Benchmarking
South Florida - Prospects
iniciar
Health Insurance
Benchmarking Florida - Prospects
Health Insurance in Florida
Nick Zaffiris
Position: CEO FloridaCompany: United HealthCare Services Contact Phone:
Profile: Nicholas (Nick) J. Zaffiris is the CEO of UnitedHealthcare Florida markets. He is responsible for delivering affordable, quality-based health programs to employers and members and is in charge of the operations and commercial business performance in Florida.
Nick joined UnitedHealthcare in June of 2007 as the Vice President of Key Accounts for the South Florida Health Plan, where he was responsible for the sales and retention of the mid-market employer accounts in his region.
United Health care
Helping people live healthier lives and helping make the health system work better for everyone.
Industry: Health InsuranceCompany size : Over 250,000 employees ( )Headquaters: Minneapolis, MN Type: Specialties: Health Care, Wellness and Health Management, Retiree Solutions, and Information Technology
https://www.unitedhealthgroup.com/
Opportunities / Solutions
Yet to be determined, they work with Medicare Plan C.
Products/Services
Medicare Advantage plans Medicaid plans Individual and family health insurance plans Dental insurance plans Vision insurance plans Life insurance plans Prescription drug plans Health and wellness resources
50 states / Nationwide
Network/Counties
Established
Founded in 1977
https://www.linkedin.com/company/unitedhealth-group/
Company linkedin profile
UnitedHealthcare
Hospitals, clinics, and community health centers.
Clients/Partners
Services Access via
Telephone, online and United Healthcare app.
Medicare Advantage plans, Medicaid plans, Individual and family health insurance plans, Dental insurance plans, Vision insurance plans, Life insurance plans, Prescription drug plans, Health and wellness resources.
Product/Service details
Main business Opportunities
Caraline Coats
Position: Regional President, Florida HumanaCompany: Humana Contact phone: +1 305-698- 3100
Profile : Caraline Coats, a 14-year Humana veteran, will lead Humana’s South Florida Medicare market and report to Alan Stewart, Humana Senior Vice President and Southeast Division Leader. As South Florida Medicare President, Coats is responsible for developing and expanding Humana’s Medicare business in the 11-county South Florida region, including Broward, Miami-Dade and Palm Beach counties, and the Treasure Coast.
Humana
Humana is a health insurance company that offers a variety of services and solutions to individuals, families, and businesses.
Industry : Health Insurance CompanyCompany size : Over 30,000 employees ( )Headquaters: Louisville, Kentucky Type: Specialties:
https://www.humana.com/
Plan C Medicare insurance
Opportunities / Solutions
Health insurance /Individual and family. Medicare Advantage, Medicaid.
Products/Services
50 states / Nationwide and the District of Columbia
Network/Counties
Established
Founded in 1961
https://www.linkedin.com/company/humana/
PCompany linkedin profile
Humana
The Centers for Medicare & Medicaid Services (CMS). The Florida Agency for Health Care Administration (AHCA). Local hospitals and health care providers . Businesses.
Clients/Partners
Telephone and mobile app
Services access via
Health insurance: Humana offers a variety of health insurance plans, including Medicare Advantage plans, Medicaid plans, and individual and family health insurance plans. Medicare: Humana is a Medicare-approved provider. They offer a variety of Medicare Advantage plans, as well as prescription drug plans and Medigap plans. Medicaid: Humana is a Medicaid-approved provider. They offer a variety of Medicaid plans, as well as managed long-term care plans. Behavioral health: Humana offers a variety of behavioral health services, including mental health and substance abuse treatment. Vision: Humana offers vision insurance plans that cover eye exams, glasses, and contact lenses. Dental: Humana offers dental insurance plans that cover dental exams, cleanings, fillings, and other dental services.
Product/Service details
Humana's main business struggle is to attract and retain members. The health insurance market is very competitive, and there are many other health insurance companies offering plans in the United States.
Main business Opportunities
Patrick Geraghty
Position: CEO Company: Florida Blue Contact phone: 1-877-352-5830
Profile: He is a health care executive, Florida business leader, and board member of non-profits and business organizations focused on helping people and communities achieve better health. He believes everyone deserves affordable, quality health care. As president and CEO of mission-driven GuideWell Mutual Holding Corporation and Florida Blue, He works closely with him team, communities and business leaders throughout the state and country to find better ways to bring more affordable and quality health solutions to everyone.
Blue Cross and Blue Shield of Florida, Inc. DBA Florida Blue
Your local Blue Cross Blue Shield health partner.
Industry : Wellness and Fitness ServicesCompany size : 5,000-10,000 employees ( )Headquaters: Jacksonville, Florida. Type: Non profit Specialties: Health Insurance, Health and Wellness, Health Solutions, Health Innovation.
http://www.floridablue.com
1.-SilverSneakers is an innovative wellbeing free of charge improvement program that helps older adults stay physically active and socially engaged. 2.-60 hours of help around the house for things like light housekeeping, grocery shopping, and meal preparation 3.- Support services to help you schedule appointments, provide transportation, or explain your benefits.
Opportunities / Solutions
Individual and family health insurance plans: health insurance coverage, including prescription drugs, preventive care, and hospital stays.
Products/Services
Network/counties
Florida Over 4 MM members
Established
Founded 1986
Company linkedin profile
https://www.linkedin.com/company/florida-blue/
Blue Cross and Blue Shield of Florida, Inc. DBA Florida Blue
The Centers for Medicare & Medicaid Services (CMS), The Florida Agency for Health Care Administration (AHCA), Florida Blue is a Medicaid-approved health insurance company, Local hospitals and health care providers, Businesses/employees.
Clients/Partners
Service access via.
Telephone 24/7 service, online tools
Individual and family health insurance plans: health insurance coverage, including prescription drugs, preventive care, and hospital stays.Medicare Advantage plans: These plans offer comprehensive health insurance coverage to seniors who are enrolled in Medicare. Medicaid plans: These plans offer health insurance coverage to low-income individuals and families.
Product/services details
Medicare Advantage plans: These plans offer comprehensive health insurance coverage to seniors who are enrolled in Medicare.
