Centene Corp. is now a major player in the New York state government plan and individual major medical insurance markets.
The St. Louis-based company has completed efforts to acquire the assets of New York State Catholic Health Plan Inc., a nonprofit carrier that has been doing business as Fidelis Care, for $3.75 billion.
Centene closed on the deal last week.
Fidelis Care is based in Rego Park, in New York City. The company has been providing or administering health coverage for 1.7 million people throughout New York state, including people in industrial communities such as Buffalo, New York, and Rochester, New York, as well as in New York City.
Fidelis Care has focused on offering Medicaid plans and other plans that serve the poor, such as individual major medical policies sold through the Affordable Care Act public exchange system, and “Essential Plan” policies, or policies that resemble managed Medicaid buy-in policies.
The ACA includes a “Basic Health Program” provision that lets states use ACA subsidy money to offer residents with a moderately low income managed Medicaid buy-in plans. New York state and Minnesota have been the only two states to offer the programs so far, but other states have proposed setting up Basic Health Program arrangements, or similar types of arrangements, as an alternative to struggling ACA exchange programs.
The ACA exchange system is supposed to serve as a web-based supermarket for commercial health coverage. In many markets, exchange plan competition has dwindled.
Centene is a for-profit company that has focused mainly on serving people who qualify for health coverage from Medicaid or for rich ACA public exchange plan subsidies.
Before Centene completed the Fidelis Care deal, it was providing or administering health coverage for about 13 million people.
Centene said in a statement that completing the Fidelis Care gives it a top position in the managed care markets in four big states: California, Florida, Texas, and, now, New York state.
Centene said the Rev. Patrick Frawley, the chief executive officer of Fidelis Care, will continue to be Fidelis Care’s CEO.
Fidelis Care will keep its current headquarters in Rego Park, and it will also keep its existing operations in other communities in New York state, Centene said.
Centene and Fidelis Care have been working on an integration plan over the past nine companies, Centene said.
Centene noted that Fidelis Care now has about 4,000 employees.
— Read Molina and Centene Announcements May Boost ACA Exchange System, on ThinkAdvisor.