Florida insurance regulators give Aetna-Humana merger the green light

Another state has approved Aetna's acquisition of Humana, according to the Miami Herald.

The Florida Office of Insurance Regulation approved Aetna's plan to purchase Humana — but there are a few conditions.

Here are five things to know about the conditional approval.

1. Officials in Florida believe the acquisition will likely have little impact on insurer competition in the state. "Florida's evaluation was based on a thorough review of the competitive environment in the state," said Aetna in a statement, according to Forbes. "We are pleased that in its review, the OIR recognized how traditional Medicare competes with Medicare Advantage plans, and that consumers have robust choice in a competitive landscape."

2. In Florida, Humana covers a large number of enrollees in government-sponsored plans. Over one million Floridians are enrolled in plans from Humana or CarePlus, a Medicare HMO owned by Humana. Overall, Humana covers 340,000 Medicare Advantage members, 98,000 CarePlus members and 326,000 Medicaid members in the state, according to state records.

3. Regulators imposed a number of conditions, including:

  • Aetna must enter five new counties by 2018 and offer a detailed plan for statewide expansion by 2020.
  • Aetna must continue its "fair treatment" of its consumers with HIV, according to the report. In late 2014, Humana reached a similar agreement with the state due to a federal complaint regarding discrimination.

4. The Aetna-Humana deal isn't complete yet. The Florida Attorney General still must review the deal, as must the U.S. Department of Justice.

5. Aetna claimed it has "secured 10 of the 20 state approvals required" for the sale. Nevertheless, the DOJ may still "require divestitures in some geographies," according to Aetna's statement cited in Forbes. Still, Aetna claimed these divestures are a "standard tool," and that "[i]f divestitures are required, there are competitors in good standing that are able to provide consumers with options," according to Aetna's statement.

Copyright © 2022 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Webinars

Featured Whitepapers

Featured Podcast

Top 40 articles from the past 6 months