Medicaid plans: These plans offer health insurance coverage to low-income individuals and families.
Main business Opportunities
Jennifer A. Sweet
Position: CEOCompany: Aetna Contact phone: 1-855-335-1407
Profile: Jennifer Sweet, based in Tampa, FL, US, is currently a Chief Executive Officer at Aetna Better Health of Florida, a CVS Health Company, bringing experience from previous roles at PopHealthCare, a GuideWell Company, Florida Blue, a GuideWell Company, Integral Health Plan Inc. and Integral Health Plan Inc (under Aetna management 2010-2013). Jennifer Sweet holds a 2014 - 2015 Executive MBA, Health Sector Management & Policy @ University of Miami - School of Business. With a robust skill set that includes Access, HIPAA, Health Insurance, Healthcare, Healthcare Consulting and more.
Aetna, a CVS Health Company
Building a healthier world by making health care easy, affordable and all about you. Because Healthier Happens Together (TM)
Industry : Wellness and Fitness ServicesCompany size :10,001 + employees (+50,000)Headquaters: Hartford , Connecticut Type: Public Company
https://www.aetna.com/index.html
1.- Nurse line 24/7 2.- Meals Services ( Independent Living Systems) could be a direct competitor for ADDIUVA 3.- Assistance 24/7 https://www.lifestation.com/(competitor for ADDIUVA) 4.-Resources For Living® With one phone call, members can get help finding
local services and programs, beyond what’s
covered by plan benefits 5.-Telehealth*
Opportunities/ Solutions
Consumer Health, Accountable Care, Health Care Innovation.
Products/Services
Network/counties
50 states / Nationwide
Established
Founded in 1853.
Company linkedIn profile.
https://www.linkedin.com/company/aetna/
Aetna, a CVS Health Company
Individual and family health insurance, Medicaid, Medicare Advantage, Small business health insurance, Virtual health Plans.
Clients/Partners
Services access via
Telephone and social media
Individual & family health insurance plans: These plans offer comprehensive health insurance coverage, including prescription drugs, preventive care, and hospital stays.Medicare Advantage plans: These plans offer comprehensive health insurance coverage to seniors who are enrolled in Medicare. Medicaid plans: These plans offer health insurance coverage to low-income individuals and families. Small business health insurance plans: These plans offer health insurance coverage to small businesses.
product/services details
Aetna's main business struggle is to attract and retain members. The health insurance market is very competitive, and there are many other health insurance companies offering plans in the United States.
Main business Opportunities
Hector Hernandez
Position: Director Company: Health Sun Contact phone: 305-448-8100
Profile: Founded in 2005, HealthSun is a local Medicare Managed Care Organization with administrative offices located in Miami, Florida. Serving more than 50,000 members in Dade, Broward and Palm Beach Counties, HealthSun is one of the fastest growing health plans in South Florida. Additionally, HealthSun has received an overall CMS Star Rating of 5 out of 5 Stars for 2018, 2019, 2020 and 2021. Our valued members are serviced through our extensive provider network and dedicated professionals. As a local plan, we recognize the healthcare needs of our community and strive to provide our members with only the best service and experience possible.
HealthSun
HealthSun is a Medicare Managed Care Organization (MCO) that offers a variety of health care plans to seniors in South Florida.
Industry : Hospital and Health careCompany size : 500-1,000 employees ( )Headquaters: Blue Bell, Pennsylvania Type: Specialties:
http://www.healthsun.com
Does not have plan C coverage, there are opportunities in the transport service provided.
Opportunities/ Solutions
Medicare Advantage plans, Medicaid plans, Special Needs Plans/specialized health care coverage .
Products/Services
Dade, Broward, and Palm Beach Counties in Florida. Network over 25,000 providers, including doctors, hospitals, and pharmacies, and 50,000 members.
Network/counties
Established
Founded 2005
Company linkedin profile
https://www.linkedin.com/company/healthsun-health-plans-inc/
HealthSun
Clients: seniors . Their partners include: The Centers for Medicare & Medicaid Services (CMS)
The Florida Agency for Health Care Administration (AHCA)
Local hospitals and health care providers
Clients/Partners
Services access via
Telefono, mobile App, portal en línea.
Medicare Advantage plans: These plans offer comprehensive health care coverage, including prescription drugs, preventive care, and hospital stays. Medicaid plans: These plans offer health care coverage to low-income individuals and families. Special Needs Plans: These plans offer specialized health care coverage to individuals with complex medical needs.
Products /services details
HealthSun's main business struggle is to attract and retain members. The Medicare and Medicaid markets are very competitive, and there are many other MCOs offering plans in South Florida.
Main business Opportunities
Ernest Jenkins
Position: Vice President of SalesCompany: Cigna Healthcare Email: ernestjenkinsjr@gmail.com
Profile: Ernest Jenkins, based in Fort Lauderdale, FL, US, is currently a Vice President of Sales at Cigna Healthcare at Cigna, bringing experience from previous roles at Cigna, United Health Care, Benelogic and Aon Consulting. Ernest Jenkins holds a 1998 - 2000 MBA in Business @ Wilmington University. With a robust skill set that includes Health Insurance, Insurance, Account Management, Brokers, Employee Benefits and more, Ernest Jenkins contributes valuable insights to the industry.
Cigna Healthcare
Industry: Managed Healthcare and InsuranceCompany size : Over 68,000 employeesHeadquaters: Bloomfield, Connecticut, USA Type: Public Company Specialties: Health insurance plans, including medical, dental, vision, behavioral health, and pharmacy benefits management
https://www.cigna.com/
Yet to be determined
Opportunities / Solutions
Medical Insurance, behavioral health and wellness programs, dental and vision insurance, supplemental health solutions, health savings accounts (HSAs) and spending accounts (FSAs)
Products/Services
Cigna offers national coverage
Network/Counties
Established
Founded in 1982
https://www.linkedin.com/company/cignahealthcare/
Company linkedin profile
Cigna Group serves a dual role, catering to both individual consumers and businesses. Individuals and families can enroll in Cigna's health insurance plans, while businesses partner with Cigna to offer health benefits to their employees.
