S&P 500 Component
|Industry||Managed health care|
|Founded||May 28, 1853(as Aetna Life Insurance Company)|
|Founder||Eliphalet Adams Bulkeley|
|Headquarters||151 Farmington Ave, Hartford, Connecticut, 06105 U.S.|
Mark T. Bertolini|
(Chairman and CEO)
Karen S. Lynch
|Revenue||US$ 60.535 billion (2017)|
|US$ 3.571 billion (2017)|
|US$ 1.904 billion (2017)|
|Total assets||US$ 55.151 billion (2017)|
|Total equity||US$ 15.837 billion (2017)|
Number of employees
|Parent||CVS Health (pending)|
Aetna Inc. (//; stylized as ætna) is an American managed health care company, which sells traditional and consumer directed health care insurance plans and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans. Aetna is a member of the Fortune 500.
In June 2017, the company announced plans to move its headquarters to New York City in late 2018. On December 3, 2017, it was announced that CVS would purchase Aetna for an estimated $69 billion, a deal which the New York Times reported would "reshape the American health care industry." In doing so, CVS announced the company's headquarters would remain in Hartford, scrapping plans to move to New York City.
- 1 Members
- 2 Lobbying and campaign contributions
- 3 Quality of care
- 4 Current leadership
- 5 Ownership
- 6 Financials
- 7 History
- 8 Fines, lawsuits and settlements
- 9 Life insurance policies on slaves
- 10 See also
- 11 References
- 12 External links
Aetna offers health care, dental, pharmacy, group life, disability, and long-term care insurance and employee benefits, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare. Membership numbers: (as of September 30, 2016)
- 23.1 million medical members
- 14.3 million dental members
- 15.3 million pharmacy benefit management services members
- 13.609 million group insurance members
- An estimated 1,200,000 health-care professionals
- 695,971+ primary care doctors and specialists
- 5,712 hospitals
Lobbying and campaign contributions
Aetna has spent more than $2.0 million in 2009 on lobbying. The company spent $809,793 between January 2009 and the end of March 2009—up 41 percent from the same period in 2008. Aetna's campaign contributions include more than $110,000 to US Senator Joe Lieberman (ID-CT) in 2009. From 2005 through 2009, Aetna contributed $56,250 to Senator Max Baucus (D-MT), chairman of the Senate Finance Committee, making Aetna the senator's seventh highest contributor over that time period.
Quality of care
In the California Health Care Quality Report Card 2011 Edition, Aetna received 2 out of 4 stars in Meeting National Standards of Care and 1 out of 4 in Members Rate Their HMO. In the California Health Care Quality Report Card 2010 Edition, Aetna received 3 out of 4 stars in both Meeting National Standards of Care and How Members Rate Their HMO, for a rating of "Good" (out of "Poor, " "Fair, " "Good, " or "Excellent").
- Mark Bertolini became CEO of Aetna on November 29, 2010, and chairman on April 8, 2011.
- Karen S. Lynch (Rohan) is the President of Aetna.
- Steven B. Kelmar is Executive Vice President of Corporate Affairs and Chief of Staff to the CEO and Chairman, Mark Bertolini.
- Thomas Sabatino is Executive Vice President and General Counsel.
- Richard di Benedetto is Executive Vice President in charge of Aetna International.
- Deanna Fidleris Executive Vice President in charge of Human Resources.
- Shawn M. Guertin is Executive Vice President, CFO and Chief Enterprise Risk Officer.
- Meg McCarthy is Executive Vice President of Operations and Technology.
- Harold L. Paz, M.D., M.S. is Executive Vice President and Chief Medical Officer.
- Fran S. Soistman is Executive Vice President in charge of Government Services
- Joseph M. Zubretsky is Senior Executive Vice President in charge of Healthagen.
It was announced on December 3, 2017 that CVS Health Corporation would purchase Aetna for an estimated $69 billion USD. Aetna stockholders are said to receive $207 USD per share— $145 USD in cash and 0.8378 of a CVS share, or $62 USD in stock. Mr. Larry Merlo will be chief executive of the two brands.
- 1819 - Henry Leavitt Ellsworth, Yale graduate and attorney, becomes second president of Aetna (Fire) Insurance Company, succeeding Thomas Kimberly Brace. Ellsworth, who later became the first U. S. Patent Commissioner, served as Aetna's president for two years until 1821, when he resigned, but Ellsworth continued as a director for another 16 years. Ellsworth's brother, William Wolcott Ellsworth, also served as a director, as well as the company's first General Counsel.
