Kukho iinkampani ezininzi ze- inshorensi zempilo e-US Abaninzi abaphatha indawo encinane kwingingqi, kanti abanye baqinisekisa izigulane kwilizwe lonke. Kukho iMedicaid kunye neMediare.
Zikhona ezintandathu zeenkampani ezinkulu ze-inshorensi zempilo: I-WellPoint, i-CIGNA, i-Aetna, i-Humana, i-United Healthcare kunye ne-BlueCross BlueShield, nangona iphela isebenza kwimeko yelizwe.
Iinkampani ezinkcenkceshe zempilo ezinkcenkceshe zintlanu ziqinisekisa ukuba ziqingatha isiqingatha se-insured population okanye ngaphezulu kwabantu abayizigidi ezili-100. Apha sijonge kwiinkampani ezinkcenkceshe zezempilo ezinhlanu.
WellPoint, Inc.
I-WellPoint inamalungu angamawaka angama-34 kwizicwangciso zayo zempilo kunye nezigidi ezingaphezu kwezi-70 ze-insurea xa iifasta zayo zifakiwe. Oku kwenza i-WellPoint inkampani enkulu ye-inshorensi yezempilo ngokwebulungu.
I-WellPoint yenziwe ngokuhlanganiswa kwe-WellPoint Health Networks Inc. kunye ne-Anthem, Inc., ngo-2004.
I-WellPoint iyintloko e-Indianapolis, e-Indiana. Umntu omeleyo welayisensi we-Blue Cross kunye neBlue Shield Association ekhonza amalungu eCalifornia, eColorado, eConnecticut, eGeorgia, e-Indiana, eKentucky, eMaine, eMexico, eNevada, eNew Hampshire, eNew York, e-Ohio, eVirginia naseWisconsin.
Izicwangciso ze-WellPoint zenza ishishini njenge-Anthem Blue Cross, i-Anthem Blue Cross kunye ne-Blue Shield, i-Blue Cross ne-Blue Shield yaseGeorgia, iBlue Blue Cross Blue Shield, okanye i-Empire Blue Cross (kwiinkonzo zaseNew York).
I-WellPoint isebenza abathengi kweli lizwe njenge UniCare.
Omnye kwi-9 yaseMelika uyagcinwa nge-WellPoint.
Izicwangciso zokunyamekela eziPhezulu zeWellPoint zibandakanya: imibutho yokubonelela ngenkonzo (i-PPOs); imibutho yokugcina impilo, (i-HMOs); izicwangciso zeenkonzo (POS); izicwangciso zenkxaso yemveli kunye nezinye izicwangciso ze-hybrid, kubandakanywa izicwangciso zempilo ezixhaswa ngumthengi (ii-CDHPs); kunye nesibhedlele kuphela kunye nemveliso encedisayo.
Inkampani ikwabandakanya iinkonzo zokunyamekela eziphathekayo kubathengi abazixhaswa ngemali, kubandakanywa nokucwangciswa kwamabango, ukubhala phantsi, ukuyeka i-inshorensi, iinkonzo ze-actuarial, ukunikezela kwenethiwekhi, ukuphathwa kweendleko zonyango, ukuphathwa kwezifo, iinkqubo zokuphila kunye nezinye iinkonzo zolawulo.
Iinkampani ezinxulumene nazo zinikeza uluhlu olulodwa lweemveliso kunye nezinye iinkonzo kunye neenkonzo ezifana nokuncedisa i-inshorensi yobomi kunye nokukhubazeka, amazinyo, imbono, iinkonzo zokuncedisa impilo, ukulawulwa kwezibonelelo ze-radiology, iikhompyutheni eziphathekayo zonyango, ukugcinwa kwe-inshorensi yenkxaso, kunye nokuchithwa kwemali akhawunti.
Inkampani ye-inshurensi ye-CIGNA
Ekwase-Philadelphia, ePa., Umlando weCIGNA uhamba emva kweminyaka eyi-125. Ingeniso yenkampani (ngoDisemba 2011) yi-$ 21.3 billion.
I-CIGNA inezigidi ezili-11,4 ezi-insure e-US kunye nezinye izigidi ezingama-7.6 ngaphandle kwe-US (kumazwe angama-29 ahlukeneyo) kwaye ikwabekwe kwiNombolo 129 kwiluhlu lwe-Fortune 500.
Ngo-2010, i-CIGNA iqhutywe iibhilizi ezingama-119 zezonyango.
I-CIGNA inezigaba ezintathu:
- I-CIGNA HealthCare inikeza izicwangciso zempilo kunye neenkonzo kuzo zombini iinkampani kunye nabantu, ukunika unyango, amazinyo, impilo yokuziphatha, i-pharmacy, kunye nokubonelelwa kwenkathalo.
- I-CIGNA Group Inshuwalense yenye yezona zibonelela ngabanikezeli bokukhubazeka kweqela, ubomi kunye nokuhlaselwa kwengozi eMelika.
