Big contracts were renewed or awarded for the first time in the Mid-Atlantic this summer. Anthem Blue Cross and Blue Shield (the largest health insurance carrier in Virginia) and Kaiser Permanente will continue to provide administrative services for Virginia's employee benefit plan, which covers 197,600 state employees, dependents and retirees. For the first time, Optima Health also joined the mix of carriers with a contract to provide a pilot insurance program, COVA Connect, which emphasizes prevention and wellness and is limited to the Hampton Roads area. Aetna scored in the battle for big contracts in the Mid-Atlantic, by winning the North Region TRICARE contract, which is expected to bring the Hartford-based insurer $1.1 billion of gross revenue over five years and 2.8 million more members. UnitedHealth Group had to ante up in the state of Maryland, where it was forced to pay more than $1.5 million in restitution and penalties this summer, most of that amount for inappropriately denying claims in the state. Meanwhile, brokers say that the recession means that employers are searching for aggressively priced products, especially consumer driven health plans. The carriers themselves saw diminished profits in their commercial HMOs in 2008, mainly from investments, and they are scrambling to make up the difference with premium increases.