- On May 28, 1853, the Annuity department separated from Aetna Insurance to be incorporated as the Aetna Life Insurance Company, with Eliphalet Bulkeley as president. (The fire insurance company went on to become part of Connecticut General, which merged into Cigna.)
- On November 29, 1853, J. B. Bennett was appointed general agent of the company.
- 1854 Aetna hired its first full-time employee, Thomas O. Enders, later to become company president.
- 1857 Aetna moved to new offices on Hungerford and Cone Streets in Hartford. The Panic of 1857 struck Hartford and the nation, causing the closing of all but one bank and many other businesses. Eliphalet Bulkeley blocked a move to liquidate the company during the economic downturn.
- The Aetna Insurance Company issued life insurance policies on an undetermined number of African-American slaves, naming their owners as beneficiaries.
- 1861 - Aetna began offering participating life insurance policies which paid dividends to policyholders just as the mutual life insurance policies did. Aetna launched its new product with a promotional effort including higher commissions for its agents while most companies were cutting back due to the outbreak of the American Civil War and the consequent loss of premium payments from Southern policyholders. However, the death toll of the war coupled with the booming wartime economy caused an expansion of the life insurance business to match Aetna's expansion.
- 1865 - By 1864 Aetna had increased its volume of business by 600% over 1861 and its annual premium income ninefold, exceeding one million dollars. As a result, Aetna possessed the financial stability and resources it needed to meet the stringent regulatory requirements placed on life insurance companies in Massachusetts and New York; by 1865 the company was authorized to begin soliciting business in these states.
- 1867 - Company income rose from $78,000 in 1861 to $5,129,000 by 1867. Aetna moved to its third home office at 670 Main Street, Hartford. By 1924, Aetna had 94 million dollars, 43% of its assets, invested in farm mortgages.
- 1868 Aetna altered its business practices, hiring its first actuary and abandoning the half-note premium system in favor of an all-cash premium plan.
- 1872 - Eliphalet A. Bulkeley died and Thomas O. Enders became president.
- 1878 - Aetna increased its capitalization from $150,000 to $750,000.
- 1879 - Enders' failing health forced him to resign and Eliphalet Bulkeley's son Morgan G. Bulkeley replaced him.
- 1888 - Aetna outgrew its old offices on 670 Main Street in Hartford and purchased its fourth home office, next door at 650 Main Street; the first building Aetna actually owned, and Aetna's home office for the next 42 years.
- 1891 - Aetna issued its first accident policy, purchased by Morgan Bulkeley himself.
- 1892 - Aetna held its first general agents conference in Chicago.
- 1899 - Aetna became one of the first publicly held insurance companies to enter the health insurance field.
- 1902 - Aetna created an Accident and Liability department to offer employers' liability and workmen's collective insurance, in reaction to the growing strength of the Progressive social reform movement. This would become the cornerstone of the Aetna Accident and Liability Company.
- 1903 - An Engineering and Inspection Division was created to improve workplace safety.
- 1904 - Aetna introduced its first corporate seal, conveying Aetna's status as the largest life insurer in the world writing accident, health and liability coverage; the logo portrayed the company's home office bursting out from within a globe, with large block typeface spelling out Aetna's ranking.
- 1907 - Aetna created a casualty subsidiary to handle items such as automobile property coverage; Aetna soon began aggressively expanding into related lines such as collision and damage. This business developed into the Aetna Casualty and Surety Company.
- 1908 - Aetna hired its first home office female employee (Julia Kinghorn, telephone switchboard operator), the first of what has become more than two-thirds of Aetna’s employees.
- 1910 - Under the management of E. E. Cammack, Aetna began using Hollerith punched cards machines for tabulating and hired 35 women to input mortality statistics on keypunch machines, the company's first female home office clerks.
- 1911 - Aetna began its first national advertising campaign. The same year, Aetna formed a bond department to market fidelity and surety coverages.
- 1912 - Aetna introduced the first combination automobile policy, with several separate types of coverage combined into one contract. Several Aetna insureds were killed on the RMS Titanic.
