State HIX competition grows

Many residents in New England are going to have more choices in the public exchanges this fall, as some insurers' growth strategies are tested.

After New Hampshire’s first open enrollment period — where WellPoint’s Anthem Blue Cross was the only carrier and one with a narrow network that dismayed some consumer and hospital advocates — four insurers have announced plans to sell on and off the Granite State’s exchange.

The New Hampshire Insurance Department has just licensed Maine Community Health Options, the second federally-supported cooperative plan to enter the state, following the Massachusetts-based co-op Minuteman Health. Along with them, Harvard Pilgrim and Assurant Health will be selling plans for the first time in the exchange, leaving some New Hampshire residents with five choices of carriers, when just last year they only had one.

In 2013, before the start of the exchange market, Anthem Blue Cross had a 40 percent share of New Hampshire’s combined insurance market, followed by Harvard Pilgrim at 20 percent, Cigna at 18 percent and Aetna at 8 percent, according to the insurance department. Anthem alone covered more than 75 percent of those with individual policies.

“We are pleased that Marketplace customers are on track to have more choices in 2015 than they do today,” said New Hampshire Insurance Commissioner Roger Sevigny in a media release. “New Hampshire residents have asked for options.”

Minuteman Health and Maine Community Health Options are the fourth and fifth co-ops to be crossing state lines, following the likes of CoOportunity Health, which started out selling in both Iowa and Nebraska, and Kentucky Health Cooperative and Montana Health CO-OP, which are planning to enter West Virginia and Idaho respectively.

New Hampshire will be the second state, after Oregon, to have two health cooperatives.

“We think that competition among health care plans is going to be a very positive development for New Hampshire residents and businesses,” said Minuteman CEO Thomas Policelli, a former Cigna and UnitedHealth Group manager. “We recognize that New Hampshire is a different market than Massachusetts, and we plan to bring the right solutions.”

The co-op’s New Hampshire division will be led by Glenn Klink, a VP and 20 year veteran of Exeter Health Resources, the holding company that operates the 100-bed Exeter Hospital, a physicians network and a home health and hospice provider, and also a managed care alumnus of Prudential and Aetna.

Maine Community Health Options is starting out slow in New Hampshire, planning to sell in the four border counties in the first year, while crafting a broad network and considering expanded service areas in the future. Led by CEO Kevin Lewis, the former CEO of the Maine Primary Care Association, Maine Community Health Options went head to head with Anthem in the Maine’s exchange in the first open enrollment period — and grabbed some 80 percent of the exchange market, garnering about 37,000 members, almost double its projections.

Maine’s exchange is also going to see new competition for the 2015 plan year. Harvard Pilgrim, which has a sizable group business in Maine and was the one-time administrator of a now discontinued state-subsidized individual insurance program, is set to join as the third carrier after sitting out the first open enrollment period.

With Massachusetts’ market dominated by Blue Cross and Blue Shield and Vermont on the path to a single payer system, Harvard Pilgrim is trying to expand in New Hampshire to the north and Connecticut to the south.

The Wellesley, Massachusetts.-based nonprofit was recently licensed to sell in Connecticut and opened offices in Hartford, and plans to start selling exchange policies in the 2016 plan year, sitting out next year to watch to the competition among four insurers — Anthem, ConnectiCare, the co-op HealthyCT and, the newest entrant, UnitedHealthcare.