Two New England health insurance providers, Harvard Pilgrim Health Care and Tufts Health Plan, want to merge.

The combined insurer would be one of the largest in New England, covering about 2.4 million people in the region, according to a news release. Both companies are based in Massachusetts, but Harvard Pilgrim has an office in Manchester and there is a Tufts office in Concord.

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The merger plan must still be approved by state and federal regulators, including the New Hampshire Insurance Department, which opposed a 2017 proposal to merge health insurance companies Anthem and Cigna. Those companies eventually abandoned the plan to merge after several state attorneys general opposed it, including former New Hampshire Attorney General Joseph Foster. Current Attorney General Gordon MacDonald has not made any statements to support or oppose the proposed merger of Harvard Pilgrim and Tufts.

Jennifer Patterson, the state insurance department’s director of life and health, said the department is required by state law to review mergers of health insurance companies.

The law requires the department to review the financial implications of the merger and the competence of the companies’ officers, Patterson said. If the two companies are large enough, the insurance department also studies what the merger will do to competition.

Harvard Pilgrim is the second-largest insurer in New Hampshire after Anthem, covering 27 percent of people who have some form of health insurance; 5 percent of Granite Staters with health insurance have Tufts.

Tufts Health Plan and Harvard Pilgrim both cover people who get health insurance through their jobs and provide plans for people on Medicare, Medicaid and for those who buy insurance independently.

The boards of directors for both insurers voted unanimously to approve the merger. The new group would be steered by a board of directors made up of both Tufts and Harvard Pilgrim board members, according to a news release.

Tom Croswell, president and CEO of Tufts Health Plan, would serve as CEO of the new organization. Michael Carson, who serves as president and CEO of Harvard Pilgrim Health Care, would serve as president and oversee the organization’s subsidiaries.

The boards of directors of both insurers voted unanimously to approve the merger, according to a news release issued Wednesday by the two organizations. The new organization will be steered by a board of directors made up of both Tufts and Harvard Pilgrim board members, according to the release.

According to the most recent federal tax returns, both organizations have been operating at a loss.

Harvard Pilgrim reported $1.9 billion revenue/$3.4 million losses in 2017. Tufts, in 2016 reported: $1.6 billion in receipts, $9.6 million deficit, the most recent year of federal income tax forms available.

The merger will create “administrative cost efficiencies,” according to the release. That could mean job losses.

Tufts spokesman Sonia Hagopian said the insurer would not release any further information about how the merged organizations might find those “administrative cost efficiencies,” or if finding those efficiencies might mean layoffs.

Asked about possible layoffs, Harvard Pilgrim spokesman Kim Moore said Wednesday afternoon she would try to find more information, but did not return with information Wednesday.

Senior reporter Kevin Landrigan contributed to this report.