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Health plans

Zywave , Inc.

http://www.zywave.com

Zywave is a pioneer in developing industry-leading employee benefits and property & casualty insurance software solutions for brokers and their clients. Our insurance agency software includes agency management, claims data analysis, benefit plan analysis, compliance, risk management, client communication, agency marketing, and pharmacy benefit management solutions. As the insurance technology industry continues to evolve, so do we. Every day, we look for new ways to help brokers differentiate their agency through advanced property and casualty and employee benefits insurance software. Designed by brokers for brokers, our insurance software solutions are utilized by nearly 1,000 partners, representing a majority of the top 100 insurance brokers, to retain and grow their business.

  • 12/8/2013
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Clear Choice Health Plans Inc

http://www.clearchoicehp.com

Clear Choice Health Plans, Inc. offers large group plans for employers with 50+ employees. As a health insurance company based in Oregon, we understand the needs of Oregonians. We offer health plans designed to meet each employer's unique needs and personal customer service you would expect from a company that is part of the community. In addition to a complete panel of local providers, our members have access to an extensive network of providers nationwide. Brokers, please contact us at (541) 388-9228 or marketing@clearchoicehp.com for details.

  • 12/8/2013
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Altius Health Plans Inc

http://www.altiushealthplans.com

Altius Health Plans offers a wide range of products to meet the needs of the Utah employer groups and individuals families. All of Utah's fine physicians and hospitals can be accessed through one of the Altius benefit packages. They include: Peak Advantage A unique plan featuring total choice of all health care providersâ€"all of the timeâ€"under a simple four-tier benefit plan.

  • 12/8/2013
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MultiPlan , Inc.

http://www.multiplan.com

Founded in 1970, MultiPlan is the nation's oldest and largest supplier of independent, network-based cost management solutions. With more than half a million healthcare providers under contract, an estimated 40 million consumers accessing our network products, and some 73 million claims processed through our networks each year, we're the right choice for healthcare payers and providers, who today face unprecedented cost and competitive pressures. We're large enough to offer solution breadth and depth, yet nimble enough to tailor our solutions to the evolving needs of payers and providers. And, we're also the only company that can offer access to the leading independent national primary PPO, as well as our complementary network and fee negotiation services through a single electronic claim submission. We have the right experience to offer the right solutions, the right systems and the right service for today's healthcare payers and providers.

  • 12/8/2013
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Maine Employers' Mutual Insurance Company

http://www.memic.com

Maine Employers' Mutual Insurance Company (MEMIC) is a private mutual insurance company, based in Portland, Maine. We sell workers' compensation insurance to Maine employers and also serve as the guarantor of workers' compensation for all employers in the state. MEMIC is the parent company of Manchester, N.H.-based MEMIC Indemnity Company, which insures employers across the U.S. Our hallmark is unmatched commitment to workplace safety and fair treatment for workers. Since our inception in 1993, workplace injuries have dropped more than 30 percent in Maine. Today, MEMIC is Maine's largest and leading workers' compensation insurer. We insure more than 21,000 employers and their estimated 170,000 workers. MEMIC maintains an "A" (Excellent) by A.M. Best, the insurance industry's most respected benchmarking organization. MEMIC Indemnity Co. is rated "A-" (Excellent) by A. M. Best.

  • 12/8/2013
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CareCore National LLC

http://www.carecorenational.com

Since 1994, CareCore National has provided comprehensive, customized programs to health plan clients that seek to manage appropriate utilization of diagnostic imaging services. CareCore National's innovative, and quality-driven approach to radiology utilization management has made it the country's fastest-growing outpatient diagnostic imaging utilization management services provider. In addition to utilizing expert clinical criteria, CareCore National uses innovative approaches managing all aspects of diagnostic imaging services working with its clients to identify opportunities to improve utilization and enhance quality. CareCore National's expert staff, comprised of medical directors and nurses, administers the dynamic clinical protocols and innovative approaches required for imaging management. CareCore National is the largest radiology benefit management company, covering over 24 million national subscribers, and is certified by the National Committee for Quality Assurance and URAC (American Accreditation HealthCare Commission).

  • 12/8/2013
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International Student Organization

http://www.isoa.org

ISO, International Student Organization, is a membership organization for international students who are currently studying in the USA, and for American students studying abroad. Founded in 1958, ISO was established as a solution to the particular needs of international students. We decided to concentrate our efforts on students who are looking for a comprehensive medical insurance with minimum out-of-pocket expenses. ISO is a leading service provider organization administered solely by current and former international students. Our own academic experience has shaped the organization, allowing us to offer students basic services and information that will make their course of study more pleasant. Our aim is to offer international students the best medical insurance at the most affordable price. Our reputation as a proactive student organization has given us access to leading insurance carriers.

