Payer

Open enrollment for individual plans on the ACA exchange runs from Nov. 1 to Jan. 15.  

Humana subsidiary CarePlus Health Plans received $641,467 in net overpayments in 2015, an audit by HHS' Office of Inspector General published Oct. 26 found. 

WellCare, Centene's Medicare Advantage subsidiary, will offer co-branded plans with Mutual of Omaha in 2024. 

Employers are looking to deductible-free health plans as employees report increasing concerns about the cost of healthcare, according to Mercer's 2023-2024 "Inside Employees' Minds" survey. 

Aetna is expanding its ACA plans to five new states in 2024. 

Bright Health and Friday Health Plans are unable to meet their risk-adjustment payment obligations, leaving other insurers $1.1 billion short, CMS disclosed Oct. 27. 

Insurers appointed new executives to lead their Medicaid business, and one CEO expects Medicaid expansion is around the corner in more states. 

North Carolina's treasurer, Dale Folwell, is urging the board that oversees the state's employee health plan to end coverage for GLP-1 drugs such as Wegovy and Saxenda, citing high costs.

Jefferson Health Plan will add four new plans in 2024. 

The lead defendant in a 15-defendant healthcare fraud scheme will serve over eight years in prison for conspiring to defraud Blue Cross Blue Shield.