Clients/Partners
Services access via
Telephone, whatsapp, social media, mobile app,
Lawrence Schreiber
Position: Board MemberCompany: AV Med
Profile: An accomplished healthcare executive with a skill set uniquely attuned to the rapidly changing national, regional and local healthcare marketplace, Larry Schreiber is the President and CEO of SantaFe Healthcare. In his roles he has responsibility and accountability for the strategic, organizational and overall performance of SantaFe Healthcare and its Affiliates. A Certified Employee Benefits Specialist (CEBS) and strategic leader, Schreiber brings 30 years of experience to each challenge he tackles. He believes the best health care is focused on provider collaborations that help people to get and stay healthy.
AV MED
Opportunities / Solutions
Yet to be determined
Medicare Advantage plans (combining Parts A & B with prescription drug coverage).
Products/Services
Yes, AvMed specializes in Medicare Advantage plans.
Medicare Advantage Plans
Focuses on Florida with limited availability in other states.
Locations & Service Areas
Miami, Florida (Founded in 1949).
Headquarters
Clients
Primarily seniors eligible for Medicare.
Not publicly available, but AvMed is a leading Medicare Advantage provider in Florida.
Operational Numbers
Competition in the Medicare Advantage market, attracting and retaining members.
Business Struggles
AvMed offers online tools for members to manage their plans and access health information.
Technology Usage
https://www.avmed.org
Efrain Duarte
Position: Chief Executive OfficerCompany: Solis Health Plans Email: eduarte@solishealthplans.com
Profile: He is a distinguished leader and Doctor in medicine who harnesses over 17 years of valuable experience in leading healthcare organizations such as Simply, Better Health, Clear Health Alliance, Amerigroup, and HealthSun. Duarte studied Business Administration from the Universidad Galileo de Guatemala and received a Doctorate in Medicine from Universidad Mariano Galvez de Guatemala. He has proven that he is effective in driving cost-efficient results, statewide expansions, membership retention strategies. He has spearheaded the development of new product offerings and generated operational efficiencies by prioritizing interpersonal relationships.
Solis Health Plans
Offers Medicare Advantage plans with a focus on serving local communities.
Services & Solutions
Yes, Solis plans are currently limited to select counties in Florida.
Florida Availability
Yes, Solis specializes in Medicare Advantage plans.
Medicare Advantage Plans
Operates in Miami-Dade, Broward, Palm Beach, Hillsborough, Pinellas, and Polk counties in Florida.
Locations & Service Areas
Doral, Florida (Founded in 2016).
Headquarters
Clients
Primarily seniors eligible for Medicare residing in their service areas.
Specific figures not publicly available, but Solis is a growing company in the Florida Medicare Advantage market.
Operational Numbers
Expanding into new counties within Florida and competing with established players.
Business Struggles
Solis offers online tools for members to find providers, manage their plans, and access health information. They also leverage telehealth services.
Technology Usage
https://www.solishealthplans.com/
Dunia Grijalba
Position: Market President, Florida. Company: Devoted Health Email: dgrijalba@devoted.com
Profile: 10+ years with a national provider group advocating for access to care for over 100k seniors. Previous healthcare experience at national payers. She worked at Avisena managing and analyzing the revenue of physician groups to improve efficiencies and maximize profitability. While at Humana she focused on contracting and managing physicians relationships for the Medicare Advantage lines of business.
Devoted Health
Focuses on Medicare Advantage plans with additional benefits like dental, vision, and hearing coverage.
Services & Solutions
Yes, Devoted offers plans in select counties across Florida.
Florida Availability
Yes, Devoted specializes in Medicare Advantage plans.
Medicare Advantage Plans
Operates in specific regions across 14 states. You can check their website for details https://www.devoted.com/search-providers/.
Locations & Service Areas
Waltham, Massachusetts (Founded in 2014).
Headquarters
Clients
Primarily seniors eligible for Medicare.
Specific figures not publicly available, but Devoted is a growing company in the Medicare Advantage market.
Operational Numbers
Competition in the Medicare Advantage market and expanding into new regions.
Business Struggles
Devoted utilizes technology for care coordination, telehealth services, and member engagement through their online portal and mobile app.
Technology Usage
https://www.devoted.com/es/
Connie Vassallo
Position: Director, Network RelationsCompany: Simply Healthcare Plans Phone: 1-844-405-4296
Profile: Extraordinary leader with over 20 years’ experience in the healthcare industry. Hands-on experience leading operations, contracting, network development, program implementations, and growth strategies. In depth knowledge of Commercial, Medicare, Medicaid and Long Term Care.
Simply Healthcare Plans
Offers Medicare Advantage plans and Medicaid coverage for Florida residents.
Services & Solutions
Yes, Simply Healthcare plans are exclusive to the state of Florida.
Florida Availability
Yes, Simply Healthcare provides various Medicare Advantage plans.
Medicare Advantage Plans
Operates solely within Florida.
Locations & Service Areas
Miami, Florida (Founded in 2009).
Headquarters
Clients
Primarily Florida residents eligible for Medicare or Medicaid.
Specific figures not publicly available.
Operational Numbers
Competition within the Florida Medicare and Medicaid markets.
Business Struggles
Offers online tools for members to manage plans, find providers, and access health information.
Technology Usage
https://www.simplyhealthcareplans.com/florida-home/simply.html
Steven Ruiz
Position: PresidentCompany: CarePlus Health Plans Email: sruiz@careplus-hp.com
Profile: Steven Ruiz is a highly experienced professional with 15.6 years of work experience in the Managed Care Industry. He has a strong background in managed care, healthcare management, and Medicare. Currently, he holds the position of Market Vice President at CarePlus HealthPlans, a subsidiary of Humana. With a focus on network development and provider relations, Steven has successfully led teams and implemented healthcare information technology strategies. He is based in the United States and has a proven track record in the healthcare industry.
CarePlus Health Plans
Offers Medicare Advantage plans and Medicaid coverage for Florida residents.
Services & Solutions
Yes, CarePlus operates mainly in South Florida.
Florida Availability
Yes, CarePlus primarily offers Medicare Advantage plans.
Medicare Advantage Plans
Primarily serves Miami-Dade, Broward, and Palm Beach counties in Florida.
