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Company Description

Contact Info

44 South Broadway

Suite 1200

White Plains, NY 10601

United States

Phone: 914-934-5200

Fax: 914-934-0700

Universal American Corp., a specialty health and life insurance holding company, provides health insurance and managed care products and services to the growing Medicare and Medicaid population in the United States. Through insurance subsidiaries, the company is licensed to market Medicare and insurance products in all 50 states and the District of Columbia. Segments The company operates in two segments, Senior Managed Care and Traditional Insurance. Senior Managed Care segment This segment reflects the company’s Medicare Advantage HMO, PPO, and private fee-for-service (PFFS) businesses. During 2013, the company operated Medicare coordinated care plans, including PPOs and HMOs, as well as its network-based PFFS and rural PFFS business, which provides coverage to Medicare beneficiaries in 34 states. The company developed products meeting CMS network access requirements in selected core markets to enable the retention of its PFFS membership in certain of these areas. These businesses provide managed care for persons with Medicare under contracts with CMS. Medicare Advantage—HMO Plans: The company’s HMO plans are offered under contracts with CMS and provide various basic Medicare covered benefits with reduced member cost-sharing, as well as additional supplemental benefits, including a defined prescription drug benefit. The company operates separate Management Service Organizations (MSOs) that manage that business and affiliated Independent Physician Associations (IPAs). The company operates plans offering the product TexanPlus in 12 counties in Houston and southeastern Texas through SelectCare of Texas, which had approximately 49,800 members enrolled, as of December 31, 2013. The company also has Medicare Advantage HMO operations in locations outside of southeastern Texas including four counties in north Texas offering TexasFirst Health Plans through SelectCare Health Plans and nine counties in Oklahoma City offering Generations Healthcare through Today's Options of Oklahoma, Inc. Medicare Advantage—PPO Plans: The company’s PPO plans are provided under the name ‘Today's Options PPO’. They are offered under contracts with CMS and provide various basic Medicare covered benefits with reduced member cost-sharing, as well as additional supplemental benefits, including a defined prescription drug benefit. This coordinated care product is built around contracted networks of providers who, in cooperation with the health plan, coordinate an active medical management program. In 2013, the company offered PPO plans to 40 markets in 119 counties in 17 states. Medicare Advantage—PFFS Plans: The company’s PFFS plans are provided under the name ‘Today's Options’. They are offered under contracts with CMS and provide improved health care benefits compared to traditional Medicare, subject to cost sharing and other limitations. Some of these products include a defined prescription drug benefit. In 2013, the company offered PFFS products in a total of 34 states, which included PFFS products with network restrictions to 50 markets in 291 counties in 18 states and PFFS products without network restrictions to 943 counties in 29 states. Traditional Insurance segment The Traditional Insurance segment reflects the results of Medicare supplement and other senior health products, specialty health insurance products, primarily fixed benefit accident and sickness insurance, and senior life insurance business, as well as long-term care, disability, major medical, universal life and fixed annuities. Strategy The principal components of the company’s business strategy include the following: continuing to build Medicare Advantage business and expand Healthy Collaboration model in core markets; expanding relationships with health care providers both within and outside Medicare Advantage footprint to further develop existing and additional accountable care organizations; employing medical management capabilities to improve the health and well-being of those it serves and reduce healthcare costs; working in collaboration with healthcare providers to help them assume and manage risk, in order to achieve measurably better quality and lower cost; engaging the people served to help them make smart and economic choices about their healthcare; and developing additional capabilities to participate in the growing dual eligible and long-term care sectors. Significant Events The company acquired the Total Care Medicaid health plan on December 1, 2013. It provides Medicaid managed care services to approximately 35,000 beneficiaries in upstate New York; and its membership includes beneficiaries of the Medical Assistance Program, known as Medicaid. Total Care Medicaid also participates in Child Health Plus and Family Health Plus programs for low-income, uninsured children and adults. Marketing and Distribution The company distributes its Medicare Advantage products through multiple channels, including career agency, independent agents, as well as through telephonic and Internet enrollment. Regulations The company’s insurance companies have implemented measures to comply with the Office of Federal Asset Control requirements, whereby the names of customers and potential customers must be reviewed against a listing of known terrorists and money launderers. Its insurance company subsidiaries provide for known and expected insolvency assessments based on information provided by the National Organization of Life & Health Guaranty Associations. Competition The company competes with other health insurance companies and managed care organizations on a national, regional and local market basis, including United Healthcare, Humana, Wellpoint, including various ‘Blues’ plans, Aetna and Cigna. History Universal American Corp. was founded in 1981. The company was incorporated under the laws of the state of Delaware in 2011.


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