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As Anthem surges forward with efforts to salvage its proposed $54 billion merger with Cigna, several obstacles may hinder the Indianapolis-based insurer from successfully completing the merger.

Dayton, Ohio-based CareSource saw enrollment in its ACA exchange plans increase by roughly 20 percent year-over-year across the four states in which it sells exchange-based insurance, according to a Dayton Daily News report. 

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Ontario, Calif.-based Prime Healthcare Services will remain in-network with Anthem Blue Cross after backtracking on plans to end its contract with the Indianapolis-based insurer hours after the decision was publicized, reports the Record Searchlight.

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