Locations & Service Areas
Miami, Florida (Founded in 1994).
Headquarters
Clients
Primarily seniors eligible for Medicare.
Not publicly available.
Operational Numbers
Competition in the Medicare Advantage market, attracting and retaining members.
Business Struggles
CarePlus offers online tools for members to manage their plans and access health information.
Technology Usage
https://www.careplushealthplans.com/
Matthew Hubbard
Position: PresidentCompany: wellcare Email: mhubbard@centene.com
Profile: Matthew Hubbard, based in Tampa, FL, US, is currently a Director at Centene Corporation, bringing experience from previous roles at WellCare Health Plans (Centene's parent company) and IBM. Matthew Hubbard holds a 1994 - 1998 Bachelor of Science - BS in Management Information Systems, General @ Florida State University. With a robust skill set that includes IT Strategy, IT Infrastructure Management, Information Technology, Business Continuity, It Management Software and more, Matthew Hubbard contributes valuable insights to the industry.
WellCare
Manages care through Medicaid, Medicare Advantage, and Medicare Prescription Drug plans.
Services & Solutions
Yes, WellCare plans are available in Florida.
Florida Availability
Yes, WellCare offers a variety of Medicare Advantage plans.
Medicare Advantage Plans
Operates nationwide through a network of healthcare providers.
Locations & Service Areas
Tampa, Florida (Founded in 1980).
Headquarters
Clients
Individuals and families covered by Medicaid and Medicare programs.
Not publicly available, but WellCare serves millions of members.
Operational Numbers
Competition in the healthcare market, managing costs, and evolving government regulations.
Business Struggles
Invests in online member portals, mobile apps, and telehealth services to improve accessibility and member experience.
Technology Usage
https://www.wellcare.com/
Brandon Haushalter
Position: CEOCompany: Doctors HealthCare PlansEmail: bhaushalter@gmail.com
Profile: Brandon Haushalter has a significant work experience in the healthcare industry, particularly in executive roles. Brandon served as the Chief Executive Officer at Doctors HealthCare Plans, Inc. since 2023. Previously, they held the same position at HCA Florida Kendall Hospital from 2016 to 2023 and at Johnston Willis Hospital from 2014 to 2016. Before becoming a CEO, Brandon worked as the Chief Operating Officer at Chippenham Hospital (HCA) from 2012 to 2014. Brandon also served as the Chief Executive Officer at Bluffton Regional Medical Center (Community Health Systems) from 2010 to 2012 and as the Chief Operating Officer at St. Joseph Hospital (Community Health Systems) from 2009 to 2010. Brandon started their career at Trinity Medical Center (Community Health Systems) as the Assistant CEO from 2004 to 2009.
Doctors HealthCare Plans
Manages care through Medicaid, Medicare Advantage, and Medicare Prescription Drug plans.
Services & Solutions
Yes, WellCare plans are available in Florida.
Florida Availability
Yes, WellCare offers a variety of Medicare Advantage plans.
Medicare Advantage Plans
Operates nationwide through a network of healthcare providers.
Locations & Service Areas
Tampa, Florida (Founded in 1980).
Headquarters
Clients
Individuals and families covered by Medicaid and Medicare programs.
Not publicly available, but WellCare serves millions of members.
Operational Numbers
Competition in the healthcare market, managing costs, and evolving government regulations.
Business Struggles
Invests in online member portals, mobile apps, and telehealth services to improve accessibility and member experience.
Technology Usage
https://www.wellcare.com/
Diego Atienza
Position: Director of Provider RelationsCompany: Leon Medical CenterEmail:
Profile: Direct and oversee the development of Leon Medical Centers Provider Network.
Responsible for the management and activities of contracted providers, issue resolution, evaluation of network adequacy, recruitment of new providers. Maintaining positive provider relationships, advancing the goals of Leon Medical Centers, providing direction for quick resolution to any member issues.
Doctors HealthCare Plans
Services & Solutions
Leon Medical Centers is a network of primary care and urgent care centers that offer a variety of services and solutions to individuals and families. Their services include:
Primary care: Leon Medical Centers offers primary care services, such as preventive care, sick visits, and chronic disease management.
Urgent care: Leon Medical Centers offers urgent care services, such as treatment for minor injuries and illnesses.
Specialty care: Leon Medical Centers offers specialty care services, such as dermatology, cardiology, and orthopedics.
Laboratory services: Leon Medical Centers offers laboratory services, such as blood tests and urinalysis.
Imaging services: Leon Medical Centers offers imaging services, such as X-rays, ultrasounds, and MRIs.
Leon Medical Centers has over 50 locations in Miami-Dade and Broward Counties in Florida.
Locations & Service Areas
Leon Medical Centers was founded in 1995.
Headquarters
https://www.wellcare.com/
Doctors HealthCare Plans
Leon Medical Centers' main clients are individuals and families in Miami-Dade and Broward Counties. Their partners include: The Florida Medicaid Program: Leon Medical Centers is a contracted provider of services to the Florida Medicaid Program.
The Florida Agency for Health Care Administration: Leon Medical Centers is a licensed provider of services to the Florida Agency for Health Care Administration.
Local hospitals and health care providers: Leon Medical Centers partners with local hospitals and health care providers to provide care to their patients.
Clients and partners
Yes, WellCare plans are available in Florida.
Florida Availability
Yes, WellCare offers a variety of Medicare Advantage plans.
Medicare Advantage Plans
Leon Medical Centers has over 1,000 employees. Leon Medical Centers' annual revenue is over $100 million.
Operational Numbers
Leon Medical Centers' main business struggle is to attract and retain patients. The health care market is very competitive, and there are many other primary care and urgent care centers in Miami-Dade and Broward Counties.
Business Struggles
Leon Medical Centers uses technology to improve their service in a number of ways. For example, they use a mobile app to allow patients to access their medical records and schedule appointments. They also use a data analytics platform to track the effectiveness of their services and identify areas where they can improve.
