Editor's Note: Since this piece was originally published in Benefits Selling, Anthem Inc. purchased Cigna Corp. for $48.4 billion. 

When Aetna announced its intention to acquire Humana for $37 billion in early July, the shock-wave effect was almost instantaneous. Insurance commissioners and attorneys general in several states announced their intentions to review the merger, stock in both companies dropped, and some industry experts—and outsiders—wondered whether this could be a harbinger of the future of health insurance, or even a step in the direction of a single-payer system.

Then, in a smaller but still significant deal, Centene's acquisition of Health Net for $6.3 billion was announced, and the speculation about the potential impact on the industry grew more pointed.

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