  • 12/8/2013
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Community Care Behavioral Health Organization

http://www.ccbh.com

Community Care Behavioral Health Organization (Community Care), a non-profit, federally tax-exempt, behavioral health managed care organization (BH-MCO), manages behavioral health services for nearly one million members whose health coverage is sponsored through Medicaid, Medicare and commercial plans. Incorporated in 1996, our mission is to improve the health and well-being of the community through the delivery of clinically effective, cost-efficient, and accessible behavioral health services. Our vision is to improve the quality of services for members through a stakeholder partnership focused on outcomes. We believe that quality is measured by the improved health of our members, which translates to higher functioning in the community. Community Care believes that the highest quality services are best provided through a not-for-profit partnership with public agencies, experienced local providers, and involved members and families. We continually strive to improve the quality of services for our members. With a network of approximately 2,000 behavioral health providers and headquartered in Pittsburgh, Pennsylvania, Community Care is the only BH-MCO with contracts in every Pennsylvania HealthChoices region (Southeast, Southwest, Northeast, North Central, and Lehigh-Capital). Community Care manages behavioral health care for nearly 600,000 Medicaid managed care enrollees in both urban and rural settings , more than any other BH-MCO in the Commonwealth. We currently manage approximately $600 million in medical services and administrative revenue. With nearly 500 employees, Community Care has multiple offices that serve the five HealthChoices regions; in the Lehigh-Capital region (Camp Hill, Pennsylvania), Northeast region (Scranton/Wilkes-Barre, Pennsylvania), North Central region (State College-opening June, 2007, Dubois-opening June, 2007, Stroudsburg-opening July 2007), Southwest region (Pittsburgh, Pennsylvania), and Southeast region (Exton, Pennsylvania).

  • 12/8/2013
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Fiserv Health Inc

http://www.fiservhealth.com

Fiserv Health's BPO services provide: Predictable fixed costs Minimized up-front capital resource outlays Seamless management of workloads (without fixed infrastructure investments) High quality service from experts who reduce or control operating costs Quality improvement initiatives via best industry practices and operational efficiencies Service level guarantees As your outsourcing partner, Fiserv Health can help you control costs and improve revenues. In short, we help you put first things first.

  • 12/8/2013
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WellChoice , Inc.

http://www.wellchoice.com

WellChoice, Inc. is the parent company of the largest health insurer in the State of New York based on PPO and HMO membership. Through our subsidiaries, we offer managed care and traditional indemnity products to approximately 5 million members nationwide. Our service areas include the New York metropolitan area* where we hold a leading market position covering over 22% of the population, parts of upstate New York and sixteen counties in New Jersey. We have the exclusive right to use the Blue Cross and Blue Shield names and marks in 10 downstate New York counties and one or both of these names and marks in selected counties in upstate New York. As we build on our more than 70 years of history serving the health insurance needs of New York, we are well positioned for growth due to the following competitive strengths: Our Blue Cross and Blue Shield brands Our focus, history and leading market position in a highly desirable geographic area The size and quality of our provider networks Our underwriting and pricing discipline The range of our product offerings, including managed care products and traditional indemnity products Our broad customer base including large, middle-market, and small groups; individuals; and national accounts A dedication to providing the highest level of customer service A proven commitment to our members to provide access to quality care Our experience with systems integration and technological innovation Our Leadership

  • 12/8/2013
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WPS Health Insurance

http://www.wpsic.com

WPS is one of the largest health benefits providers in the state, and after more than 60 years, remains Wisconsin's only not-for-profit insurer offering health plans statewide to the public and private sectors. With offices in Appleton, Eau Claire, Green Bay, Madison, Milwaukee, and Wausau, and more than 4,000 employees, we're deeply committed to this state and its citizens. From traditional PPO plans and self-funded administration to consumer-driven options like our HSA-qualified high-deductible, HRA, and ConsumerSelect plans, WPS offers a broad array of products to meet the needs of our group and individual customers. In addition, more than 30,000 Wisconsin seniors have turned to us for supplemental insurance that helps them fill the gaps left by Medicare, and over 29,000 more have enrolled in our Medicare Part D plan. Plus, our comprehensive provider networks include the physicians, specialists, clinics, and hospitals across Wisconsin that our customers know and trust. We also offer national networks to cover out-of-state health care needs. WPS rounds out its product offering through our wholly owned subsidiaries, Arise Health Plan and The EPIC Life Insurance Company. Arise Health Plan, our subsidiary based in Green Bay, offers HMO and Point-of-Service plans to the group and individual markets. The EPIC Life Insurance Company has been a choice provider of group ancillary insurance products for more than 23 years, offering Term Life, AD&D, Short-Term and Long-Term Disability, Dental, and Vision benefits throughout the Midwest. EPIC insures more than 73,000 group members.

  • 12/8/2013
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Excellus , Inc.

http://www.excellus.com

Excellus, Inc., headquartered in Rochester, NY, is a $4 billion not-for-profit company that finances and delivers health care in Upstate New York and provides long-term-care insurance across the nation. The corporation's health-insurance group, Excellus Health Plan, includes: BlueCross Blue Shield of Central New York,

  • 12/8/2013
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HealthSpring Inc.