- 1913 - Aetna formed its second affiliate, the Automobile Insurance Company, to write fire insurance on cars. This soon expanded to include windstorm, tornado, leasehold, and ocean and inland marine insurance. Aetna formed a Group department to sell group life insurance, one of the first insurers to do so; the first step towards Aetna’s current health care business.
- 1960 - Aetna expanded outside the U. S., buying a Canadian company, Excelsior Life Insurance Company. In 1968, it bought a majority interest in Producer's and Citizen's Cooperative Assurance Company, of Sydney, Australia. In 1981, it bought a 40 percent interest in two Chilean companies, and soon thereafter invested in ventures in England, Spain, Hong Kong, Taiwan, Indonesia and Korea.
- 1970 - Aetna's Pension, Casualty and Life Division under the direction of B.E. Burton, President and Lead Actuary, saw billion-dollar growth in the post-ERISA pension administration segment that placed Aetna in the top 5 global pension and investment asset management and recordkeeping firms in the world, with over $11.8 billion (US) in new sales and assets under management during the decade.
- Between 1996 and 1999, Aetna initiated a series of company acquisitions. In 1996, Aetna acquired U.S. Healthcare, founded by Leonard Abramson. In 1998, Aetna bought NYLCare Health Plans for $1.05 billion, adding 2.2 million members. The next year, it bought Prudential HealthCare for $1 billion, making it the largest provider of health benefits in the U. S., with more than 21 million members. The company spent more than $20 million to revamp its computer systems, enabling the company to identify and discontinue unprofitable accounts. With this new and extensive information about policyholders, new management, and a shift in strategy, Aetna sharply raised premiums on less profitable accounts. Within a few years, Aetna shed 8 million covered lives due to premiums that customers could no longer afford.
- 2000 - Aetna hired John Rowe as CEO and executive chairman. Rowe cut approximately 15,000 jobs and raised insurance premiums by 16 percent per year. In 2002, He also shrunk Aetna's customer base from 19 million members to 13 million by abandoning unprofitable markets, including almost half of the counties nationwide in which it offered Medicare products.
- 2000 - Aetna sold its financial services and international businesses to ING for $7.7 billion, spun off its health business to its shareholders, thus focusing its business as an independent health and group benefits company.
- 2001 - Aetna recruited global public relations and marketing executive Roy Clason, Jr. to lead the companies reputation management strategies during Aetna's multi-year corporate turnaround campaign.
- 2006 - John Rowe ended his 65 months as CEO and executive chairman of Aetna; during his tenure, the former Harvard geriatrician earned $225,000 a day (including Sundays and holidays).
- 2007 - Aetna chief medical officer Troy Brennan told the Aetna Investor Conference that, "The (U. S.) healthcare system is not timely. " He cited "recent statistics from the Institution of Healthcare Improvement… that people are waiting an average of about 70 days to try to see a provider. And in many circumstances people initially diagnosed with cancer are waiting over a month, which is intolerable. "
- 2007 - Aetna acquired plan operator Schaller Anderson in July, signaling a push into the growing business of running plans for Medicaid and the State Children's Health Insurance Program.
- 2008 - Aetna CEO Ron Williams received $38.12 million in compensation - the highest annual compensation in the insurance sector and the 22nd-highest compensation of all American CEOs.
- 2008 - Aetna began offering pet health insurance in Alabama, District of Columbia, Idaho, Iowa, Montana, North Dakota and Texas, with plans to quickly expand to all 50 states. “As the new underwriter for Pets Best policies, we look forward to working closely with Pets Best and the AVMA GHLIT to extend the reach of the pet insurance industry to bring trusted, affordable pet health insurance products to pet owners nationwide, ” said Gretchen Spann, Aetna’s head of pet insurance.
- 2008 - Aetna's 2008 revenue, excluding net realized capital losses, increased 14 percent over 2007 to $31.6 billion.
- Through June 30, Aetna took in $14 billion in premiums: $10.7 billion of that amount from employers and employees, $2.9 billion more from Medicare recipients who bought a supplemental insurance plan to cover the gaps in what Medicare covers, and another $400 million for handling Medicaid claims. Aetna reported that it paid out $11.9 billion in health care reimbursements and $2.3 billion in administrative expenses (20 percent).
