Home Health Care: Insurance and Managed Care WellPoint WellPoint – Business Description

WellPoint – Business Description


Wellpoint (formed after the merger between Anthem and Wellpoint Health Network) is a leading commercial health benefits company in the US.The company is an independent licensee of the Blue Cross Blue Shield Association (BCBSA) and serves approximately 34 million people as the Blue Cross licensee for California and as the Blue Cross and Blue Shield licensee for 13 other states in the US.

The company has three reportable segments: commercial and consumer business (CCB); specialty, senior and state-sponsored business (4SB); and other.

CCB segment includes business units which offer similar products and services, including commercial accounts and individual programs. The company offers a diversified mix of managed care products, including preferred provider organizations (PPOs), health maintenance organizations (HMO), traditional indemnity benefits and point of service (POS) plans. The company also offers a variety of hybrid benefit plans; including consumer-driven health plans (CDHP), hospital only, and limited benefit products. Additionally, the company provides a broad array of managed care services to self-funded customers, including claims processing, underwriting, stop loss insurance, actuarial services, provider network access, medical cost management and other administrative services.

In 4SB segment comprises businesses providing specialty products and services such as Medicare Part D, Medicare Advantage, Medicare Supplement, Medicaid, life and disability insurance benefits, pharmacy benefit management (PBM), specialty pharmacy, dental, vision, behavioral health benefit services, and long-term care insurance. The company also provides network rental and medical management services to workers compensation carriers.

The other segment includes results from Federal Government Solutions business and other businesses that do not meet the quantitative thresholds for an operating segment as defined in FAS 131.The company’s Federal Government Solutions business includes FEP and National Government Services, which acts as a Medicare contractor in several regions across the nation.