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Harvard Pilgrim expands NH hospital choices

New Hampshire Union Leader

June 16. 2014 8:32PM

CONCORD - Harvard Pilgrim Health Care unveiled its network of providers for the online health insurance marketplace at on Monday, promising to include all New Hampshire hospitals, unlike the Anthem network launched last fall, which excluded 10 of the state's 26 hospitals and caused an uproar.

Beth Roberts, senior vice president for regional markets at Harvard Pilgrim, said the Massachusetts-based, non-profit health insurance company has contracts with 24 of the 26 hospitals, and is in promising negotiations with the remaining two — Parkland Hospital in Derry and Portsmouth Regional Hospital, the only for-profit hospitals in the state.“They have expressed interest but we don’t have a signed contract yet,” she said. “The local leadership of the two hospitals is very interested in coming into our full network product, but the larger systems take more time to negotiate the deal.”

Roberts said Harvard Pilgrim did not jump into the Obamacare marketplace in the first year because the company needed more time to put together the broadest possible provider network.“We knew we could not launch effectively in 2014 and make our introduction or debut as strong as possible,” she said.

Anthem has been the only insurance company on the New Hampshire Obamacare website since launched in October with many hospitals excluded.

Roberts credited the hospitals in the state for their willingness to negotiate the prices Harvard Pilgrim will pay on behalf of its customers.

“It’s important to note that all of the hospitals had to work closely with us because we are asking them to make rate concessions,” she said. “The reason it took time to build the full-network is that we worked with all of the hospitals in the state to be sure we can offer an affordable, full-network product, and we want to give the hospitals full credit for that.”

Harvard Pilgrim is also in a separate partnership with 12 hospitals in a limited network, called ElevateHealth, which is likely to offer lower premiums than its full-network options.The company is one of four health insurance organizations that plan to join Anthem on the health care website in the fall. The others are Assurant Health, headquartered in Milwaukee, Wis.; Maine Community Health Options; and Minuteman Health, based in Massachusetts.Given the controversy surrounding Anthem’s limited network in the first year of the exchange, the state Insurance Department has scheduled information sessions today from noon to 1 p.m. in Concord, at the University of New Hampshire School of Law, 2 White St.; and on June 19, from 9 to 9:45 a.m. at the Mount Washington Valley Economic Council’s Tech Village at 53 Technology Lane, Room 211, in Conway.

Both sessions will be free and open to the public. Members of the New Hampshire Insurance Department will share information about the networks proposed by the five insurance companies, the types of plans offered (HMO, PPO, POS, etc.) and the levels of coverage offered (gold, bronze, silver, etc.).

“In 2015, New Hampshire residents will have a variety of networks and plan designs to choose from,” said New Hampshire Insurance Commissioner Roger Sevigny. “We are pleased that consumers will benefit from this competition with increased choice, and we are looking forward to sharing more information about the networks with the public.”

The rates for the various plans will not be revealed, since the plan designs and rates must still be approved by state and federal regulators, and may not be disclosed until they are posted on the website in November.“When a provider says that they will include all providers in their network, the absolute first question should be, “What will the premiums be?” said Greg Moore, state director for the conservative policy group, Americans for Prosperity.“If the new insurer’s premiums are 30 to 40 percent higher than Anthem’s, then all you’ve done is substitute one problem for another,” he said. “Given the fact that the Insurance Department has made clear that it will not release premium data until Nov. 15, it’s going to be up to the insurers to give those costs.”

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