- On September 22, more than 200 people gathered in front of Aetna's Hartford headquarters to call for a public health insurance option they said is essential to true national health care reform. The insurance industry, including Aetna, has opposed a public option.
- On October 2, Connecticut Attorney General Richard Blumenthal and Healthcare Advocate Kevin P. Lembo asked Aetna and four other insurance companies for information the companies may have sent policyholders regarding the impact of proposed legislation on Medicare Advantage and prescription drug programs. According to Blumenthal, some insurance companies have exaggerated or stretched the impact of health care reform.
- On October 27, Aetna stock values shot up when U. S. Senator Joe Lieberman of Connecticut broke with the Democratic caucus that he is a member of and vowed to join a Republican-led filibuster if the public option was not removed from the Senate's health care reform bill.
- On October 30, Aetna reported a third quarter profit increase of 18 percent.
- On November 3, US Senator Tom Harkin, chairman of the Committee on Health, Education, Labor and Pensions, launched an investigation into health insurance pricing, asking Aetna and three other major insurers to justify their pricing practices. The investigation began after small business owners testified before Harkin's committee that skyrocketing health care premiums were severely hurting their livelihoods.
- Aetna announced the layoff off some 3.5% of its work force, 625 employees, and a similar number of reductions early next year. The current cuts include 160 jobs in Connecticut. "Streamlining our business now will enable us to improve our competitiveness and redirect resources to areas with a greater potential for future growth, " said Aetna CEO Ron Williams. During the third quarter of 2009, Aetna earned $326.2 million, or 73 cents per share. That represents an increase from $277.3 million, or 58 cents per share, in the same quarter last year.
- On November 30, Aetna CEO Ron Williams told analysts that Aetna would increase prices in 2010 and force 600,000 to 650,000 Aetna customers to drop their coverage. Aetna President Mark Bertolini justified the move as "ensuring that each customer is priced to an appropriate margin. " Aetna chief executive Ronald Williams owns 7.6 million Aetna stock and options.
- Aetna filed a $4.9 billion correction to its 2008 health insurance regulatory filings on December 7, 2009. The new filings show that Aetna spends less on small business health care than previously reported. “Health insurance companies have a duty to provide accurate financial information both to consumers and to their regulators about how much money they actually spend on health care and how much they spend on profits, on executive salaries, and on figuring out how to deny care to people when they really need it, ” said Senator Jay Rockefeller, Chairman of the U.S. Senate Committee on Commerce, Science, and Transportation. “Unfortunately, it looks like Aetna and other health insurers haven’t been taking this duty very seriously. I’m disappointed that my Committee had to launch a full-scale congressional investigation to get these companies to meet their basic reporting obligations. ”
- On December 14, Aetna stocks rose dramatically after U. S. Senator Joe Lieberman of Connecticut threatened to filibuster the Senate health care reform bill if it included a Medicare buy-in proposal.
- December 29: Aetna chief executive Ron Williams owns approximately 7.6 million Aetna stock and options. The price gain for Aetna stocks of $8.50 from October lows to December 29 adds at least $37 million in value to Williams' holdings.
- On February 3, Aetna laid off more than 100 Connecticut workers. This follows the lay off of 160 Connecticut Aetna employees in November 2009.
- Aetna reported 2009 fourth-quarter net income of $165.9 million, or 38 cents per share, on $8.69 billion in revenue on February 6, 2010.
- On April 30, Aetna announced a 29 percent increase in net income for the first quarter of 2010 compared with the same quarter a year ago, as the insurer benefited from higher investment income.
- In April, Aetna notified policyholders that it was in a contract dispute with Continuum Health Partners and that its contract with Continuum Health Partners would lapse as of June 5, 2010. Continuum Health Partners comprises five major New York City hospitals: Beth Israel Medical Center, Roosevelt Hospital, St. Luke's Hospital, Long Island College Hospital and New York Eye and Ear Infirmary. The June 5th date passed and the contract lapsed, an outcome that could mean much higher costs for thousands of New Yorkers. Aetna is obligated in its contract with doctors to retain those doctors in-network for a policyholder for a period of a year or until the expiration date of the policyholder's contract, whichever comes first. Aetna did not inform policyholders of this fact. Continuum Health provided a form to policyholders to make this request. U. S. Senator Kirsten Gillibrand has asked executives of Aetna and Continuum Health Partners to re-enter negotiations, saying, "I urge you to re-enter negotiations on a new three-year agreement for reimbursement rates, for the sake of the patients that need health coverage. " In July, the Faculty Union of Pratt Institute, United Federation of College Teachers Local 1460, prepared a letter to Aetna expressing their unhappiness over the termination of the contract.