Technology Usage
https://www.wellcare.com/
Benchmarking
contenidos voccare
Created on August 3, 2023
Start designing with a free template
Discover more than 1500 professional designs like these:
View
Vertical Genial One Pager
View
Mobile App Dossier
View
Color Shapes Dossier
View
Notes Dossier
View
Futuristic Tech Dossier
View
Crowdfunding Campaign
View
Company Dossier
Explore all templates
Transcript
Benchmarking
South Florida - Prospects
iniciar
Health Insurance
Benchmarking Florida - Prospects
Health Insurance in Florida
Nick Zaffiris
Position: CEO FloridaCompany: United HealthCare Services Contact Phone:
Profile: Nicholas (Nick) J. Zaffiris is the CEO of UnitedHealthcare Florida markets. He is responsible for delivering affordable, quality-based health programs to employers and members and is in charge of the operations and commercial business performance in Florida. Nick joined UnitedHealthcare in June of 2007 as the Vice President of Key Accounts for the South Florida Health Plan, where he was responsible for the sales and retention of the mid-market employer accounts in his region.
United Health care
Helping people live healthier lives and helping make the health system work better for everyone.
Industry: Health InsuranceCompany size : Over 250,000 employees ( )Headquaters: Minneapolis, MN Type: Specialties: Health Care, Wellness and Health Management, Retiree Solutions, and Information Technology
https://www.unitedhealthgroup.com/
Opportunities / Solutions
Yet to be determined, they work with Medicare Plan C.
Products/Services
Medicare Advantage plans Medicaid plans Individual and family health insurance plans Dental insurance plans Vision insurance plans Life insurance plans Prescription drug plans Health and wellness resources
50 states / Nationwide
Network/Counties
Established
Founded in 1977
https://www.linkedin.com/company/unitedhealth-group/
Company linkedin profile
UnitedHealthcare
Hospitals, clinics, and community health centers.
Clients/Partners
Services Access via
Telephone, online and United Healthcare app.
Medicare Advantage plans, Medicaid plans, Individual and family health insurance plans, Dental insurance plans, Vision insurance plans, Life insurance plans, Prescription drug plans, Health and wellness resources.
Product/Service details
Main business Opportunities
Caraline Coats
Position: Regional President, Florida HumanaCompany: Humana Contact phone: +1 305-698- 3100
Profile : Caraline Coats, a 14-year Humana veteran, will lead Humana’s South Florida Medicare market and report to Alan Stewart, Humana Senior Vice President and Southeast Division Leader. As South Florida Medicare President, Coats is responsible for developing and expanding Humana’s Medicare business in the 11-county South Florida region, including Broward, Miami-Dade and Palm Beach counties, and the Treasure Coast.
Humana
Humana is a health insurance company that offers a variety of services and solutions to individuals, families, and businesses.
Industry : Health Insurance CompanyCompany size : Over 30,000 employees ( )Headquaters: Louisville, Kentucky Type: Specialties:
https://www.humana.com/
Plan C Medicare insurance
Opportunities / Solutions
Health insurance /Individual and family. Medicare Advantage, Medicaid.
Products/Services
50 states / Nationwide and the District of Columbia
Network/Counties
Established
Founded in 1961
https://www.linkedin.com/company/humana/
PCompany linkedin profile
Humana
The Centers for Medicare & Medicaid Services (CMS). The Florida Agency for Health Care Administration (AHCA). Local hospitals and health care providers . Businesses.
Clients/Partners
Telephone and mobile app
Services access via
Health insurance: Humana offers a variety of health insurance plans, including Medicare Advantage plans, Medicaid plans, and individual and family health insurance plans. Medicare: Humana is a Medicare-approved provider. They offer a variety of Medicare Advantage plans, as well as prescription drug plans and Medigap plans. Medicaid: Humana is a Medicaid-approved provider. They offer a variety of Medicaid plans, as well as managed long-term care plans. Behavioral health: Humana offers a variety of behavioral health services, including mental health and substance abuse treatment. Vision: Humana offers vision insurance plans that cover eye exams, glasses, and contact lenses. Dental: Humana offers dental insurance plans that cover dental exams, cleanings, fillings, and other dental services.
Product/Service details
Humana's main business struggle is to attract and retain members. The health insurance market is very competitive, and there are many other health insurance companies offering plans in the United States.
Main business Opportunities
Patrick Geraghty
Position: CEO Company: Florida Blue Contact phone: 1-877-352-5830
Profile: He is a health care executive, Florida business leader, and board member of non-profits and business organizations focused on helping people and communities achieve better health. He believes everyone deserves affordable, quality health care. As president and CEO of mission-driven GuideWell Mutual Holding Corporation and Florida Blue, He works closely with him team, communities and business leaders throughout the state and country to find better ways to bring more affordable and quality health solutions to everyone.
Blue Cross and Blue Shield of Florida, Inc. DBA Florida Blue
Your local Blue Cross Blue Shield health partner.
Industry : Wellness and Fitness ServicesCompany size : 5,000-10,000 employees ( )Headquaters: Jacksonville, Florida. Type: Non profit Specialties: Health Insurance, Health and Wellness, Health Solutions, Health Innovation.
http://www.floridablue.com
1.-SilverSneakers is an innovative wellbeing free of charge improvement program that helps older adults stay physically active and socially engaged. 2.-60 hours of help around the house for things like light housekeeping, grocery shopping, and meal preparation 3.- Support services to help you schedule appointments, provide transportation, or explain your benefits.
Opportunities / Solutions
Individual and family health insurance plans: health insurance coverage, including prescription drugs, preventive care, and hospital stays.
Products/Services
Network/counties
Florida Over 4 MM members
Established
Founded 1986
Company linkedin profile
https://www.linkedin.com/company/florida-blue/
Blue Cross and Blue Shield of Florida, Inc. DBA Florida Blue
The Centers for Medicare & Medicaid Services (CMS), The Florida Agency for Health Care Administration (AHCA), Florida Blue is a Medicaid-approved health insurance company, Local hospitals and health care providers, Businesses/employees.
Clients/Partners
Service access via.
Telephone 24/7 service, online tools
Individual and family health insurance plans: health insurance coverage, including prescription drugs, preventive care, and hospital stays.Medicare Advantage plans: These plans offer comprehensive health insurance coverage to seniors who are enrolled in Medicare. Medicaid plans: These plans offer health insurance coverage to low-income individuals and families.
