UnitedHealth Group and Sierra Health Services have received approval from Californias insurance commissioner to move ahead with their $2.6 billion merger.
California was the last of three states to grant approval. The Nevada Division of Insurance granted approval last month after a series of hearings this past summer, and Arizona quickly followed suit.
The Justice Department must still approve the deal.
Nevada Attorney General Catherine Cortez Masto is still reviewing the terms of the deal and has the option of filing a lawsuit to block it.
The American Medical Association, Nevada Gov. Jim Gibbons and others have raised concerns that the merger could reduce health plan competition in Nevada and ultimately raise premiums and lower provider reimbursement rates.
Sierra Health, Las Vegas, is Nevadas largest health insurer.
UnitedHealth and Sierra officials said the transaction is expected to be completed by the end of the year. -- by Rebecca Vesely
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