- In June, Crystal Run Healthcare, a 170-doctor group practice in Orange County, New York and Sullivan County, New York, announced that it would terminate its contract with Aetna on July 31, 2011. Crystal Run stated that, "Aetna proposes to pay us significantly less than other commercial health care plans with whom we contract. Despite good faith efforts, we cannot come to an agreement at this time. We want to afford every opportunity to our patients to make informed choices regarding their health care coverage. " Aetna replied, "It is extraordinary that a responsible physician group would alarm patients in this manner more than a year before there could be any impact to those patients. "
- On July 27, Aetna reported that its second-quarter profit rose 42 percent, as the percentage of premiums the company spent on medical care fell versus a year ago. The insurer earned $491 million, or $1.14 a share, in the three months ended June 30. That compares with net income of $346.6 million, or 77 cents a share, in the same period last year.
- On September 9, Aetna announced that it would demolish its 1,300,000-square-foot (120,000 m2) structure in Middletown, Connecticut that once housed approximately 5,000 Aetna employees on a 261-acre (1.06 km2) campus. Aetna has not said exactly how it will redevelop the site, although a data center currently located there will remain regardless of future plans.
On July 3, 2015, Aetna announced that it planned to acquire Humana for US$37,000,000,000 in cash and stock, or US$230 a share. Aetna and Humana shareholders would have owned 74% and 26% of the new combined company. The acquisition was subject to United States government approval and was expected to close in late 2016.
On January 23, 2017, a federal judge blocked Aetna's merger with Humana, saying it would leave senior citizens with fewer options for Medicare coverage. On February 14, 2017, Aetna Inc. and Humana Inc. officially quashed a $34 billion merger agreement, after judges ruled against the merger for a second time.
On December 4, 2017, CVS Health announced plans to purchase Aetna for approximately $69 billion. The deal is expected to close in the latter half of 2018, subject to approval by both shareholders and federal regulators.
On February 11, 2018, CNN reported that California's Department of Insurance had launched an investigation into Aetna following sworn testimony from Dr. Jay Ken Iinuma, a former medical director for the insurer, in a lawsuit against the insurer in which he revealed he never reviewed any patients' medical records when deciding whether to approve or deny claims for coverage. The California Insurance Commissioner, Dave Jones, issued a statement confirming the investigation the following day. On February 27, 2018, the ranking members of the Senate Committee on Finance and Committee on Health, Education, Labor, and Pensions, Senators Ron Wyden and Patty Murray, issued a letter to Aetna demanding further information regarding Dr. Iinuma's testimony and the insurer's medical claims determination and patient appeal processes.
Fines, lawsuits and settlements
- A jury in California awarded $116 million in punitive damages for "malice, oppression and fraud" to a patient's widow who contended he died after a subsidiary of Aetna delayed approving treatment for stomach cancer that its own doctors had recommended. Lawyers on both sides called it the largest such verdict against a health maintenance organization. In 2001 a settlement was reached.
- The U.S. Court of Appeals affirmed a $1,855,000 federal jury award for Brokerage Concepts Inc. (BCI) against Aetna U. S. Healthcare (formerly U. S. Healthcare), its Pennsylvania subsidiary, and one of its former senior executives, Richard Wolfson. In its suit, BCI accused Aetna U. S. Healthcare of tortious interference with contractual relations. BCI alleged the managed-care company used its economic power in the business of prescription drug sales to coerce one of BCI's clients, the "I Got It at Gary's" pharmacy chain, into using another Aetna U. S. Healthcare subsidiary, Corporate Health Administrators, as its health benefits management firm. According to the suit, Aetna U. S. Healthcare threatened to drop "I Got it at Gary's" from its pharmacy network if the company didn't switch to Corporate Health Administrators.
- The Maryland Insurance Commissioner ordered five Maryland health plans to pay a total of $1.4 million in penalties for failing to comply with the state's claims payment practices; Aetna was cited twice and ordered to pay the largest fine of $850,000.
