PORTLAND (AP) – Anthem Blue Cross and Blue Shield of Maine submitted the only bid to provide coverage under Maine’s Dirigo Health Program, officials announced Friday.
A spokesman for the Governor’s Office of Health Policy and Finance said it was no surprise to see a single bid for the Dirigo plan, even though state officials had hoped for competing bids.
Since Anthem is the sole company offering new individual coverage to Mainers, it made sense that it was also the only insurer capable of meeting the cost and time line set out by the state, Adam Thompson said.
“It might be a symptom of our insurance market, the fact that we don’t have a lot of players in the state and there’s very little competition in the small group and individual markets,” Thompson said. “One of the things we’re trying to do with Dirigo is increase competition in the market by putting another affordable product out there.”
Anthem’s Dirigo insurance coverage would be designed as a preferred provider plan, with deductibles of $1,250 and $1,750 offered to small businesses in the first year. The higher deductible would be offered to a limited number of self-employed people and individuals.
Gov. John Baldacci said Friday that he looked forward to reviewing Anthem’s proposal to administer the Dirigo Health Program.
“This is a big day for Maine as we are a step closer to providing affordable health care through Dirigo,” Baldacci said.
If the state decides Anthem’s proposal does not meet its needs, it can create its own nonprofit agency to provide the Dirigo product.
“That’s our Plan B,” Thompson said. He said the state would negotiate with Anthem to find a plan that works for the insurer, for Dirigo, and for Mainers who don’t currently have insurance.
Dirigo is Maine’s program to make health care accessible to the state’s 138,000 uninsured residents by 2009. The program was envisioned by the Legislature as a state-private partnership.
The state’s request for proposals went out last month and five insurers intially expressed interest. Cigna, Aetna, Harvard Pilgrim Health Care and United Health Care chose not to submit bids.
The Dirigo Health Plan will cover comprehensive medical services, including prescription drugs and hospital, physician and specialist visits.
Discounts will be given to members with household incomes less then 300 percent of the federal poverty level, which is $28,000 a year for a household of one and $56,500 for a household of four.
Dirigo is scheduled to begin enrolling customers later this summer. In its first year, the Dirigo Health Plan will be available to businesses with 50 or fewer eligible employees, the self-employed and individuals.
Trish Riley, director of the Governor’s Office of Health Policy and Finance, said the Anthem bid will be carefully reviewed.
“The review process will begin immediately,” Riley said in a statement. “We know we can work with Anthem and are cautiously optimistic that our expectations will be met in their bid.”
Riley said the state should have no problem in the first year enrolling 31,000 uninsured people and another 10,000 insured people who want to switch to the program.
AP-ES-06-11-04 1538EDT
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