QUOTE AND NEWS
Jutia Group  Oct 14  Comment 
[Business Wire] - WellPoint’s affiliated Medicare offerings for the 2014 enrollment season will include new plans, new provider collaborations, enhanced benefits and online doctor visits. Read more on this. WellPoint Inc. (WLP), valued at...
Market Intelligence Center  Oct 10  Comment 
For a hedged play on WellPoint Inc (WLP) MarketIntelligenceCenter.com’s algorithms selected the Dec. '14 $120.00 covered call for a net debit in the $114.18 area. That is also the break-even stock price for the covered call. This trade will...
MarketWatch  Oct 2  Comment 
Health giant OKs $5 billion boost to share buybacks.
MarketWatch  Oct 2  Comment 
Health insurance giant WellPoint Inc. is increasing its share repurchasing program by $5 billion, the company announced after the close Thursday. The increase brings the total amount of authorized share repurchases to $6 billion. WellPoint said...
Motley Fool  Oct 1  Comment 
We asked our top analysts for their favorites. Here are their picks.
Motley Fool  Sep 25  Comment 
WellPoint's growth from healthcare reform and ageing seniors positions it perfectly to become one of America's most important companies.
Market Intelligence Center  Sep 23  Comment 
For a hedged play on WellPoint Inc (WLP) MarketIntelligenceCenter.com’s algorithms selected the Dec. '14 $125.00 covered call for a net debit in the $118.22 area. That is also the break-even stock price for the covered call. This trade will...
Benzinga  Sep 22  Comment 
The second and third-largest U.S. health insurers diverged in the ratings of an investment bank Monday. Bank of America's Kevin Fischbeck boosted his rating on WellPoint Inc (NYSE: WLP) to Buy with a target of $140, while cutting his rating on...
StreetInsider.com  Sep 22  Comment 
52-Week High: Clorox (NYSE: CLX) $98.31. Clorox popped early on speculation that it rejected a takeover offer from packaged-goods peer. In addition, the company reported its affiliate Corporación Clorox de Venezuela S.A. (Clorox Venezuela) is...
SeekingAlpha  Sep 15  Comment 
By Ashleigh Rogers: WellPoint (NYSE:WLP) is one of the largest managed care companies in the US serving almost 40 million people primarily under its Blue Cross/Blue Shield nameplates in California and 13 other states. While the company is the...




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Wellpoint Inc. (NYSE: WLP) is the largest managed care company in the United States in terms of enrollment, with 28.4 million Blue Cross and/or Blue Shield enrollees as of end FY2010.[1] With its exclusive license to the Blue Cross Blue Shield brand in its most significant markets and the nation's largest provider network, Wellpoint can compete with other managed care companies by offering nationwide access to care at lower costs than smaller companies. Wellpoint's large size helps it negotiate more favorable reimbursement terms with health care providers like hospitals and physicians, which reduces costs and provides a competitive advantage.[2]

Wellpoint's profitability depends on its ability to accurately predict and manage health care costs for its members by using underwriting criteria and negotiating favorable contracts with providers. Upward trends in medical costs and an aging population adversely affect the company's profits by increasing its expenses.[3] The managed care industry is characterized by consolidation and increasing price sensitivity among consumers.

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Key Trends & Forces

Healthcare reform will impact many aspects of WellPoint's business

With the Patient Protection and Affordable Care Act signed, the much awaited and much debated health reform law was put in force. Several of its provisions will affect Wellpoint and other insurers. The overall effect, however, remains to be seen.[4]

The law includes a large number of health-related provisions to take effect over the next four years, including expanding Medicaid eligibility, subsidizing insurance premiums, providing incentives for businesses to provide health care benefits, prohibiting denial of coverage/claims based on pre-existing conditions, establishing health insurance exchanges, and support for medical research. The costs of these provisions are offset by a variety of taxes, fees, and cost-saving measures, such as new Medicare taxes for high-income brackets, taxes on indoor tanning, cuts to the Medicare Advantage program in favor of traditional Medicare, and fees on medical devices and pharmaceutical companies; there is also a tax penalty for citizens who do not obtain health insurance (unless they are exempt due to low income or other reasons). [5]

The expansion of Medicaid together with the health insurance mandate and premium subsidies are projected expand insurance to 32 million Americans without coverage. Wellpoint, as one of the the largest insurers as well as one of the largest Medicaid contractors, stands to benefit from this.[6]

The law will end the practices of refusing to cover patients with pre-existing conditions. This will likely lead to an increase in premium costs; however, given that the rule applies across the board, it may not hurt insurers’ competitive positioning.

Cuts to Medicare Advantage program reimbursements may hurt Wellpoint, with its 470,000 MA enrollees, in the short term. In the long term, Wellpoint may lose out still more: as MA beneficiary premiums increase to reflect lower government reimbursements, Medicare patients may migrate to less profitable Prescription Drug Plans and opt to receive their medical benefits from the traditional government-run Medicare program.

The health care law will also effectively begin to cap insurance company profits in 2011. Insurers will be required to spend 85% of large-group and 80% of small-group plan premiums on medical costs, or else improve health-care quality or return the difference to customers in the form of a rebate. However, Wellpoint reportedly reclassified certain administrative expenses--$500 million dollars worth--in a way that increased its medical loss ratio. In January, Wellpoint began costs such as as nurse hotlines, "medical management," and "clinical health policy," under medical benefits. Thus, the impact remains to be seen.

Rising Unemployment in has led to a Decrease in Health Care Enrollment with Subsequent Losses in Membership.

Unemployment rates are up to current rates reaching at around 9-10% levels -- the highest it has been in a quarter-century.[7] As unemployment increases, laid off workers lose access to employer-based health care. This subsequent decrease in health care expenditure impacts health care providers and the health care industry at large by decreasing their membership.[8] As a result, health insurers has seen a decrease in growth in net income and operating earnings, especially in its health care market.

Rising healthcare costs put pressure on earnings

Rising healthcare cost is a major concern for health insurance companies, and trends show healthcare costs for U.S. businesses rising 9%. These rising medical costs combine with the recession and increased unemployment to create a "tug-of-war" between the need to raise premiums and the downtrend on enrollment and willingness of consumers and business to pay high premiums.[9] These competing pressures are having the overall effect of lowering all health insurers' revenues and margins. Health insurer's ability to mitigate the negative effects of rising healthcare and unemployment will be critical to it's ability to maintain strong earnings and compete in the health insurance industry.

Competition

As the nation's largest managed care organization by medical enrollment, Wellpoint is able to use its size and nationwide presence to negotiate more favorable contracts with health care providers like physicians and hospitals, thereby reducing the amount it spends on health care benefits for members.

Consumers have favored health insurance plans offering larger networks and greater member choice relating to coverage and physicians. The BlueCard program, in which each of the 39 independent Blue Cross Blue Shield licensed companies participates, lets any BCBS licensed company take advantage of any other BCBS licensed company's provider networks and discounts when a member works or travels outside of the state in which the policy is written. The program provides Wellpoint and other BCBS licensed companies with a competitive advantage, especially when competing for the business of employers with offices around the country[10]

Wellpoint enjoys the number one market share in almost all of the 14 states in which it operates using the Blue Cross Blue Shield License. Among these Blue states, the company has a 30 percent or greater share of the market in four of them and another four states in which it has greater than 40 percent market share.[11]

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