Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of Medicare Contractor's Pension Segmentation Requirements at Anthem Insurance Companies, Inc. for the Period January 1, 1991, to January 1, 2003," (A-07-04-00181)

October 18, 2005


Complete Text of Report is available in PDF format (532 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

Our objectives were to determine if Anthem complied with the Medicare contractsí pension segmentation requirements while updating AdminaStarís Medicare segment assets from January 1, 1991, to January 1, 2003, and Maineís Medicare segment assets from December 31, 2000, to January 1, 2003.  We found that Anthem did not comply with the Medicare contractsí pension segmentation requirements while updating AdminaStarís and MaineísMedicare segment assets.  As a result, Anthem overstated AdminaStarís Medicare segment assets by $440,294 from January 1, 1991, to January 1, 2003, and Maineís Medicare segment assets by $192,694 from December 31, 2000, to January 1, 2003.   

We recommended that Anthem: (1) decrease AdminaStarís Medicare segment pension assets by $440,294 as of January 1, 2003; (2) decrease Maineís Medicare segment pension assets by $192,694 as of January 1, 2003; and (3) implement controls to ensure that it updates the Medicare segmentsí assets in accordance with the Medicare contracts.  Anthem agreed with our report findings.  Anthem also provided information that we used to clarify the report background.