Best Insurance Companies To Buy For 2014: Universal American Corp (UAM)
Universal American Corp., incorporated on December 22, 2010, through its health insurance and managed care subsidiaries, primarily serves the growing Medicare population by providing Medicare Advantage products. It provides a variety of healthcare services, including case management and care coordination, clinical quality and utilization review and behavioral health services to Medicaid agencies and other third parties. The Company's business segments include Senior Managed Care, which provides Medicare Advantage segment reflects its Medicare Advantage HMO, PPO and PFFS businesses, and Traditional Insurance segment reflects its insurance products not offered through government programs, which includes Medicare supplement, other senior health insurance, specialty health insurance and life insurance. The Company provides medical management services, information and analysis, and other support services to enable its health care partners to serve their patients better.
In addition , it seeks an opportunity to address the high cost of health care for the remaining 75% of the Medicare population enrolled in traditional fee-for-service Medicare and have joined primarily with primary-care and multi-specialty provider groups to form thirty-one Accountable Care Organizations, or ACOs, pursuant to the Medicare Shared Saving Program, or Shared Savings Program.
On March 2, 2012, the Company acquired APS Healthcare, Inc., known as APS Healthcare. APS Healthcare provides specialty healthcare solutions primarily to Medicaid agencies. APS Healthcare offers a broad range of healthcare solutions, including case management and care coordination, clinical quality and utilization review, and behavioral health services that enable its customers to improve the quality of care and reduce healthcare costs.
Senior Managed Care - Medicare Advantage
The Company's Senior Managed CareMedicare Advantage segment reflects its Medicare Advantage HMO, PPO and PFFS bu! sinesses.. During the year ended December 31, 2012, the Company operated Medicare coordinated care plans including PPOs and HMOs as well as its network-based private fee-for-service (PFFS) and rural PFFS business, which provides coverage to Medicare beneficiaries in 36 states. These businesses provide managed care for persons with Medicare under contracts with CMS. Its HMO plans are offered under contracts with CMS and provide all basic Medicare covered benefits with reduced member cost-sharing as well as additional supplemental benefits, including a defined prescription drug benefit. It operates HMO plans are offered under contracts with CMS and provide all basic Medicare covered benefits with reduced member cost-sharing as well as additional supplemental benefits, including a defined prescription drug benefit. It also has Medicare Advantage HMO operations in locations outside of Southeastern Texas including four counties in North Texas offering TexasFirst Health Plans thro ugh SelectCare Health Plans; nine counties in Oklahoma City offering Generations Healthcare through Today's Options of Oklahoma, Inc; and three counties in Indianapolis, Indiana offering Today's Options HMO through SelectCare Health Plans.
The Company's PPO plans are provided under the name Today's Options PPO, which offered under contracts with CMS and provide all basic Medicare covered benefits with reduced member cost-sharing as well as additional supplemental benefits, including a defined prescription drug benefit. This coordinated care product is built around contracted networks of providers who, in cooperation with the health plan, coordinate an active medical management program. In 2012, the Company offered PPO plans to 41 markets in 120 counties in 17 states.
The Company's PFFS plans are provided under the name Today's! Options,! which offered under contracts with CMS and provide enhanced health care benefits compared to traditional Medic are, subject to cost sharing and other limitations. These pl! ans have l! imited provider network restrictions, which allow the members to have more flexibility in the delivery of their health care services than other Medicare Advantage plans with limited provider network restrictions. Some of these products include a defined prescription drug benefit. In addition to a fixed monthly payment per member from CMS, individuals in these plans may be required to pay a monthly premium in selected counties or for selected enhanced products. In 2012, it offered PFFS products in a total of 36 states, which included PFFS products with network restrictions to 51 markets in 280 counties in 18 states and PFFS products without network restrictions to 1,052 counties in 32 states.
The Company's traditional insurance segment reflects the results of its Medicare supplement, other senior health insurance, specialty health insurance, and life insurance. It designed the products in this segment primarily for the senio r market and market them through its career agency force and its network of independent general agencies. The Company discontinued marketing and selling traditional insurance products after June 1, 2012. This segment also includes other products that it stopped selling several years ago, such as long-term care, medical insurance and disability insurance, as well as previously produced or acquired term, universal life, and whole life insurance products and single and flexible premium fixed annuities.
The Company competes with United Healthcare, Humana, Wellpoint, Aetna and CignaAdvisors' Opinion:
- [By Brian Orelli]
Health insurers such as Universal American (NYSE: UAM ) and Humana (NYSE: HUM ) that offer supplementary Medicare insurance could be hurt if seniors decided to! drop the! added coverage, but I doubt the increased premiums will put a major dent in seniors' budgets. Retirees making more than $85,000 per year will have to pay about $250 more per year than they do right now. Any losses will be more than be made up for by the Centers for Medicare and Medicaid Services' decision this month to reverse its previously announced cuts to reimbursement rates.
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