Businessweek

WellCare Health Plans, Inc. provides managed care services to government-sponsored health care programs, focusing on Medicaid and Medicare. The company offers various health plans for families, children, and the aged, blind and disabled, as well as prescription drug plans. As of December 31, 2012, the company served approximately 2.7 million members nationwide. As of December 31, 2012, the company operated Medicaid health plans in Florida, Georgia, Hawaii, Illinois, Kentucky, New York and Ohio. It also operated its Medicare Advantage (MA) coordinated care plans (CCPs) in California, Connecticut, Florida, Georgia, Hawaii, Illinois, Louisiana, Missouri, New Jersey, New York, Ohio and Texas, as well as a stand-alone Medicare prescription drug plan (PDP) in 49 states and the District of Columbia. As of January 1, 2013, the company began serving Medicare members in Arizona as a result of its acquisition of certain assets of Desert Canyon Community Care from Humana, Inc. As of February 1, 2013, the company began serving Medicaid members in South Carolina as a result of its acquisition of UnitedHealth Group, Incorporated's South Carolina subsidiary. All of the company’s Medicare plans are offered under the WellCare name, for which the company holds a federal trademark registration, with the exception of its Hawaii CCP, California CCP, and Arizona CCP, which the company respectively offer under the name 'Ohana, Easy Choice and Desert Canyon Community Care. For its Medicaid plans, the company offers brand names depending on the state, consisting of the Staywell and HealthEase brands in Florida, the 'Ohana brand in Hawaii, the Harmony brand name in Illinois and the WellCare brand name in Georgia, Kentucky, New York and Ohio. Product Segments The company’s operations are conducted in three business segments: Medicaid, MA, and PDPs. Medicaid The Medicaid segment includes plans for beneficiaries of Temporary Assistance for Needy Families (TANF), Supplemental Security Income (SSI), Aged Blind and Disabled (ABD) and other state-based programs that are not part of the Medicaid program, such as Children's Health Insurance Program (CHIP), Family Health Plus (FHP), and Managed Long-Term Care (MLTC) programs. In its Medicaid segment, the company operates five membership states. The Medicaid programs and services the company offers to its members vary by state and county and are designed to serve its constituencies in the communities in which the company operates. The company’s Medicaid plans provide its members with access to a spectrum of medical benefits from primary care and preventive programs to full hospitalization and long-term care. MA The company contracts with Centers for Medicare and Medicaid Services (CMS) under the Medicare program to provide an array of Part C and Part D benefits to Medicare eligible persons. These benefits are provided through its MA plans, which comprise CCPs. CCPs are administered through HMOs and require members to seek health care services and select a PCP from a network of health care providers. In addition, the company offers Medicare Part D coverage, which provides prescription drug benefits, as a component of its MA plans. As of January 1, 2013, the company offered MA plans in a total of 204 counties across 14 states, with approximately 15 million eligible beneficiaries in these service areas. The company offers duals special needs plans (D-SNPs) in nearly all the counties that the company serves. It covers a spectrum of medical services through its MA plans. For many of its plans, the company provides additional benefits not covered by Original Medicare, such as vision, dental and hearing services. As of December 31, 2012, the company had approximately 213,000 MA members. PDPs The company has contracted with CMS to serve as a plan sponsor offering stand-alone Medicare Part D PDP plans to Medicare-eligible beneficiaries through its PDP segment. The Medicare Part D program offers national in-network prescription drug coverage with approximately 60,000 pharmacies, subject to limitations in certain circumstances. The company offers PDP plans in 49 states and the District of Columbia and is focused on beneficiaries. In 2013, the company launched a new PDP product targeted to value-focused beneficiaries that actively choose their plan. As of December 31, 2012, the company served approximately 869,000 PDP members. History WellCare Health Plans, Inc. was founded in 1985.