Anthem, Cigna Shareholders Approve $48 B Tie-Up

A $48-billion deal that would create the nation’s largest health insurer inched closer to completion after shareholders of both Anthem and Cigna voted in favor of a buyout.

The companies said that nearly all of their shareholders approved the deal, announced last July, when Blue Cross-Blue Shield coverage provider Anthem said it would pay $103.40 and a portion of its stock for each Cigna share. The boards of both companies have already approved the deal, and shareholder backing was widely expected, but the acquisition still has one more key hurdle to clear.

Both federal and state regulators are reviewing the combination, which would create an insurance company that would cover more than 50 million people. This deal and a proposed combination of Aetna and Humana have raised anti-trust concerns in part due to the negotiating leverage that the bigger insurers might gain over entities like health care providers. The insurers have said that the combinations pose little threat to competition because plenty of rivals will remain in individual markets.

Anthem and Cigna expect the acquisition to close in the second half of next year, as do Aetna and Humana.

Anthem Inc., based in Indianapolis, is already the nation’s second-largest health insurer. Cigna Corp., based in Bloomfield, Connecticut, ranks fourth in terms of enrollment.

Anthem specializes in selling individual coverage and insurance to workers of small businesses. It also has grown its government business, which includes Medicare, Medicaid and coverage of federal employees. Aside from health insurance, Cigna also sells group disability and life coverage in the U.S., and it has a growing international segment.

Anthem shares fell $1.86 to $131.12 in afternoon trading, while Cigna fell $1.90 to $137.75. Broader indexes fell less than 1 percent.

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