NEW YORK (AP) — Anthem is buying rival Cigna in a deal valued at $54.2 billion that will create the nation’s largest health insurer by enrollment, covering about 53 million patients in the U.S.

The deal comes just three weeks after the insurer Aetna bid $35 billion for Humana in a buyout frenzy that will transform five massive U.S. health companies into three even larger ones.

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Shareholders of Cigna, based in Bloomfield, Connecticut, will receive $103.40 per share in cash and 0.5152 shares of Anthem stock for each of their shares. The companies put the total value at $188 per share. The deal is targeted to close in the second half of 2016.

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Anthem, based in Indianapolis, has pursued Cigna aggressively for months.

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