  • 12/8/2013
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Physicians Plus Insurance Corporation

http://www.pplusic.com

Based in Madison, Wisconsin, Physicians Plus is a nationally recognized managed care organization focused on improving the health of our members and the communities we serve. Our organization was founded in 1986, and is owned two-thirds by Meriter Health Services, Inc. and one-third by Physicians Plus Investment Group. We provide high quality, cost-effective health insurance to approximately 100,000 members in south central Wisconsin with access to a network of more than 2,000 caring providers. We value your thoughts about our products and services. Please contact us at any time with your questions or feedback, or submit ideas for improvement.

  • 12/8/2013
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AmeriHealth Mercy

http://www.amerihealthmercy.com

AmeriHealth Mercy is a mission-driven organization, dedicated to ensuring the delivery of quality health care to low-income populations covered by publicly funded programs throughout the United States. Our success as a Company is attributable to how well we help people get care, stay well, and build healthy communities. Without this commitment to our mission, we would not have been offered so many opportunities to expand our business to other parts of the country. Our outstanding team of associates is committed to developing and implementing innovative approaches to improve the health status of the members and communities we serve. AmeriHealth Mercy continues to prove that managed care works in Medicaid.

  • 12/8/2013
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GTESS Corporation

http://www.gtess.com

GTESS, based in Dallas, Texas (in the Richardson technology corridor), is dedicated to meeting the claims processing needs of our clients. We apply proprietary medical claims processing technology to healthcare information practices to offer premier medical claims processing services to healthcare payers through long-term customer partnerships, a unique combination of state-of-the-art technology, healthcare best practices and a deep commitment to product, service and support quality. Our primary system developers work with healthcare-experienced professionals in customer service, operations and sales and marketing roles. Their common goal: to offer premier medical claims processing services to healthcare payers through long-term customer partnerships, a unique combination of state-of-the-art technology, healthcare best practices and a deep commitment to product, service and support quality. GTESS is well positioned to be the medical claims processing partner powering the healthcare payers of the future. Our Board of Directors has unparalleled experience in leading and growing technology companies and serve unique roles in evolving industries, and our management team possesses a can-do attitude and a deep reservoir of healthcare knowledge.

  • 12/8/2013
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Neighborhood Health Plan Inc

http://www.nhp.org

Neighborhood Health Plan (NHP) is a not-for-profit health maintenance organization serving MassHealth, business, and Non-Group members across Massachusetts. NHP was founded in 1986 by the Massachusetts League of Community Health Centers and the Greater Boston Forum for Health Action. NHP works in partnership with community health centers and other community-responsive providers, and offers a provider network covering most of the state of Massachusetts.

  • 12/8/2013
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AmeriChoice Corporation- A United Health Group Company

http://www.americhoice.com

AmeriChoice, a business unit of UnitedHealth Group, serves more than 1.3 million beneficiaries of government health care programs in 16 states from Rhode Island to California. Since 1989, AmeriChoice has served these programs exclusively, earning a reputation as an innovative developer of public sector health care solutions. We understand the imperatives of public sector health care, we have invested in the systems and personnel required to successfully provide quality service to our customers and we have designed health plans that meet the unique needs of the populations we serve. The unique AmeriChoice Personal Care ModelÔ features direct member contact by clinical staff who work to build a support network for chronically and acutely ill members involving family, physicians and government and community-based organizations. The goal is to employ practical solutions to improve members' health and keep them in their communities, with the resources they need to maintain the highest possible functional status. AmeriChoice pioneered 24/7 bi-lingual Member Service Helplines and uses a variety of advanced technology applications to ensure that high quality, timely and appropriate health care is available to all members. We were the first company to use telemedicine equipment in an inner-city health care program. We developed our own software to monitor member access to services. We use a sophisticated clinical risk stratification tool to ensure that our members are receiving optimal care. We emphasize preventive health and education. We regularly encourage members to get annual physicals and routine diagnostic and screening tests, and we often work with community organizations to ensure that there are no cultural or language barriers to our members getting the care they need. AmeriChoice believes that compassion and respect are essential components of a successful health care company. We contract with community-based networks and employ a diverse workforce, with varied backgrounds and extensive practical experience that gives us a better understanding of our members and their needs. Our detailed knowledge of our members and our service areas, the application of cutting-edge technology and the commitment of our employees have made AmeriChoice the leading choice for quality public sector health care.

  • 12/8/2013
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United American Healthcare Corporation

http://www.uahc.com

United American Healthcare Corporation (UAHC) provides management and consulting services to a managed care organization in Tennessee. The Company also arranges for the financing of healthcare services and delivery of these services by primary care physicians and specialists, hospitals, pharmacies and other ancillary providers to commercial employer groups and government-sponsored populations in Tennessee. Management and consulting services provided by the Company include feasibility studies for licensure, planning, corporate governance, management information systems, human resources, marketing, pre-certification, utilization review programs, individual case management, budgeting, provider network services, accreditation preparation, enrollment processing, claims processing, member services and cost containment programs. (Source: 10-K)

  • 12/8/2013
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NCQA

  • 12/8/2013
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Note

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