Aetna

Ouch! Darn it! Missed one!One of life's verities is that whenever a man opens a new shirt, he finds a thousand straight pins -- or at least eight or 10.They are simply a fact of sartorial life, taken for granted except when a forgotten pin delivers a pointed reminder of its presence.Then it's "Why are all those*! pins in new shirts and how do they get there?"The pins are there because, industry sources say, no better way has been found to keep new shirts folded crisply and neatly, and they get there by the grace of people like Michelle Anderson, Agnes Green and Tina Bhatt, who emplace them -- by hand -- eight to 10 per shirt, depending on fabric and style.

Aetna's plans announced Monday to acquire Coventry Health Care Inc. for $5.6 billion could catapult the insurance giant to the front of an industry race to capitalize on Obamacare and the health needs of aging baby boomers. The deal, subject to approval by Coventry stockholders and industry regulators, is expected to be completed in mid-2013. Aetna said it would pay about $5.6 billion to acquire Bethesda-based Coventry and will take on the company's debt, driving up the total value of the transaction to $7.3 billion.

Aetna's plans announced Monday to acquire Coventry Health Care Inc. for $5.6 billion could catapult the insurance giant to the front of an industry race to capitalize on Obamacare and the health needs of aging baby boomers. The deal, subject to approval by Coventry stockholders and industry regulators, is expected to be completed in mid-2013. Aetna said it would pay about $5.6 billion to acquire Bethesda-based Coventry and will take on the company's debt, driving up the total value of the transaction to $7.3 billion.

Singing the praises of major U.S. insurance companies is not a common pastime on these pages, but recent events require at least a stanza and perhaps even a chorus. Such is the tuneful news that several have decided that no matter how the U.S. Supreme Court rules, they intend to retain certain provisions of President Barack Obama's health care reform law. UnitedHealth Group, Inc. was the first to make that announcement and was later joined by Aetna and Humana. The move will allow policyholders to get certain kinds of preventive care without a co-payment, allow adult children up to age 26 to stay on parents' health plans, and avoid lifetime claims limits on individuals with chronic diseases, just as they would under the health care reform act. UnitedHealth's leadership in this is particularly helpful because it is the nation's largest health insurer by market value.

Taking the second step in a new strategy, Integrated Health Services of Owings Mills announced an agreement with Aetna U.S. Healthcare yesterday to offer Medicare HMO plans to nursing home residents in Pennsylvania, Delaware and Massachusetts.Integrated announced a similar deal for Florida two weeks ago with a different HMO operator, Humana.The arrangements allow the HMOs to enroll residents in Integrated's long-term care facilities -- a market they have not previously reached -- and pays Integrated for providing primary care with its own doctors and nurses.

A headline on a story about Geico Corp. in yesterday's Business section incorrectly characterized a transaction between Geico and Aetna Life & Casualty Co. Geico has agreed to transfer, not sell, its homeowners insurance business to Aetna Life & Casualty.The Sun regrets the errors.Geico Corp., the Bethesda insurer, has given up on its relatively small homeowners insurance business and will transfer to Aetna Life & Casualty, the companies said yesterday.Geico writes homeowners policies through a wholly owned insurance agency called Insurance Counselors Inc., which is based in Maryland.

Aetna Life & Casualty Co. said yesterday that it would eliminate 2,600 jobs as part of a program of broad changes.Coming on the heels of similar reports by other leading U.S. insurers, the announcement is a sign of continuing problems in the industry.The Hartford-based insurer said the move would save the company $50 million next year and more after that. The job reductions were announced along with the company's third-quarter earnings, which were down sharply.Analysts praised the move as necessary although painful.

THE VILLAIN Calvera said, "Generosity, that was my first mistake," as he peered ominously from beneath his mega-sombrero at the gringo gunman in the classic scene from the 1960 film The Magnificent Seven. The testosterone is practically gushing off the screen as Calvera, played by a distinctly non-Hispanic Eli Wallach, continues to lecture the seven Anglos hired by hapless peasants to stop him. "I leave these people a little extra," Calvera continued, "and then they hire these men to make trouble.

HARTFORD, Conn. -- Travelers/Aetna Property Casualty Corp.'s third-quarter earnings exceeded analysts' expectations as the insurer boosted sales of policies to individuals.The fourth-largest U.S. property and casualty insurer said yesterday that its earnings, excluding gains from investment sales, totaled $246.1 million, or 62 cents a share, for the quarter ended Sept. 30.The earnings exceeded Wall Street's consensus estimate of 55 cents a share, based on a survey of eight analysts by Zacks Investment Research.

Aetna U.S. Healthcare came under fire from the American Medical Association yesterday in the wake of complaints from doctors in six states that the health insurer's contracts are illegal and compromise patient care.If the alleged problems are not corrected, the AMA may file a lawsuit to try to force Aetna to make changes, the association said yesterday.In a letter to Aetna, the doctors' group contends that the contract allows insurance company officials to override patient care decisions without an avenue of appeal.