- I-CIGNA International inikeza ubomi bomshuwalense wezempilo, ingozi kunye neyongezelelekileyo kunye neenkonzo zempilo ezizodwa kunye neentlawulo ze-inshurensi zabasebenzi ekuxosheni abasebenzi beenkampani ezizweni jikelele.
Aetna
I-Aetna yasungulwa ngo-1853 eHartford, Conn., Kwaye inikeza ngononophelo lwezempilo, amazinyo, i-pharmacy, ubomi beqela, kunye ne-inshorensi yokukhubazeka, kunye neenzuzo zabasebenzi. Unamalunga angama-18 yezigulane, ama-13.5 wezigulana zamazinyo, kunye ne-8.5 yezigidi ze-pharmacy.
Umshuwalense unika iingenelo ngabaqeshi kuwo onke amazwe ama-50, kunye nemveliso kunye neenkonzo ezijoliswe ngqo kubaqeshi bamazwe abancinci, abaphakathi kunye nabakhulu.
I-Aetna iphinda isebenzise iiMediare neeMedicaid abaxhamli kwiimarike ezithile. Ingeniso ye-Aetna ngo-2010 yayiyizigidi ezingama-34,246 yezigidi, phantsi kwe-1.5% ukusuka kunyaka odlulileyo.
Humana
Eyasungulwa ngo-1961 kunye ne-headquarters e-Louisville, Ky., Humana yaqala njengekhaya elinamakhaya angamahlengikazi kwaye yakhula yaba izibhedlele ezingaphezu kwe-100 ngaphambi kokubandakanyeka kwimpilo.
U-Humana unamaqela angama-10.2 wezigulane kunye neNombolo 73 kwiluhlu lwamaphephancwadi e-Fortune yeenkampani ezinkulu zase-US, ezibekwe yintlawulo yonyaka.
U-Humana unikeza uluhlu lweenkonzo kunye nezicwangciso ezibandakanya:
- IziHlomelo zeHumana ze-Medicare, zabathengi abafanelekayo
- I-Humana One, i-inshurensi yodwa kunye nezicwangciso ezininzi
- I-Humana One Amazinyo Neembono
- I-Humana One Life kunye ne-Assurance Insurance, enika izicwangciso zobomi bodwa, kwisibonelelo sokubhedlele esibhedlele, kunye nemigaqo ejoliswe kwizifo ezithile. HumanaDental, kubaqeshi
- HumanaVisionCare
Umboneleli wezeMpilo unikezela nomphathi we-pharmacy benefit, i-Humana Pharmacy Solutions, exhaswa yinkampani ye-Fortune eyi-100 kwaye enye ye-PBM ephezulu kwi-nation.
I-Humana Pharmacy Solutions 'kukunika amalungu ukuba afumaneke kwiyeza abayidingayo ngenkxaso ngenkqubela yezilwanyana ezinokulingana, eziza kubaluleka ngakumbi kulungu kunye nomqeshi.
Unyango lweMpilo
I-UnitedHealthcare iyisahlulo sokusebenza seQumrhu le-UnitedHealth, elona likhulu kunabo bonke abathintekayo bempilo eMelika. Inkampani yasungulwa ngo-1977 ngokulungiswa kwakhona kweCharter Med Inc., eyasungulwa ngo-1974.
Inkampani inikezela ngemveliso kunye neenkonzo kwiiMelika ezigidi ezingama-70 kunye neenkqubo zalo zolawulo lwezobisi zibonelela ngokufikelela ekufikelelekeni kwezidakamizwa kubantu abayizigidi ezili-13.
Ukunakekelwa kwezempilo eManyeneyo kunamacandelo amathathu:
- Umqeshi weZizwe eziManyeneyo kunye noMntu ngamnye ulungiselela izicwangciso zenkxaso kunye nesisombululo senkonzo ngokuzinikezelwa kwabaqeshi abakhulu, abaninzi kunye nabaqeshi belizwe kunye nokulungelelanisa iinkonzo zoncedo lwezempilo kunye nezenkonzo egameni labaqeshi abancinci ukuya phakathi, kunye nabafundi, abafundi kunye intsapho.
- I-UnitedHealth Care Medicare & Umhlalaphansi yiyona shishini elikhulu kulo lonke uhlanga olunikezelwe ukuhlangabezana neemfuno zabantu abadala.
- U-CommunityHealthcare Community & I-State isebenza kwaye ilawulwe iinkonzo zonyango kwiinkqubo zikaRhulumente ezixhaswe nguRhulumente kunye nabaxhamli babo.
Ingeniso yenkampani kwikota yokuqala yalo nyaka yayiyizigidi ezingama-25,432 ezigidi, ezivela kwii-23,193 yezigidi kwikota yokuqala ka-2010.
Uononophelo lwezeMpilo oluManyeneyo lubekwe kwiNombolo ye-22 kwiluhlu lwe-Fortune 500 olusekelwe kwimali engenayo. Kwakhona kwafumana inombolo yeNombolo 1 ye-Innovation kwi-Inshorensi kunye neCandelo loNonophelo loLawulo kwi-Fortune magazine ngo-2011 lweeNkampani ezininzi zeNkcazo zehlabathi.