wait before striking. [Read more…]
In a significant move aimed at improving the lives of North Carolina’s youth impacted by domestic violence, WellCare of North Carolina has announced a $100,000 donation to Camp HOPE America. This initiative, which supports children affected by domestic violence and trauma, comes as part of WellCare’s ongoing efforts to foster healthier, safer communities across the state. [Read more…]
In a monumental step towards supporting victims of domestic violence, WellCare of North Carolina and the Centene Foundation have announced a $1.95 million investment in The Umbrella Center, a new family justice center in Charlotte. This three-year investment will aid in developing the center at 4822 Albemarle Road, which is set to open in the summer of 2026, and provide essential services to those impacted by domestic violence, sexual assault, elder abuse, human trafficking, and child abuse. [Read more…]
In a heartwarming display of solidarity and inclusivity, eleven schools across Texas joined forces with Superior HealthPlan and the Centene Foundation to champion No One Eats Alone® Day for the eighth consecutive year. This transformative initiative, dedicated to combating social isolation among students, has emerged as a beacon of hope, fostering a culture of belonging and acceptance in schools statewide. [Read more…]
In a strategic move to supercharge growth across its global health empire, The Cigna Group (NYSE: CI) has just dropped the bombshell of leadership changes. Brace yourselves for a wave of transformation that promises to reshape the landscape of Evernorth Health Services and Cigna Healthcare. [Read more…]
Nevada residents, get ready for some fantastic news! Cigna Healthcare is making its Medicare Advantage (MA) debut in the Silver State, marking a significant milestone for the renowned health insurer. The company is set to launch its $0 premium MA plan in two counties within the Las Vegas area, promising attractive extra perks and access to a trusted network of healthcare providers. The plan is set to take its inaugural bow during Medicare’s Annual Enrollment Period (AEP), which kicks off on October 15 and runs through December 7, with a start date of January 1, 2024. [Read more…]
Cigna Healthcare is set to provide an extended range of Medicare Advantage (MA) plans across 29 states in 2024, catering to the diverse needs of older adults and dual-eligible beneficiaries. These expanded offerings aim to enhance healthcare accessibility and affordability for millions of potential customers. [Read more…]
Allina Health | Aetna has unveiled an array of significant updates to its Medicare Advantage (MA) plans for 2024. These enhancements aim to provide increased value, additional cost savings, and flexible fitness benefits to beneficiaries, including those who qualify for Extra Help. [Read more…]
Cigna Healthcare, the health benefits provider under The Cigna Group (NYSE: CI), is taking a proactive stance this autumn to combat food insecurity among older Americans. With a significant investment of $1 million, the company aims to make a substantial impact by supporting both national and community-based organizations. This initiative is expected to provide over 3 million meals to those in need, enhance access to 1.88 million pounds of fresh produce, and contribute to the conservation of 21 million gallons of water and the reduction of 2.89 tons of CO2e emissions through responsible food distribution. These efforts align with the goal of improving health outcomes while positively impacting the environment. [Read more…]
Cigna Healthcare is the health benefits division within The Cigna Group, (NYSE: CI). Virgin Pulse is a digital-first global health and well-being engagement firm. This partnership will provide a more connected and personalized health experience for approximately 11 million customers. This new platform is available on myCigna and is part of Cigna Healthcare’s commitment to empower people – and their workforces – to make healthier choices and to develop healthier habits. [Read more…]
Enhance Health announced the addition of two new members to its executive leadership team, as the company continues to expand rapidly. [Read more…]
Centene Corporation, a leading healthcare company committed to helping people lead healthier lives, has been selected as one of Newsweek’s” America’s Greatest Working Places 2023.” Centene Corporation, one of the 1,000 U.S. businesses that made the list’s inaugural edition, received the highest rating possible: five stars. [Read more…]
Valera Health, a telemental healthcare provider known for its high-quality and accessible care, recently announced its comprehensive mental health services are now in-network for some Humana Medicare Advantage members. [Read more…]
Cambia Health Solutions is pleased to welcome Mike Rains as its next chief financial officer to lead the critical work of driving financial stability across the enterprise. [Read more…]
The Cigna Group announced today Chris DeRosa, President, U.S. Government, will assume leadership of Cigna Healthcare’s Medicare and Individual & Family Plan (IFP) businesses, as Chuck Berg, Senior Advisor, announces his departure. [Read more…]
Celent, a global research and consulting company, has recognized Cathay Life Insurance for its expertise. This is the fifth Model Insurer Award that the company has received. Celent is a leading consulting firm in the financial technology sector, and the Model Insurer award is the highest honor that an industry can receive. [Read more…]
The Cigna Group, a global health company (NYSE:CI), announced today that Dr. Philip Ozuah was appointed to its Board of Directors. His appointment will take effect on June 1, 2023. [Read more…]
vybe Urgent Care, the largest independent operator of urgent-care centers in Greater Philadelphia, announced that it now accepts UnitedHealthcare Community Plan for Families (CHIP) and CHIP. The new plans, which are in addition to UnitedHealth Group commercial insurance plans, are available at all of vybe’s locations. [Read more…]
CVS Health (r) has announced that Brian Kane, Executive Vice President and president of Aetna will join the company on September 1, 2023. He will join the executive leadership team of CVS Health and report directly to Karen S. Lynch, President and CEO. [Read more…]