Suit should go forward, lawyers for Jews argue Attorneys for William L. Jews, the former CareFirst BlueCross BlueShield chief executive who was fired in 2006, argued yesterday that a lawsuit to collect his full severance benefits should be allowed to go forward in federal court. In August, Jews filed suit in U.S. District Court against the state's insurance commissioner, Ralph S. Tyler, who in July cut Jews' termination compensation in half - from $18 million to $9 million - because he found the package excessive.

SOME HAVE argued that Maryland HMOs must pass the cost of the newly enacted 2 percent premium tax on to consumers because of the natural physics of how business costs are borne. Price is determined by what the market will bear. And competition shapes what the market will bear. The airlines, for example, suffering fuel price increases, have attempted to pass on these added costs to customers. Because of intense competition among the airlines, however, these attempts have largely failed.

Magellan Health Services Inc., which provides mental health coverage, said yesterday that it was selling part of its business to Aetna, its largest customer. The sale will have "negligible, if any" impact on Magellan's employees in Columbia, said Erin S. Somers, Magellan's vice president for public relations. Magellan had its headquarters in Columbia until about a year ago, when its CEO and other top executives moved to Farmington, Conn. It still has 585 employees in Columbia. When the deal closes at the end of 2005, Aetna Inc. will take over the three Magellan centers that service 10.5 million Aetna members.

In the Region Court rejects challenge to Aetna lawsuit settlement A federal appeals court has rejected a challenge to Aetna's $170 million settlement of class action litigation with physicians. In a decision filed Friday and made public yesterday, the 11th U.S. Circuit Court of Appeals in Atlanta upheld the settlement's approval by the U.S. District Court in Miami last fall. The settlement ended 4-year-old class action lawsuits in which doctors alleged that Aetna had systematically denied, delayed or reduced claims payments.

Aetna announced yesterday that it has agreed to pay up to $6.27 million and improve its claim-paying practices to settle a lawsuit potentially involving tens of thousands of dentists. The nationwide lawsuit, filed by the American Dental Association and three individual dentists two years ago, accused Aetna of improperly denying, reducing and delaying claim payments. The dental association represents about 147,000 dentists nationally. But the number of dentists who will participate in the settlement isn't known.

MIAMI - A federal judge in Miami gave Aetna Inc., the second-biggest U.S. health insurer, preliminary approval yesterday for a $170 million plan to settle claims by 700,000 doctors that the company unfairly cut reimbursements. The settlement, approved by U.S. District Judge Federico Moreno, gives physicians $100 million. Hartford, Conn.-based Aetna also agreed to pay $20 million to create a foundation to address health care problems and $50 million in legal costs. The agreement, which will reduce Aetna's second-quarter earnings by $75 million, lifts the threat of a multimillion-dollar damage award against the company and might provide a blueprint for settlements by rival managed-care providers.

MIAMI - A federal judge in Miami gave Aetna Inc., the second-biggest U.S. health insurer, preliminary approval yesterday for a $170 million plan to settle claims by 700,000 doctors that the company unfairly cut reimbursements. The settlement, approved by U.S. District Judge Federico Moreno, gives physicians $100 million. Hartford, Conn.-based Aetna also agreed to pay $20 million to create a foundation to address health care problems and $50 million in legal costs. The agreement, which will reduce Aetna's second-quarter earnings by $75 million, lifts the threat of a multimillion-dollar damage award against the company and might provide a blueprint for settlements by rival managed-care providers.

By the end of the summer, one in 12 Americans will be covered by a single health insurance company, Aetna-U.S. Healthcare, under a proposed merger approved yesterday by federal regulators.Connecticut-based Aetna, already the nation's largest health plan, will increase its membership by 50 percent, to 21 million, now that the Justice Department has given the green light to the company's proposed takeover of the Prudential Insurance Co. of America's health care division.As part of the $1 billion deal, regulators are requiring Aetna to sell a portion of its health maintenance organization business in Dallas and Fort Worth, Texas.

AUSTIN, Texas - Gosh, I'm feeling ever so much better about the economy with the new Bush team on the job. William H. Donaldson to head the Securities and Exchange Commission: just the man to take on the Establishment! Founder of the Wall Street investment firm Donaldson, Lufkin and Jenrette, former chairman of the New York Stock Exchange and former chairman of insurance giant Aetna. A veritable Ralph Nader. The media report "Wall Street is delighted" that Mr. Donaldson, a longtime friend of the Bush family, will be their new regulator.

WASHINGTON - Looking to offer seniors more options after HMOs cut back their participation in Medicare, the federal Department of Health and Human Services announced yesterday a demonstration program in 23 states, with the Baltimore area one of the test sites. The pilot program will offer seniors a chance to participate in preferred provider organizations (PPOs), networks of health care providers that have agreed to accept discounted payments from the insurer. They are the most popular form of insurance for people younger than 65. As consumers chafed under HMO restrictions, such as the need to get referrals from a "gatekeeper" doctor, PPO enrollment has burgeoned.