In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding.
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.
Unum Group is an American insurance company headquartered in Chattanooga, Tennessee. Founded as Union Mutual in 1848 and known as UnumProvident from 1999-2007. The company is part of the Fortune 500. Unum Group was created by the 1999 merger of Unum Corporation and The Provident Companies and comprises four distinct businesses – Unum US, Unum UK, Unum Poland and Colonial Life. Its underwriting insurers include The Paul Revere Life Insurance Company and Provident Life and Accident Insurance Company.
UnitedHealth Group Incorporated is an American multinational health insurance and services company based in Minnetonka, Minnesota. Selling insurance products under UnitedHealthcare, and health care services under the Optum brand, it is the world's eleventh-largest company by revenue and the largest health care company by revenue.
Moda Tower is a 24-story office building in Portland, Oregon. At 308 ft. (94m), it is Portland's tenth-tallest building. Health insurance company Moda Health is the primary tenant of the high-rise. Unico Properties purchased Moda Tower in 2018.
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.
Insurance in the United States refers to the market for risk in the United States, the world's largest insurance market by premium volume. According to Swiss Re, of the $6.782 trillion of global direct premiums written worldwide in 2022, $2.959 trillion (43.6%) were written in the United States.
Standard Insurance Company, also branded as The Standard, is an American insurance and financial company which is a subsidiary of StanCorp Financial Group, headquartered in Portland, Oregon. On July 23, 2015, Meiji Yasuda, a Japanese mutual insurance group, made an offer to purchase Stancorp Financial for $5 billion. The transaction was completed in the first quarter of 2016.
In the United States, health insurance marketplaces, also called health exchanges, are organizations in each state through which people can purchase health insurance. People can purchase health insurance that complies with the Patient Protection and Affordable Care Act at ACA health exchanges, where they can choose from a range of government-regulated and standardized health care plans offered by the insurers participating in the exchange.
A health insurance mandate is either an employer or individual mandate to obtain private health insurance instead of a national health insurance plan.
The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act (PPACA) and colloquially as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the enactment of Medicare and Medicaid in 1965. Most of the act's provisions are still in effect.
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.
Cover Oregon was the health insurance marketplace for the U.S. state of Oregon, established as Oregon's implementation of the Patient Protection and Affordable Care Act. Cover Oregon was intended to enable Oregonians and small businesses to purchase health insurance at federally subsidized rates.
Covered California is the health insurance marketplace in the U.S. state of California established under the federal Patient Protection and Affordable Care Act (ACA). The exchange enables eligible individuals and small businesses to purchase private health insurance coverage at federally subsidized rates. It is administered by an independent agency of the government of California.
The Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) or nicknamed Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965. Once the law was signed, provisions began taking effect, in a process that continued for years. Some provisions never took effect, while others were deferred for various periods.
Maine Community Health Options v. United States, 590 U.S. ___ (2020), was a United States Supreme Court case involving the expired Risk Corridors program of the Patient Protection and Affordable Care Act (ACA), through which the Department of Health and Human Services (DHHS) mitigated losses of unprofitable healthcare plans through the profits of the profitable plans during the first three years of the program. Congress had passed legislation as riders in appropriations bills, which prevented the government from making payments to the unprofitable plans. Several of the insurers went bankrupt from the lack of payment, and multiple insurers sued the government to recover their funds on the basis the risk corridor was a commitment to be paid. The Federal Circuit Appeals Court rejected those claims, concluding that the subsequent appropriation riders absolved the government of its responsibility to pay. In the 8–1 decision that consolidated three of the subsequent appeals, the Supreme Court ruled that Congress's riders did not cancel the government's obligation under the ACA to pay the full amount to the unprofitable plans, and that the insurers had properly sought relief through a Tucker Act action in the Court of Federal Claims.
A risk corridor is a provision in US healthcare legislation that aims to stabilize health insurance premiums by limiting the financial risks borne by insurance providers. Risk corridors are found in Medicare Part D and the Affordable Care Act (ACA). In the Medicare Part D prescription drug program, risk corridors were established to protect participating insurers from bearing an excessive amount of risk due to fluctuations in drug pricing. These risk corridors were intended to ensure that the program was financially viable for insurers, while also helping to keep premiums affordable for consumers.
Mountain Health CO-OP, formerly Montana Health CO-OP, is a nonprofit, member-led health insurance company that currently offers products in Montana, Idaho, and Wyoming. The company was founded as a health insurance cooperative under a provision of the Patient Protection and Affordable Care Act for the purpose of introducing more competition into state insurance markets.
