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Health insurance companies know that the health insurance arm is capped at 80% so they have added vertical companies to capture the profits. Check the full breath of CVS for example. Their Health Insurance may be capped at 80% profits but their doctor’s offices, their pharmacy and so on don’t have a cap. It’s just moving the money around to comply with the 80% rule while moving the profits to sister companies along the stack. Basically Hollywood accounting in health insurance.