Product/services details
Medicare Advantage plans: These plans offer comprehensive health insurance coverage to seniors who are enrolled in Medicare. Medicaid plans: These plans offer health insurance coverage to low-income individuals and families.
Main business Opportunities
Jennifer A. Sweet
Position: CEOCompany: Aetna Contact phone: 1-855-335-1407
Profile: Jennifer Sweet, based in Tampa, FL, US, is currently a Chief Executive Officer at Aetna Better Health of Florida, a CVS Health Company, bringing experience from previous roles at PopHealthCare, a GuideWell Company, Florida Blue, a GuideWell Company, Integral Health Plan Inc. and Integral Health Plan Inc (under Aetna management 2010-2013). Jennifer Sweet holds a 2014 - 2015 Executive MBA, Health Sector Management & Policy @ University of Miami - School of Business. With a robust skill set that includes Access, HIPAA, Health Insurance, Healthcare, Healthcare Consulting and more.
Aetna, a CVS Health Company
Building a healthier world by making health care easy, affordable and all about you. Because Healthier Happens Together (TM)
Industry : Wellness and Fitness ServicesCompany size :10,001 + employees (+50,000)Headquaters: Hartford , Connecticut Type: Public Company
https://www.aetna.com/index.html
1.- Nurse line 24/7 2.- Meals Services ( Independent Living Systems) could be a direct competitor for ADDIUVA 3.- Assistance 24/7 https://www.lifestation.com/(competitor for ADDIUVA) 4.-Resources For Living® With one phone call, members can get help finding local services and programs, beyond what’s covered by plan benefits 5.-Telehealth*
Opportunities/ Solutions
Consumer Health, Accountable Care, Health Care Innovation.
Products/Services
Network/counties
50 states / Nationwide
Established
Founded in 1853.
Company linkedIn profile.
https://www.linkedin.com/company/aetna/
Aetna, a CVS Health Company
Individual and family health insurance, Medicaid, Medicare Advantage, Small business health insurance, Virtual health Plans.
Clients/Partners
Services access via
Telephone and social media
Individual & family health insurance plans: These plans offer comprehensive health insurance coverage, including prescription drugs, preventive care, and hospital stays.Medicare Advantage plans: These plans offer comprehensive health insurance coverage to seniors who are enrolled in Medicare. Medicaid plans: These plans offer health insurance coverage to low-income individuals and families. Small business health insurance plans: These plans offer health insurance coverage to small businesses.
product/services details
Aetna's main business struggle is to attract and retain members. The health insurance market is very competitive, and there are many other health insurance companies offering plans in the United States.
Main business Opportunities
Hector Hernandez
Position: Director Company: Health Sun Contact phone: 305-448-8100
Profile: Founded in 2005, HealthSun is a local Medicare Managed Care Organization with administrative offices located in Miami, Florida. Serving more than 50,000 members in Dade, Broward and Palm Beach Counties, HealthSun is one of the fastest growing health plans in South Florida. Additionally, HealthSun has received an overall CMS Star Rating of 5 out of 5 Stars for 2018, 2019, 2020 and 2021. Our valued members are serviced through our extensive provider network and dedicated professionals. As a local plan, we recognize the healthcare needs of our community and strive to provide our members with only the best service and experience possible.
HealthSun
HealthSun is a Medicare Managed Care Organization (MCO) that offers a variety of health care plans to seniors in South Florida.
Industry : Hospital and Health careCompany size : 500-1,000 employees ( )Headquaters: Blue Bell, Pennsylvania Type: Specialties:
http://www.healthsun.com
Does not have plan C coverage, there are opportunities in the transport service provided.
Opportunities/ Solutions
Medicare Advantage plans, Medicaid plans, Special Needs Plans/specialized health care coverage .
Products/Services
Dade, Broward, and Palm Beach Counties in Florida. Network over 25,000 providers, including doctors, hospitals, and pharmacies, and 50,000 members.
Network/counties
Established
Founded 2005
Company linkedin profile
https://www.linkedin.com/company/healthsun-health-plans-inc/
HealthSun
Clients: seniors . Their partners include: The Centers for Medicare & Medicaid Services (CMS) The Florida Agency for Health Care Administration (AHCA) Local hospitals and health care providers
Clients/Partners
Services access via
Telefono, mobile App, portal en línea.
Medicare Advantage plans: These plans offer comprehensive health care coverage, including prescription drugs, preventive care, and hospital stays. Medicaid plans: These plans offer health care coverage to low-income individuals and families. Special Needs Plans: These plans offer specialized health care coverage to individuals with complex medical needs.
Products /services details
HealthSun's main business struggle is to attract and retain members. The Medicare and Medicaid markets are very competitive, and there are many other MCOs offering plans in South Florida.
Main business Opportunities
Ernest Jenkins
Position: Vice President of SalesCompany: Cigna Healthcare Email: ernestjenkinsjr@gmail.com
Profile: Ernest Jenkins, based in Fort Lauderdale, FL, US, is currently a Vice President of Sales at Cigna Healthcare at Cigna, bringing experience from previous roles at Cigna, United Health Care, Benelogic and Aon Consulting. Ernest Jenkins holds a 1998 - 2000 MBA in Business @ Wilmington University. With a robust skill set that includes Health Insurance, Insurance, Account Management, Brokers, Employee Benefits and more, Ernest Jenkins contributes valuable insights to the industry.
Cigna Healthcare
Industry: Managed Healthcare and InsuranceCompany size : Over 68,000 employeesHeadquaters: Bloomfield, Connecticut, USA Type: Public Company Specialties: Health insurance plans, including medical, dental, vision, behavioral health, and pharmacy benefits management
https://www.cigna.com/
Yet to be determined
Opportunities / Solutions
Medical Insurance, behavioral health and wellness programs, dental and vision insurance, supplemental health solutions, health savings accounts (HSAs) and spending accounts (FSAs)
Products/Services
Cigna offers national coverage
Network/Counties
Established
Founded in 1982
https://www.linkedin.com/company/cignahealthcare/
Company linkedin profile
Cigna Group serves a dual role, catering to both individual consumers and businesses. Individuals and families can enroll in Cigna's health insurance plans, while businesses partner with Cigna to offer health benefits to their employees.
