Now that federal healthcare reform is passed, insurance companies and their regulators are turning their focus to immediate tasks, in particular setting up a high-risk pool for an estimated 5,000 individuals with pre-existing conditions. In addition, insurers are facing a federal mandate to spend a prescribed amount of their premium dollars on medical care, which will limit profits. This comes at a time when the state is scrutinizing their rating practices. In fact, Highmark has temporarily backed off plans to medically underwriting small groups under pressure from the insurance commissioner. With their attention diverted to regulation, carriers are not making the bold plays for market share they had in the past, which, along with the slow economy, will likely continue for 2010 the flat growth rate in the commercial sector the plans saw in the last half of 2009. Meanwhile, health plans are focusing on quality programs. Independence Blue Cross has boosted its incentive programs for providers to set up medical homes and improve quality of care, while Highmark Inc. is getting attention from other Blue plans across the country for its hospital incentive program. On the pharmacy front, insurers are starting to loosen up policies that restricted customers from getting 90-day supplies of maintenance medications at retail pharmacies. IBC has a new drug plan that pushes generic medications.