Aetna 2015 Annual Report Download - page 78

Annual Report- Page 72
as significant acquisitions (including the Proposed Acquisition), strategic alliances, joint ventures and multi-year
strategic projects (including developing, operating and seeking to expand our consumer business and implementing
new provider support programs), simultaneously. Our existing business partnership relationships and a limited
budget of human resources and capital present further challenges.
If we are unable to successfully simplify and integrate our businesses, processes and systems, including those from
acquisitions (including the Proposed Acquisition), to realize anticipated economic and other benefits in a timely
manner, it could result in substantial costs or delays and adversely affect our business, operations and operating
results.
Sales of our products and services are dependent on our ability to attract and motivate internal sales personnel
and independent third-party brokers, consultants and agents. We may be subject to penalties or other regulatory
actions as a result of the marketing practices of brokers and agents selling our products.
Our products are sold primarily through our sales personnel, who frequently work with independent brokers,
consultants and agents who assist in the production and servicing of business. The independent brokers, consultants
and agents generally are not dedicated to us exclusively and may frequently recommend and/or market health care
benefits products of our competitors. Accordingly, we must compete intensely for their services and allegiance. Our
sales could be adversely affected if we are unable to attract, retain or motivate sales personnel and third-party
brokers, consultants and agents, or if we do not adequately provide support, training and education to this sales
network regarding our complex product portfolio, or if our sales strategy is not appropriately aligned across
distribution channels. This risk is heightened as we develop, operate and seek to expand our consumer business and
our business model evolves to include a greater focus on consumers and direct-to-consumer sales, such as
competing for sales on Insurance Exchanges.
In addition, there have been a number of investigations regarding the marketing practices of brokers and agents
selling health care and other insurance products and the payments they receive. These investigations have resulted
in enforcement actions against companies in our industry and brokers and agents marketing and selling those
companies’ products. For example, CMS and state departments of insurance have increased their scrutiny of the
marketing practices of brokers and agents who market Medicare products. These investigations and enforcement
actions could result in penalties and the imposition of corrective action plans and/or changes to industry practices,
which could adversely affect our ability to market our products.
We face a wide range of risks, and our success depends on our ability to identify, prioritize and appropriately
manage our enterprise risk exposures.
As a large company operating in multiple complex industries and in many countries, we encounter a variety of
risks. The risks we face include, among other matters, the range of industry, competitive, regulatory, financial,
operational or external risks identified in this “Forward Looking Information/ Risk Factors” discussion. We
continue to devote resources to further develop and integrate our enterprise-wide risk management processes.
Failure to identify, prioritize and appropriately manage or mitigate these risks, including risk concentrations across
different segments, products (e.g., Insured vs. ASC), industries, customers and geographies, can adversely affect our
operating results, our ability to retain or grow business, or, in the event of extreme circumstances, our financial
position or business operations.
We also face other risks that could adversely affect our business, operating results or financial position, which
include:
• Health care benefits provider fraud that is not prevented or detected and impacts our medical cost trends or
those of our self-insured customers. In addition, in an adverse and/or uncertain economic environment,
whether in the United States or abroad, our businesses may see increased fraudulent claims volume, which
may lead to additional costs because of an increase in disputed claims and litigation;