Clients/Partners
Services access via
Telephone, whatsapp, social media, mobile app,
Lawrence Schreiber
Position: Board MemberCompany: AV Med
Profile: An accomplished healthcare executive with a skill set uniquely attuned to the rapidly changing national, regional and local healthcare marketplace, Larry Schreiber is the President and CEO of SantaFe Healthcare. In his roles he has responsibility and accountability for the strategic, organizational and overall performance of SantaFe Healthcare and its Affiliates. A Certified Employee Benefits Specialist (CEBS) and strategic leader, Schreiber brings 30 years of experience to each challenge he tackles. He believes the best health care is focused on provider collaborations that help people to get and stay healthy.
AV MED
Opportunities / Solutions
Yet to be determined
Medicare Advantage plans (combining Parts A & B with prescription drug coverage).
Products/Services
Yes, AvMed specializes in Medicare Advantage plans.
Medicare Advantage Plans
Focuses on Florida with limited availability in other states.
Locations & Service Areas
Miami, Florida (Founded in 1949).
Headquarters
Clients
Primarily seniors eligible for Medicare.
Not publicly available, but AvMed is a leading Medicare Advantage provider in Florida.
Operational Numbers
Competition in the Medicare Advantage market, attracting and retaining members.
Business Struggles
AvMed offers online tools for members to manage their plans and access health information.
Technology Usage
https://www.avmed.org
Efrain Duarte
Position: Chief Executive OfficerCompany: Solis Health Plans Email: eduarte@solishealthplans.com
Profile: He is a distinguished leader and Doctor in medicine who harnesses over 17 years of valuable experience in leading healthcare organizations such as Simply, Better Health, Clear Health Alliance, Amerigroup, and HealthSun. Duarte studied Business Administration from the Universidad Galileo de Guatemala and received a Doctorate in Medicine from Universidad Mariano Galvez de Guatemala. He has proven that he is effective in driving cost-efficient results, statewide expansions, membership retention strategies. He has spearheaded the development of new product offerings and generated operational efficiencies by prioritizing interpersonal relationships.
Solis Health Plans
Offers Medicare Advantage plans with a focus on serving local communities.
Services & Solutions
Yes, Solis plans are currently limited to select counties in Florida.
Florida Availability
Yes, Solis specializes in Medicare Advantage plans.
Medicare Advantage Plans
Operates in Miami-Dade, Broward, Palm Beach, Hillsborough, Pinellas, and Polk counties in Florida.
Locations & Service Areas
Doral, Florida (Founded in 2016).
Headquarters
Clients
Primarily seniors eligible for Medicare residing in their service areas.
Specific figures not publicly available, but Solis is a growing company in the Florida Medicare Advantage market.
Operational Numbers
Expanding into new counties within Florida and competing with established players.
Business Struggles
Solis offers online tools for members to find providers, manage their plans, and access health information. They also leverage telehealth services.
Technology Usage
https://www.solishealthplans.com/
Dunia Grijalba
Position: Market President, Florida. Company: Devoted Health Email: dgrijalba@devoted.com
Profile: 10+ years with a national provider group advocating for access to care for over 100k seniors. Previous healthcare experience at national payers. She worked at Avisena managing and analyzing the revenue of physician groups to improve efficiencies and maximize profitability. While at Humana she focused on contracting and managing physicians relationships for the Medicare Advantage lines of business.
Devoted Health
Focuses on Medicare Advantage plans with additional benefits like dental, vision, and hearing coverage.
Services & Solutions
Yes, Devoted offers plans in select counties across Florida.
Florida Availability
Yes, Devoted specializes in Medicare Advantage plans.
Medicare Advantage Plans
Operates in specific regions across 14 states. You can check their website for details https://www.devoted.com/search-providers/.
Locations & Service Areas
Waltham, Massachusetts (Founded in 2014).
Headquarters
Clients
Primarily seniors eligible for Medicare.
Specific figures not publicly available, but Devoted is a growing company in the Medicare Advantage market.
Operational Numbers
Competition in the Medicare Advantage market and expanding into new regions.
Business Struggles
Devoted utilizes technology for care coordination, telehealth services, and member engagement through their online portal and mobile app.
Technology Usage
https://www.devoted.com/es/
Connie Vassallo
Position: Director, Network RelationsCompany: Simply Healthcare Plans Phone: 1-844-405-4296
Profile: Extraordinary leader with over 20 years’ experience in the healthcare industry. Hands-on experience leading operations, contracting, network development, program implementations, and growth strategies. In depth knowledge of Commercial, Medicare, Medicaid and Long Term Care.
Simply Healthcare Plans
Offers Medicare Advantage plans and Medicaid coverage for Florida residents.
Services & Solutions
Yes, Simply Healthcare plans are exclusive to the state of Florida.
Florida Availability
Yes, Simply Healthcare provides various Medicare Advantage plans.
Medicare Advantage Plans
Operates solely within Florida.
Locations & Service Areas
Miami, Florida (Founded in 2009).
Headquarters
Clients
Primarily Florida residents eligible for Medicare or Medicaid.
Specific figures not publicly available.
Operational Numbers
Competition within the Florida Medicare and Medicaid markets.
Business Struggles
Offers online tools for members to manage plans, find providers, and access health information.
Technology Usage
https://www.simplyhealthcareplans.com/florida-home/simply.html
Steven Ruiz
Position: PresidentCompany: CarePlus Health Plans Email: sruiz@careplus-hp.com
Profile: Steven Ruiz is a highly experienced professional with 15.6 years of work experience in the Managed Care Industry. He has a strong background in managed care, healthcare management, and Medicare. Currently, he holds the position of Market Vice President at CarePlus HealthPlans, a subsidiary of Humana. With a focus on network development and provider relations, Steven has successfully led teams and implemented healthcare information technology strategies. He is based in the United States and has a proven track record in the healthcare industry.
CarePlus Health Plans
Offers Medicare Advantage plans and Medicaid coverage for Florida residents.
Services & Solutions
Yes, CarePlus operates mainly in South Florida.
