Health Insurance

Aetna, Inc. is an Ameri coffin nail wellness damages club, which is the use up descendant of Aetna (Fire) Insurance Company, of Hartford, Connecticut. In 1850 Aetna began operation of an Annuity Fund and the partnership would soon to be known as Aetna Life Insurance Company. In 1899 Aetna became one of the first openly held redress companies to enter the wellness redress field. Since then Aetna has become committed to providing entranceway to cost- in force(p) wellness aid of the gameyest possible standard, to protect race against wellness- cerebrate guesss and enable them to achieve two nigh(a) wellness and financial security.Aetna has hand overd such products and services for 150 years, and has the readiness to be a attractor in building a squiffy and effective system of health c ar by cooperating with health condole with professionals and public officials Aetna, Inc. provides a twine of traditional and consumer driveed health upkeep insurance products an d related services, including health check, pharmaceutical, dental, behavioral health, congregation life, long-term aid, and disability designs, and health check worry capabilities. Aetna is a member of the Fortune 100 Aetna Mission & ValuesOur bon tons mission, values and goals are expressed finished The Aetna Way. The Aetna Way, comprising the elements be commencement, encompasses our pctd sense of pop the question and provides clarity as we pursue our operational and strategic goals Why We be The Aetna Mission What We Believe In Our Values What Were Trying to pass on How We Run Our Business Why We Exist The Aetna Mission Aetna is dedicated to share bulk achieve health and financial security by providing diffuse access to safe, cost-effective, exalted- type health criminal maintenance and protecting their finances against health-related guesss.Building on our 150-year heritage, Aetna wear out be a leader cooperating with doctors and hospitals, employers, pa tients, public officials and others to build a stronger, more than effective health care system. What We Believe In Our Values At Aetna, we put the people who use our services at the center of everything we do and live by a core set of values rectitude Quality Service and Value Excellence and Accountability Employee Engagement What Were Trying to AchieveWe seek to achieve superior guest satisfaction done innovative products, comprehensive health and related advances choices, effective service and easy-to-understand breeding. Our goals are To give individuals and families pass onable shell outage choices, helpful service and information so they get the financial protection and health care they need from ginmill through chronic and critical care. To respect and pass effectively with doctors and hospitals by establishing efficient surgical operationes and providing prompt claims salarys and useful information that helps them provide safe, cost-effective, high-quality health care. To provide employers advice, cost-effective benefits choices and programs that improve the health status and productivity of their work forces. To participator with brokers and consultants through responsive service, timely information and attractive commissions so they may effectively advise employers on their benefits choices. To whirl employees an engaging and diverse work environment that permits them to satisfy their professional ambitions, take pride in their contri exceptions and share in Aetnas success. To be a leading corporate citizen, improving the quality of life in communities where we live and work. To award shareholders a superior transcend on their investment in our company. How We Run Our Business Based on our values, which guide our day-to-day activities, we adhere to specific handicraft practices that help us fulfill our mission, reach our goals, and achieve profitable growth. Plans We build and monitor task plans, taking corrective actions on negative variances. Products We develop and undefiledly scathe innovative products. Networks We develop and manage networks of doctors and hospitals to support multiple product and supporting choices. Access to Care We provide our members access to cost-effective high-quality health care piece of music accurately predicating and managing medical cost. Claims and Billing We achieve timely and accurate claims payments and premium billing and collection. Productivity We pursue continuous productive and process improvement. Service We work together effectively cross the organization to give our customers quality service. Information We provide objective information to help our members fool informed decisions intimately heir financial and health care needs. right Achieve financial and operational integrity through clear, prompt and accredited information that accurately reflects our financial and operational performance. Rewards We appreciate effort scarce we recogniz e and reward employees for achieving business results. Satisfaction We deliver superior customer satisfaction. Porters Five Forces of Competition framework views the profitability of an industry as decided by the five forces of competitive pressure. As described be wiped out(p), only high competitive rivalry detracts from the attractiveness of the health insurance industry for firms shortly in the business. Threat of Entry (Low)Entry into the health insurance industry is obstruct by high economies of scale, high capital requirements, and high government and levelheaded barriers. Economies of scale are needed to establish a collection and claims payment network greathearted enough to provide a reasonable weft of providers for patients and in any case allow the insurance company to fork out a simple geographic coverage. Moreover, a large client base is needed to avail risk management. wellness insurance companies need to deport enough patients cover so that they have large enough proportion premiums from healthy patients to cover the costs of taking care of sick patients.There are also large capital requirement because health insurance companies are required by law to have a certain amount of reserves functional to pay claims at all times. Health insurance companies are also required by law to pay out 50-65% of their premiums in medical cost coverage. These government and legal barriers not only peg down a large portion of the financing the health insurance companies, they also determine who muckle operate a health insurance company through licensing. Supplier Power (Low)Suppliers to the health insurance industry allow providers, hospitals, and medical device/pharmaceutical companies. Most suppliers have low price sensitivity due to intense competition to get on a health insurance companies provider list or formulary. Since most people gougenot afford medical care without health insurance, health insurance companies provide a product that is crit ical for a patient to be able to access a suppliers service or product. Additionally, the size of the health insurance company relative to their suppliers tends to be large.Because of their size, health insurance companies purchase health care from hospitals and doctors at a much lower cost than individual patients. Health insurance companies also have bargaining power because suppliers are tall(a) to have the capital or skills required to integrate vertically. Hospitals and providers operate in a low margin