- The State of Texas fined Aetna $1.15 million for failing to promptly pay doctors and hospitals for services. Texas Insurance Commissioner Jose Montemayor also ordered Aetna to pay restitution to physicians and health care providers who did not receive timely payment for claims.
- The New York Department of Insurance fined Aetna US Healthcare and UnitedHealthcare a total of $2.5 million, citing a litany of bungled claims, improper treatment denials, unlicensed health insurance agents, and poorly performing claims processors using out-of-date software.
- Aetna agreed to streamline communications, reduce administrative complexity, and improve the quality of the health care system, ending litigation between Aetna and 700,000 physicians and medical societies. The physicians' lawsuit, settled for $470 million, charged Aetna with systematically reducing payments to physicians and overriding their treatment decisions.
- Aetna and the American Dental Association (ADA) announced a class-action settlement by dentists who accused Aetna of interfering with dental procedures to cut costs and forcing dentists to comply with excessive paperwork. The settlement called for Aetna to pay $4 million to 40,000 to 50,000 dentists and $1 million to the ADA Foundation, a charitable group.
- Georgia Insurance Commissioner John W. Oxendine fined Aetna's Prudential Health Plan $100,000 for violating Georgia's prompt pay law by delaying claims payments. Aetna companies had been fined four previous times by Oxendine's office, in 2000 and again in 2002, for a total of $411,200.
- The New Jersey Department of Banking and Insurance filed an administrative order levying a $9.5 million fine against Aetna for refusing to appropriately cover certain services provided by out-of-network providers—including emergency treatment—in violation of New Jersey rules and regulations.
- Former Aetna employee Cornelius Allison of Darby, Pa., filed suit against Aetna in U. S. District Court in Pennsylvania after hackers gained access to a company Web site holding personal data for 450,000 current and former employees as well as job applicants. The suit charged Aetna with negligence, breach of contract, negligent misrepresentation and invasion of privacy.
- The Arizona Department of Insurance fined Aetna Life Insurance Company and Aetna Health, Inc. after examination of their practices exposed multiple violations of Arizona insurance laws. The department found that Aetna violated significant state laws governing important areas of health insurance operations, including Aetna's: failure to provide policyholders with information about their rights on appeals of medical claims or services denials; failure to acknowledge receipt of policyholder appeals; failure to notify policyholders about appeal decisions/outcomes; and, in some appeals involving the denial of services for potentially life-threatening conditions, failure to inform policyholders of their decision within the required, expedited time frames.
- Aetna paid a $750,000 fine as part of a settlement with the New York Insurance Department related to the company administering an affordable healthcare plan for the state. Aetna's violations included failing to provide a required 30-day notice of rate increases to about 946 members in 2007, failing to provide notice to 1,406 terminated workers of their rights to convert to another policy, failing to report enrollment data from May 2007 through August 2008, and failing to respond to Insurance Department requests for data in March 2008.
Life insurance policies on slaves
In 2000 Deadria Farmer-Paellmann, head of the nonprofit Restitution Study Group of Hoboken, New Jersey, disclosed that from approximately 1853 to approximately 1860 Aetna had issued life insurance policies to slaveowners covering the lives of their slaves.
Aetna acknowledged that concrete evidence exists for Aetna issuing coverage for the lives of slaves and released a public apology.
In 2002, Farmer-Paellmann brought suit against Aetna and two other companies in federal court asking for reparations for the descendants of slaves. The lawsuit said Aetna, CSX and Fleet were "unjustly enriched" by "a system that enslaved, tortured, starved and exploited human beings." It argued that African-Americans are still suffering the effects of 2½ centuries of enslavement followed by more than a century of institutionalized racism. The complaint blamed slavery for present-day disparities between blacks and whites in income, education, literacy, health, life expectancy and crime.
In 2006, Farmer-Paellmann announced a nationwide boycott of Aetna over the issue of reparations for its policies covering slaves. Aetna stated that its commitment to diversity in the workplace and its investment of over 36 million dollars in such areas as education, health, economic development, community partnerships, and minority-owned business initiatives in the African-American community are more effective at aiding descendants of slaves and African-Americans in general than making restitutions for Aetna's life insurance policies on slaves.
- Related topics
- Health care reform in the United States
- Health care reform debate in the United States
- Health insurance
- Life insurance
- Managed health care
- Medicare Advantage
- Pet insurance
- Public health insurance option
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