Florida Availability
Yes, CarePlus primarily offers Medicare Advantage plans.
Medicare Advantage Plans
Primarily serves Miami-Dade, Broward, and Palm Beach counties in Florida.
Locations & Service Areas
Miami, Florida (Founded in 1994).
Headquarters
Clients
Primarily seniors eligible for Medicare.
Not publicly available.
Operational Numbers
Competition in the Medicare Advantage market, attracting and retaining members.
Business Struggles
CarePlus offers online tools for members to manage their plans and access health information.
Technology Usage
https://www.careplushealthplans.com/
Matthew Hubbard
Position: PresidentCompany: wellcare Email: mhubbard@centene.com
Profile: Matthew Hubbard, based in Tampa, FL, US, is currently a Director at Centene Corporation, bringing experience from previous roles at WellCare Health Plans (Centene's parent company) and IBM. Matthew Hubbard holds a 1994 - 1998 Bachelor of Science - BS in Management Information Systems, General @ Florida State University. With a robust skill set that includes IT Strategy, IT Infrastructure Management, Information Technology, Business Continuity, It Management Software and more, Matthew Hubbard contributes valuable insights to the industry.
WellCare
Manages care through Medicaid, Medicare Advantage, and Medicare Prescription Drug plans.
Services & Solutions
Yes, WellCare plans are available in Florida.
Florida Availability
Yes, WellCare offers a variety of Medicare Advantage plans.
Medicare Advantage Plans
Operates nationwide through a network of healthcare providers.
Locations & Service Areas
Tampa, Florida (Founded in 1980).
Headquarters
Clients
Individuals and families covered by Medicaid and Medicare programs.
Not publicly available, but WellCare serves millions of members.
Operational Numbers
Competition in the healthcare market, managing costs, and evolving government regulations.
Business Struggles
Invests in online member portals, mobile apps, and telehealth services to improve accessibility and member experience.
Technology Usage
https://www.wellcare.com/
Brandon Haushalter
Position: CEOCompany: Doctors HealthCare PlansEmail: bhaushalter@gmail.com
Profile: Brandon Haushalter has a significant work experience in the healthcare industry, particularly in executive roles. Brandon served as the Chief Executive Officer at Doctors HealthCare Plans, Inc. since 2023. Previously, they held the same position at HCA Florida Kendall Hospital from 2016 to 2023 and at Johnston Willis Hospital from 2014 to 2016. Before becoming a CEO, Brandon worked as the Chief Operating Officer at Chippenham Hospital (HCA) from 2012 to 2014. Brandon also served as the Chief Executive Officer at Bluffton Regional Medical Center (Community Health Systems) from 2010 to 2012 and as the Chief Operating Officer at St. Joseph Hospital (Community Health Systems) from 2009 to 2010. Brandon started their career at Trinity Medical Center (Community Health Systems) as the Assistant CEO from 2004 to 2009.
Doctors HealthCare Plans
Manages care through Medicaid, Medicare Advantage, and Medicare Prescription Drug plans.
Services & Solutions
Yes, WellCare plans are available in Florida.
Florida Availability
Yes, WellCare offers a variety of Medicare Advantage plans.
Medicare Advantage Plans
Operates nationwide through a network of healthcare providers.
Locations & Service Areas
Tampa, Florida (Founded in 1980).
Headquarters
Clients
Individuals and families covered by Medicaid and Medicare programs.
Not publicly available, but WellCare serves millions of members.
Operational Numbers
Competition in the healthcare market, managing costs, and evolving government regulations.
Business Struggles
Invests in online member portals, mobile apps, and telehealth services to improve accessibility and member experience.
Technology Usage
https://www.wellcare.com/
Diego Atienza
Position: Director of Provider RelationsCompany: Leon Medical CenterEmail:
Profile: Direct and oversee the development of Leon Medical Centers Provider Network. Responsible for the management and activities of contracted providers, issue resolution, evaluation of network adequacy, recruitment of new providers. Maintaining positive provider relationships, advancing the goals of Leon Medical Centers, providing direction for quick resolution to any member issues.
Doctors HealthCare Plans
Services & Solutions
Leon Medical Centers is a network of primary care and urgent care centers that offer a variety of services and solutions to individuals and families. Their services include: Primary care: Leon Medical Centers offers primary care services, such as preventive care, sick visits, and chronic disease management. Urgent care: Leon Medical Centers offers urgent care services, such as treatment for minor injuries and illnesses. Specialty care: Leon Medical Centers offers specialty care services, such as dermatology, cardiology, and orthopedics. Laboratory services: Leon Medical Centers offers laboratory services, such as blood tests and urinalysis. Imaging services: Leon Medical Centers offers imaging services, such as X-rays, ultrasounds, and MRIs.
Leon Medical Centers has over 50 locations in Miami-Dade and Broward Counties in Florida.
Locations & Service Areas
Leon Medical Centers was founded in 1995.
Headquarters
https://www.wellcare.com/
Doctors HealthCare Plans
Leon Medical Centers' main clients are individuals and families in Miami-Dade and Broward Counties. Their partners include: The Florida Medicaid Program: Leon Medical Centers is a contracted provider of services to the Florida Medicaid Program. The Florida Agency for Health Care Administration: Leon Medical Centers is a licensed provider of services to the Florida Agency for Health Care Administration. Local hospitals and health care providers: Leon Medical Centers partners with local hospitals and health care providers to provide care to their patients.
Clients and partners
Yes, WellCare plans are available in Florida.
Florida Availability
Yes, WellCare offers a variety of Medicare Advantage plans.
Medicare Advantage Plans
Leon Medical Centers has over 1,000 employees. Leon Medical Centers' annual revenue is over $100 million.
Operational Numbers
Leon Medical Centers' main business struggle is to attract and retain patients. The health care market is very competitive, and there are many other primary care and urgent care centers in Miami-Dade and Broward Counties.
Business Struggles
Leon Medical Centers uses technology to improve their service in a number of ways. For example, they use a mobile app to allow patients to access their medical records and schedule appointments. They also use a data analytics platform to track the effectiveness of their services and identify areas where they can improve.
Technology Usage
https://www.wellcare.com/