business that is always strapped for capital, and pharmaceutical companies dont have the claims processing networks needed in order to provide health insurance. emptor Power (Low) Buyers of health insurance include individuals, employers, and linked groups of people ilk AARP.Buyers tend to have high price sensitivity because health care is a large portion of a buyers total cost, especially employers. Additionally, products from health insurance companies are not well differen tiated. However, buyers have extremely low bargaining power due to their lack of size relative to health insurance companies, information asymmetry, and inability to vertically integrate. Not only can health insurance companies better negotiate with providers/hospitals for discounted health care rates, but health insurance companies also have far superior intimacy of costs.Doctors and hospitals dont routinely display the prices they charge to patients, but health insurance companies have this information through their contractual relationships with providers. Threat of Substitutes (Low) There are fewer substitutes for health insurance. Currently, the main choices buyers have are to have health insurance to cover their medical expenses or pay for health care costs themselves. The high price of medical care, especially for chronic medical conditions and unavoidableness services, makes being a self-pay patient an unattractive option.Therefore, currently 84% of the US population has either private or government health insurance. However, newfound substitutes to health insurance are being developed. Cerner, a healthcare IT company, has started to adduce claims processing services to customers of its IT products. Competitive Rivalry (High) Industry competition is high for several reasons. The industry has a low concentration with the four largest companies in the health insurance business (Wellpoint, UnitedHealth gathering, Aetna, and Health Care Service Corp. invoice for only 25% of the group health insurance premiums written. Additionally, diversity among competitors is low because health insurance companies are heavily regulated. There are nonindulgent regulations on how health insurance companies can structure themselves and what type of products they can or are required to offer. About Aetna Aetna is one of the nations leading change health care benefits companies, serving approximately 36. 1 zillion people with information and resources to help them make better informed decisions about their health care.Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www. etna. com and Aetnas Annual Report at www. aetna. com/2009annualreport. Aetna Aetna (NYSE AET) has long been a leading health care-oriented insurance company, dedicated to providing people with the means to achieve financial security and peace of mind. By oblation employee benefits and long-term care insurance as well as health care, disability, group life, dental, and pharmacy insurance, Aetna uses information and resour ces to help their members make informed decisions about the types of health care they need.The Aetna insurance company serves both employer and individual markets. Aetna provides benefits to employers in all states, with products and services tailored to employers of sizes, from smaller companies to large national employers. In some markets Aetna also provides products and services to individuals and Medicare beneficiaries. Aetna is committed to providing access to cost-effective health care of the highest possible standard, to protect people against health-related risks and enable them to achieve both good health and financial security.Aetna has provided such products and services for 150 years, and has the ability to be a leader in building a strong and effective system of health care by cooperating with health care professionals and public officials. The primary goal of Aetna is to provide innovative products and uncomplicated information that gives its customers the tools they n eed to make the best possible insurance choices to safeguard their health and financial security.Two types of health care and dental plans are offered a risk basis plan where the company assumes most or all of the risk of costs, and an employer-funded basis plan, where the plan is sponsored via an administrative services contract. In the latter situation, it is the plan sponsor rather than the company that assumes the risk. By having a variety of choices, Aetna ensures its clients can find an insurance product to match their needs. Another option that Aetna offers its clients is group insurance.Most Group Life products provide renewable term coverage in fixed amounts, or amounts which are related to individual wage levels. Group Disability Insurance consists of income-replacement benefits for both short and long-term disability. gigantic bourne Care Insurance provides for long-term custodial care expenses in a nursing home, adult day-care facility or at home. Aetna also offers wi de-ranging Case Pensions, which include several retirement products, including annuities and pensions, for defined benefit and plowshare plans.These provide a variety of options, including experience-rated and both guaranteed and non-guaranteed products. Currently, however, new business is not sought. Aetna provides fully-insured, self-funded (ASO) health care products, including Aetna Global Benefits, Medicare+Choice, Pharmacy, Vision, POS, PPO and HMO. Aetna was the first national health insurance company to offer consumer-directed health plans, and continues to be an industry pioneer with products in the Aetna HealthFundA range.This collection of consumer-directed plans includes Aetna PharmacyFundA, Aetna DentalFundA, and a program for the reimbursement of long-term care premiums. Additionally, Aetna is able to offer incorporated HealthFund products. As of March 31, 2006, Aetna provided medical coverage for more than 15 million members. Aetna also provides dental coverage for mo re than 13 million members. Aetnaas Group Insurance business provides a competitive range of asset protection and income-replacement products, including Short Term and Long Term Disability, Managed Disability, Long Term Care, Group Life, and Accidental Death & Personal Loss.As a leader in this field, Aetna provides these services for more than 13 million members. Aetna also offers a wide range of employee benefit plans, despite the rising cost of these plans. Aetna offers employee benefit and insurance products and services that help keep costs low while maintaining a consistently high standard of health care. Services include disease management and patient safety programs, case management plans, and integrated medical, pharmaceutical, dental, disability, and behavioral health information. Aetna, Inc. s a diversified health-care benefits and insurance company that provides a wide range of both traditional and consumer-directed health-related products and services. Aetna, Inc. is a d irect descendent of the Aetna Insurance Company of Hartford, Connecticut. As such, Aetna has been in the insurance business for more than 150 years. In 1996, Aetna merged with U. S. Healthcare. In the twenty-first century, Aetna has get a 100% score on the Human Rights Campaign corporate Equality Index three years running, and remains committed to providing thin health care and insurance benefits in America.