The CareFirst/WellPoint Merger
In November 2001, CareFirst BlueCross BlueShield
(CareFirst) signed a definitive agreement to merge with WellPoint Health
Networks, Inc. (WellPoint). CareFirst believes conversion to for-profit
and subsequent merger with WellPoint - one of the nation's most respected
health care companies - will strengthen the company's ability to meet
customer needs, slow the rate of future premium increases, and preserve
a local "Blues" presence throughout the region for years to
come.
WellPoint at a Glance |
- 12.8 million members
- 44 specialty members
- $10.4 billion revenue in 2000
(About $16 billion by non-profit methodology)
- $8 billion net worth
- 16,300 sales associates
- Four major operating units:
- Blue Cross of California
- Blue Cross and Blue Shield
of Georgia
- UNICARE (includes non-Blues
Branded coverage, life and mail order pharmacy fulfillment)
- RightCHOICE (Blue Cross
and Blue Shield of Missouri; HealthLink)
- Voted "Best Large Health
Company" - Forbes
- Voted "Most Admired Heath
Company"
3 straight years - Fortune
- WellPoint CEO Leonard Schaeffer
named among "America's Top 25 Managers" Business
Week
- "Top 25 Companies for
Executive Women" - Working Woman
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Why WellPoint?
- WellPoint's customer focus -known nationally
- Strong financially - continuous growth
in market share, networks, revenues and profits
- Commitment to Blue brands
- Commitment to local decision-making
- Strong in senior, individual and small
group markets
- Strong belief in the broker system
- National networks
- Track record of successful mergers
Elements of the Agreement
As part of the agreement, CareFirst must
convert to a for-profit company. Upon approval of the conversion, WellPoint
will pay 1.3 billion to acquire CareFirst. This money would be shared
among the three jurisdictions - Delaware, Washington, DC and Maryland
- in which CareFirst, affiliated Blues plans are headquartered.
The $1.3 billion will provide the largest
per-capita benefit of any not-for-profit conversion yet - and would create
an opportunity for elected officials to address unmet health care needs
throughout the region.
The agreement requires the approvals of insurance
regulators in the three jurisdictions as well as the U.S. Congress. The
formal review-and-approval process has just begun and is expected to take
at least 18 months.
Importantly, WellPoint believes that health
care decisions should be made locally. The agreement maintains local headquarters,
makes Maryland the headquarters of WellPoint's new Southeast Region, and
calls for CareFirst's President and CEO William Jews to head all Southeast
operations.
Why are Blues Plans Converting?
Conversion of Blues plans to for-profit status
is not uncommon. In fact, more than 28 million Americans are members of
Blues plans that are for-profit - or considering becoming for-profit -
organizations.
Blues plans convert for a variety of reasons.
Most commonly, Blues plans convert to for-profit status to enable them
to compete on equal footing with large for-profit national insurers. To
build membership and control premium growth, Blues need access to the
same types of financial resources that allow for-profit plans to invest
heavily in technology and development of new products.
What the Merger Means
Understandably, most people want to know
what the CareFirst/WellPoint merger really means. We believe the conversion
to for-profit status and subsequent merger with WellPoint will produce
tangible benefits for the communities we serve, our members and business
accounts and health care providers.
For the Community
Communities throughout the CareFirst
service area stand to benefit directly from the merger of CareFirst and
WellPoint. The $1.3 billion purchase price paid by WellPoint will be used
to establish charitable funds in Delaware, Washington, DC and Maryland.
These funds can be used to:
- Meet the healthcare needs of the underserved
- Expand programs such as Maryland Senior
RX Plan that serve seniors and the needy
- Support graduate medical education and
research
The community will also benefit through the
additional $24 million in taxes paid for a for-profit CareFirst. And,
CareFirst will continue to be an active, contributing corporate citizen
- with more than 6,500 employees living and working in communities throughout
the region.
For our Members and Business
Accounts
As a for-profit company aligned with WellPoint, CareFirst will be able
to achieve economies of scale and other synergies that will enable us
to operate more efficiently, reduce administrative costs and slow the
rate of premium increases. In addition, as part of one of the nation's
most innovative health care companies, CareFirst members and business
accounts will benefit through:
- Enhanced products and services, such as
customized products offering increased flexibility and choices of deductibles
and co-pays. Innovative disease management, pharmacy discount, and alternative
medicine programs are among the types of programs that will benefit
members.
- Investments in technology that will allow
us to answer customer calls more quickly and accurately.
- Improved on-line capabilities, such as
24-hour, 7-day-a-week enrollment, claims tracking and physician selection.
For Health Care Providers
CareFirst's ability to invest in technology will also produce benefits
for physicians and hospitals. Over time and with improved technology CareFirst
will be able to:
- Process and pay claims faster
- Provide on-line, real time verification
and claims status review
- Reduce administrative hassles
And, because our affiliated Blues plans in
Delaware, Washington, DC and Maryland will maintain their local headquarters
and operations, decision-making on health care matters will remain locally
based.