AIS's Directory of Health Plans: 2009

AIS's Directory of Health Plans can help you locate health plan industry players and track business trends with enrollment data and contact information for health insurance companies and primary care preferred provider networks operating in the U.S. The 2009 edition includes data records for 463 health insurance entities and 164 PPO networks.

This resource provides data so you can:
--See how the economic downturn has affected your competitors and partners by tracking changes in commercial and public-sector membership,
--Conduct accurate market share analysis,
--Find out who does what at health care companies,
--Research a health plan or provider network and find out what they do and how big they are,
--Establish enrollment benchmarks,
--Identify potential business partners and clients, and
--Compare network access fees and identify PPO networks that provide the services you need.

Believed to be the most thorough and definitive tool available for calculating health plan market share, AIS's Directory of Health Plans features many new enrollment fields to present a more accurate picture of the national health insurance market and of each health plan. In restructuring the way enrollment data is collected and counted, the 2009 edition reflects the way in which the health insurance industry has evolved, and the diversity of health plan models now available.

This allows for greater distinction between commercial vs. public-sector (government) markets, and also between fully funded (insured) products vs. self-insured or administrative services only (ASO) business.

Listings cover:
-Contact information, such as address and phone
-Key executives by function: CEO, President, Operations, Finance, Medical, Legal, Provider Relations, Marketing, Member Relations, Pharmacy, Specialty Pharmacy, PR, Information Systems, Purchasing
-Types of products offered: HMO, POS, PPO, FFS / Indemnity, CDH - HRA and HSA, Medicare - Coordinated Care and PFFS, Medicaid HMO, SCHIP, and others
-National & state-level enrollment in medical insurance products, broken down by funding mechanism, type of product, market sector, and plan model
PPO Network information such as: dependent factor, total physicians and hospitals, avg. benefit in and out of network, case mgmt fee/hour, utilization mgmt fee PMPM, network access fee, avg savings, states served and enrollment by state, services offered - Utilization Mgmt, Workers Comp, Case Mgmt, Pharmacy Network, Claims Repricing, Claims Processing, Available for Lease, Disease Mgmt

Table of Contents
Chapter 1:Highlights
--Health Plans Ranked by Total Enrollment
--Top 50 PPO Networks by # of Lives
--Health Plan and Network Subsidiaries and Affiliates, by Owner
--Health Plans Listed by Contracted or Affiliated PBM
--% of Health Plan Enrollment by Risk Type
--% of Commercial Risk-Based Enrollment by Plan Model
--% of Non-Risk (ASO) Enrollment by Sector
--Individual (commercial non-group) Enrollment as a % of Total Enrollment
--Top 10s by Enrollment: Total Commercial Risk, HMOs, PPOs, Medicare Advantage, Medicare PFFS, Medicaid HMO, CDH, Fully-Funded vs. Self-Insured or ASO
Chapter 2: Directory of Health Insurance Companies
Chapter 3: Directory of Preferred Provider Networks
Chapter 4: Health Plan Enrollment by State