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What Anthem, Centene and Cigna Are Telling Investors This Week

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To see photos of other top health insurer executives, click on the arrow on the right side of the gallery box above.

For more of our health insurance market coverage, see our Trump’s ACA World.

Anthem Inc. and Centene Corp. have reported first-quarter earnings this week.

Cigna Corp. held its annual meeting today.

Two things are clear.

One is that just how well, or poorly, the individual and small-group major medical insurance markets are doing is hazy.

Another is that executives at big health insurance companies are not talking in much detail about how they might go about selling commercial health coverage to individuals and small employers.

Managers of companies that sell insurance products such as annuities and supplemental health benefits have been talking about agents and brokers. Managers of the Affordable Care Act public health insurance programs have been talking about agents and brokers.x

(Related: Some ACA Exchanges Discover They, Um… Need You…)

Executives at the big health insurance companies are focusing on how they’ll help improve the quality and efficiency of the health care system.

Here’s a look at some of what the companies and the companies’ executives have said this week, drawn from earnings releases, earnings conference call recordings and, in Cigna’s case, slidedecks created for Cigna’s annual meeting.

1. Anthem Inc.

Anthem is reporting $1.3 billion in net income for the first quarter on $22 billion in revenue, compared with $1 billion in net income on $22 billion in revenue for the first quarter of 2017.

The company ended  the quarter providing or administering health coverage for 37 million people, or 2.5% fewer people than it was covering a year earlier.

Enrollment in the company’s Medicare plans increased 16%, to 1.7 million.

Enrollment in Anthem Medicaid plans fell 1.8%, to 6.4 million.

Enrollment in local group plans fell 0.3%, to about 16 million.

The number of people with individual commercial major medical coverage fell to 755,000, from 1.9 million.

The drop in the number of individual major medical policyholders was due mainly to company decisions to drop out of some states’ Affordable Care Act public exchange programs, executives said.

Another figure of interest to agents and brokers, “selling expense,” fell 8.9%, to $318 million.

Gail Boudreaux, Anthem’s president, talked briefly, during a company conference call with securities analysts, about the idea that the company wants to sell health insurance.

Boudreaux said that the company has set up a new sales effectiveness organization to help the company drive commercial sales while maintaining a disciplined approach to pricing.

She also said that the company will compete harder for the business of employers that want to self-insure, and that she believes the company’s strong brand reputation will help win self-insured employers back.

Boudreaux did not use the words “agent,” “broker,” “distribution” or “consulting” during the call.

John Gallina, the company’s chief financial officer, said the company’s individual major medical business “actually did a little bit better than expected.”

“The strategy that we employed with our reduced footprint is actually playing out extremely well, and that helped,” Gallina said.

2. Centene Corp.

Centene, which is best known as a Medicaid plan manager, is reporting $338 million in net income for the first quarter on $13 billion in revenue, compared with $139 million in net income on $12 billion in revenue for the first quarter of 2017.

The St. Louis-based company ended the quarter providing or managing health coverage for 13 million people, up from 12 million people a year earlier.

The number of people with the company individual major medical coverage increased to 2.2 million, from 1.9 million.

Centene has been active in selling individual major medical coverage through the ACA public exchange system. Centene’s ACA public exchange plan enrollment increased to 1.6 million, from 1.2 million.

For typical commercial health coverage issuers, coping with the severe health problems of many people with ACA exchange plan coverage was a shock.

For Centene, which has been used to dealing with the many Medicaid plan enrollees who have severe health problems, adding exchange plan enrollees has helped bring down the ratio of benefits to revenue. The company’s health benefits ratio fell to 84.3% in the latest quarter, from 87.6% in the year-earlier quarter, thanks to exchange plan enrollment growth, the company said.

Michael Neidorff, Centene’s chairman, declined to say much about his company’s expectations for 2019, but he said he believes any changes could be good for Centene.

“We believe it is unlikely that Congress will pass health care legislation in 2018,” Neidorff said. “We see any health care related changes being done via regulation.”

The Trump administration recently completed the individual major medical and ACA exchange parameters regulations for 2019, and Centene believes it can handle the changes included in those regulations, Neidorff said.

Regulators in Washington state have questioned the adequacy of the company’s exchange plan networks there. Neidorff noted during the conference call that the company has retained about 80% of its 2017 exchange plan enrollees this year. “That’s pretty good for any kind of commercial product,” Neidorff said. “It says that some things were being done right.”

Centene executives did not mention insurance agents, consultants or brokers during the call.

One of the Centene executives on the call was Kevin Counihan. In the past, Counihan was the head of Connecticut’s ACA public exchange program. He later led the public exchange team at the Centers for Medicare and Medicaid Services.

3. Cigna Corp.

Cigna Corp. today posted copies of two annual meeting slidedecks, and one set of annual meeting talking points, on the website of the U.S. Securities and Exchange Commission.

David Cordani, the company’s president, and Cigna, focused mainly on talking about the company’s pending acquisition of Express Scripts, a large pharmacy benefits manager.

In the documents, Cordani and the company talk about matters such as helping the United States control health care costs and improve people’s health, by tackling problems such as opioid abuse. They do not talk about health coverage sales or marketing strategies.

— Read Individual Major Medical Plans Could Still Exist in 2019: Actuary on ThinkAdvisor.

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