Aetna Inc. is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid insurance and benefit programs, and through Medicare. Since November 28, 2018, the company has been a subsidiary of CVS Health.
Health insurance or medical insurance is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among many individuals. By estimating the overall risk of health risk and health system expenses over the risk pool, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to provide the money to pay for the health care benefits specified in the insurance agreement. The benefit is administered by a central organization, such as a government agency, private business, or not-for-profit entity.
The Cigna Group is an American multinational managed healthcare and insurance company based in Bloomfield, Connecticut. Its insurance subsidiaries are major providers of medical, dental, disability, life and accident insurance and related products and services, the majority of which are offered through employers and other groups. Cigna is incorporated in Delaware.
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care. It has become the predominant system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010.
...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.
Teledentistry is the use of information technology and telecommunications for dental care, consultation, education, and public awareness.
Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. Express Scripts had 2016 revenues of $100.752 billion. Since December 20, 2018, the company has been a direct subsidiary of Bloomfield, Connecticut-based Cigna.
Dental insurance is a form of health insurance designed to pay a portion of the costs associated with dental care.
The Delta Dental Plans Association, also known as simply Delta Dental, is an American network of dental insurance companies composed of 39 independent Delta Dental members operating in all 50 states, the District of Columbia and Puerto Rico. These member companies provide coverage to 85 million people, enrolled in over 157,000 groups. While many of the Delta Dental member companies and Delta Dental Plans Association (DDPA) are non-profit organizations, a few of the member companies have for-profit segments.
The Oregon Health Plan is Oregon's state Medicaid program. It is overseen by the Oregon Health Authority.
In the United States, health insurance helps pay for medical expenses through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is used to describe any form of insurance providing protection against the costs of medical services. This usage includes both private insurance programs and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage.
Collective buying power is the ability of a group of consumers or businesses to leverage the group size in exchange for discounts.
The British United Provident Association Limited, trading as Bupa, is a British multinational health insurance and healthcare company with over 43 million customers worldwide.
Catamaran Corporation is the former name of a company that now operates within UnitedHealth Group's OptumRX division. It sells pharmacy benefit management and medical record keeping services to businesses in the United States and to a broad client portfolio, including health plans and employers. Working independently of the government and insurance companies allowed it to operate as a third party verifier; the RxCLAIM online claim processing system allowed for prescription drug claims to be processed online if the customer lived in and filled his/her prescription in the United States. SXC had three separate but interrelated business segments which dealt with prescription drug programs. For 2013, 23% of company revenue came from Cigna Corporation.
Elevance Health, Inc. is an American health insurance provider. Prior to June 2022, Elevance Health was named Anthem, Inc. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Anthem Blue Cross in California, Wellpoint, and Carelon. It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2022, the company had 46.8 million members within its affiliated companies' health plans.
Jake Winebaum is an American entrepreneur. Winebaum is the founder of FamilyFun magazine, Business.com, Brighter.com and co-founder of eCompanies and Applied Cognition.
Zocdoc is a New York City-based company offering an online service that allows people to find and book in-person or telemedicine appointments for medical or dental care. The platform also functions as a physician and dentist rating and comparison database. The service is free for patients, and doctors pay to advertise their appointment slots. Established in 2007, the private company had a $1.8 billion valuation by August 2015, the third-highest for a startup in New York at the time.
Kool Smiles is a dental services provider, based in the United States. Its headquarters are in the Kool Smiles Patient Support Center in Marietta, Georgia, U.S., in Greater Atlanta and has over 100 offices located across sixteen states.
The California Department of Health Care Services (DHCS) is a department within the California Health and Human Services Agency that finances and administers a number of individual health care service delivery programs, including Medi-Cal, which provides health care services to low-income people. It was formerly known as the California Department of Health Services, which was reorganized in 2007 into the DHCS and the California Department of Public Health. On September 10, 2019, DHCS Director Jennifer Kent announced her resignation, effective September 30, 2019. On September 25, 2019, Governor Gavin Newsom appointed Richard Figueroa, Jr. as Acting Director. Will Lightbourne was appointed by Governor Gavin Newsom and began serving as Director on June 16, 2020. Subsequently, Michelle Baass was appointed Director of DHCS by Governor Gavin Newsom on September 10, 2021, replacing the outgoing Will Lightbourne.
Oscar Health, Inc. is an American health insurance company, founded in 2012 by Joshua Kushner, Kevin Nazemi and Mario Schlosser, and is headquartered in New York City. The company focuses on the health insurance industry through telemedicine, healthcare focused technological interfaces, and transparent claims pricing systems which would make it easier for patients to navigate.
