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About This Resource

View sample pages
(in PDF format):

From Chapter 2: Directory of Health Insurance Companies

From Chapter 3: Directory of Preferred Provider Networks

From Chapter 4: Health Plan Enrollment by State

Honors
AIS’s Directory of Health Plans is used by J.D. Power and Associates to calculate market share statistics in their annual J.D. Power and Associates National Health Insurance Plan Satisfaction Study.
For the sixth 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 as an official directory resource of AHIP Solutions.

Table of Contents
(2009 edition)
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

Related Publications
Health Plan Week
Drug Benefit News
Health Plan Facts, Trends and Data
AIS’s 2003-2007 Health Plan Enrollment Statistics

AIS’s Directory of Health Plans: 2010

At AIS, we pride ourselves on maintaining this extensive, proprietary database of information and publishing reliable and practical information that can help you in evaluating market trends and succeeding in the health care market. You can use the data in AIS’s Directory of Health Plans to:

• Discover which health plans offer certain types of plan models — and in what states — so you can gauge your competitors’ strengths and identify where your opportunities for market expansion lie.
• Gain insight into the increasing diversity of health plan models as benefit designs adapt to meet marketplace demands.
• Create targeted mailing lists and develop call lists to network and generate leads for prospective new partners.
• Determine which PPO networks may best serve your benefit design offerings.
• Track shifts in branding as organizations have started to position themselves as national brands versus state or local entities, and as integrations, mergers and acquisitions change the competitive landscape.
• Develop benchmarks for determining the prevalence of certain type of plan models and create projections about which areas are likely to grow.

AIS’s Directory of Health Plans not only provides enrollment data, but also gives you charts, graphs, and tables to help you answer these vital questions:

• Where do you and your competitors stand nationwide in regards to enrollment and market share?
• Who are the largest PPO networks and where do they operate?
• What are the top health plans by plan model type?
• Which plans have gained NCQA accreditation status for quality of care and service?
• What PBMs are contracted or affiliated with which health plans?

Also Available as a Convenient CD Database

AIS’s Directory of Health Plans comes in two versions — a printed book version and a CD database (which comes with a free copy of the book) to best suit your needs. The CD contains all of the data in the book in multiple file formats (Excel, Access, dBase and ASCII), so you can easily create the specific kind of analysis you want. The CD also has all of the contact information electronically in mailing lists, so you can quickly select targets based on job function, company or state. Plus, the CD also contains a PDF version of the book for fast keyword searching.

Exclusive CD Bonus! The CD database version of AIS's Directory of Health Plans: 2010 contains additional enrollment details for large, multi-state health plans that can be used for market analysis. From data independently researched by AIS staff, this information is available only on the CD database.

Health Insurance Companies Company information — Company Name, Company Owner, Profit Status, Private/Public, Stock Symbol, Aliases, Contracted PBM, States Served Contact information — Address, URL, Telephone, Fax Executives by job function — CEO, President, Operations, Finance, Medical, Legal, Provider Relations, Marketing, Member Relations, Pharmacy, Specialty Pharmacy, Public Relations, Information Systems, Purchasing Enrollment data — Total Medical, Total Fully Insured, 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, Medicaid HMO (Risk), SCHIP and Other Public-Sector, Other/Unspecified Risk, Total Shared-Risk, Total Self-Funded, Commercial Non-Risk, Public-Sector Non-Risk, CDH (HRA-Based Plans, HSA-Qualified Plans), Individual (non-Group), Fully Capitated, Partially Capitated, Non-Capitated, Other

PPO Networks Company information — Network Name, Company Name, Parent/Owner, Profit Status, Private/Public, Stock Symbol, Contracted or Affiliated PBM(s) Contact information — Address, URL, Telephone, Fax Executives by job function — CEO, President, Operations, Finance, Medical, Legal, Provider Relations, Marketing, Member Relations, Pharmacy, Public Relations, Information Systems, Purchasing Network information — Lives With Network Access, Claims Processed per Year, Dependent Factor, Number of Employer Clients, Number of Payer Clients, Average Benefit In Network, Average Benefit Out-of-Network, Total Physicians, Total Hospitals, States Served Enrollment specific to each state, the District of Columbia and Puerto Rico Services offered and fees — 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, Average Savings

From Chapter 2: Directory of Health Insurance Companies

From Chapter 3: Directory of Preferred Provider Networks

From Chapter 4: Health Plan Enrollment by State

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.

All known health insurers and PPO networks operating as of Jan. 1, 2009, 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, 2008 and Dec. 31, 2008. Organizations were contacted by mail, fax or email and were offered options to fill out an online or paper form, or to provide information via email, fax, mail or telephone. Data provided directly by the companies via survey is deemed to be the most accurate and up-to-date information on that company. For companies that do not return a survey response, or where blanks are left on survey responses, researchers endeavor to complete the company record through other available means.

Fully insured HMO enrollment, when not provided by the company, is from third-quarter 2008 state department of insurance filings where available. In the few states that do not release quarterly statements, annual statements for 2007 were used to supplement the survey research for HMOs operating in those states. Medicare enrollment, when not provided by the company, was updated from the Centers for Medicare and Medicaid Services (CMS) records from October 2008. Medicaid enrollment, when not provided by the company, was taken from state reports ranging in date from September to December 2008. Data from company Web sites, SEC filings, company press releases and published news reports were used to supplement the records.

The 2010 edition will begin shipping via UPS in February 2010. Please give us your street address when you order because UPS does not deliver to PO boxes. Shipping cost is $5 per item.

Order AIS’s Directory of Health Plans for a 30-day risk-free inspection and test for yourself the value of this new data and analysis resource when it delivers in February. If within 30 days you’re not 100% satisfied, just return it to AIS and we will send you a prompt, full refund. For CD version purchasers, please review your copy of the print version before breaking the seal on the CD package. Refunds will not be made once the seal on the CD package has been broken.

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