HMOs are busy enough at home, but a few of the bigger ones including Aetna International, United Healthcare, Kaiser Permanente International and Cigna are feeling their way in the developing markets of Latin America, Asia and Central Europe.

ECONOMIST: Medicine for export

Aetna also owns financial services and international businesses, which it is in the process of selling to the Netherlands' ING Groep .

FORBES: Focus On The Forbes 500s: Aetna Earnings Down, Stock Up

Jive added new or expanded customer relationships with Aetna, Bridgepoint Education, Lafarge, ServiceSource, Palo Alto Networks, Information Security Forum, Genpact International Inc. and Plantronics.

FORBES: Jive Q1 Earnings, Revenue Top Street Estimates