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time all requested information is received to evaluate; if the thirty-day period expires or is terminated by the agency, the deal is allowed to move forward.194 If the proposal raises serious concerns regarding competition, the reviewing agency asks for an extended review as a “second request.”195 A majority of the proposed deals reviewed by the FTC and DOJ are allowed to proceed after the preliminary review.196 When a second request is initiated, companies are compelled to provide all information requested by the agencies.197 When all information requested has been provided, the agency has thirty days to review the information and make a decision on how to move forward.198 After the second request, federal regulators have three options: ( 1) close the investigation and allow the merger to move forward; ( 2) request that the filing companies to divest certain aspects of business before moving forward; or ( 3) file an injunction in federal court to block the deal.199 States also play an important role in antitrust enforcement. In their role as the chief regulator for the insurance industry, almost every state has implemented versions of the federal antitrust laws.200 As the state’s chief legal counsel, a state’s attorney general (AG) plays an important role in antitrust law enforcement. AGs have the ability to bring antitrust suits on behalf of individual citizens in a state or on behalf of the state as a purchaser.201 An AG may bring an action to enforce the state’s own antitrust laws and may join with federal investigators in antitrust reviews.202 Particular to health insurance mergers, state insurance commissioners play an important role in review and approval. Insurance commissioners are in a unique position to analyze the health insurance market in their state and consider additional factors that may impact the market specific to their state, outside
“clearance process.” Id. 194. Perlman, supra note 192. 195. FED. TRADE COMM’N, MERGER REVIEW, https://www.ftc.gov/news-events/media- resources/mergers-and-competition/merger-review (last visited Mar. 10, 2016) [hereinafter FTC, MERGER REVIEW]. 196. Id. 197. Id. 198. F TC, PREMERGER NOTIFICATION, supra note 192. 199. F TC, MERGER REVIEW, supra note 195. 200. F TC, GUIDE TO ANTITRUST LAWS, supra note 162. 201. F TC, THE ENFORCERS, supra note 147. 202. Id.; David Hatch, Texas Leads Antirust Fight Against Google, GOVERNING MAG. (Oct. 2, 2012), http://www.governing.com/blogs/view/gov-texas-leads-antitrust-fight-against- google.html (noting the Texas Attorney General’s conduction of formal antitrust review of Google); Joel Brinkley, U.S. v. Microsoft: the Overview, U.S. Judge Says Microsoft Violated Antitrust Laws with Predatory Behaviors, N. Y. TIMES (Apr. 4, 2000), http://www.nytimes. com/2000/04/04/business/us-vs-microsoft-overview-us-judge-says-microsoft-violated- antitrust-laws-with.html?pagewanted=all (noting that in 1998, nineteen State Attorney Generals joined the DOJ in suing Microsoft alleging violation of federal antitrust laws through predatory and anticompetitive behavior).