CT and NH Announce Last Days for New Tonik plans
September 26, 2011
By Mark Wilson
Anthem Blue Cross Blue Shield of Connecticut and New Hampshire have announced that Oct 14th will be the last day new members can join Tonik. This means Tonik will be effective full and anyone hoping to join after October 14th will be out of luck. Those members who have already joined Tonik can keep their plan and no action is required at this time.
The Tonik application page will still be up for new applications until the deadline. We are recommending that all CT and NH applicants submit their application by October 13 as it is unclear at what time on the following day the application will no longer be functioning.
If you have any questions about the above, please contact us at 800.930.7956
Anthem NH makes Case during negotiations with Exeter Hospital
September 10, 2010
by Sam McDonnell
Anthem Blue Cross of New Hampshire is currently in negotiations with Exeter Hospital. They are trying to come to a new agreement with Exeter Hospital that is more favorable to Anthem. Anthem claims that Exeter is 50% more expensive than similar hospitals in the state:
Please take a look at the reasoning below by Doug J. Wenners (President and General Manager) and let us know what you think!!!! We will keep you updated to the status.
“Several telling examples underscore the high cost of health care delivered at Exeter Hospital.
Exeter is among the most profitable hospitals in the state, with healthy annual operating margins of 9.93% (2007) and 10.32% (2008). According to a report from the New Hampshire Center for Public Policy Studies, titled Driving Health Care Premiums: Cost Shifting in New Hampshire , Exeter Hospital enjoyed the second highest operating margin in the state among non-profit hospitals in 2007.
Cost for common procedures at Exeter Hospital, such as CT Scans, are two times the cost than at peer hospitals like Elliot Hospital or Catholic Medical Center, according to the New Hampshire Department of Insurance website.
The New Hampshire Hospital Score card, a report commissioned by the state’s fourth largest public health care purchasers, found that Exeter Hospital was the highest cost hospital in the state.
This increase in medical spending has a direct impact upon premiums. Costs and utilization continue to rise at a rate that far outpaces the increases in median family income, and many New Hampshire businesses are already struggling to provide affordable health care coverage for their employees.”
If anyone from Exeter would like to make their case here, we would gladly publish it.
Anthem to remove lifetime maximum limits on all plans
August 21, 2010
By James Wilson Jones
Anthem Blue Cross announced today that it has begun the process to remove lifetime maximum payouts to its health insurance plans. The recent health care reform legislation states that insurance plans can no longer have lifetime and annual dollar limits on “essential health benefits” as soon as September 23, 2010.
Since the U.S. Department of Health and Human Services (HHS) has yet to clarify its definition of “essential health benefits,” Anthem Blue Cross has come up with the following list of the services they believe will be affected:
- Alcoholism-related services
- Ambulance services
- Asthma education
- Bariatric surgery
- Chiropractic manipulation and osteopathic manipulation services
- Diabetic supplies
- Diagnostic services
- Durable medical equipment
- Enteral formula and food products
- Hearing aids
- Home health care
- Hospice
- Infusion therapy
- Kidney disease treatment
- Mental health/substance abuse
- Ostomy supplies
- Outpatient occupational therapy
- Outpatient physical therapy
- Outpatient speech therapy
- Pharmacy
- Physician office visit (diagnostic services)
- Preventive services
- Prosthetic devices/limbs
- Skilled nursing services
- Prosthetic devices/limbs
- Skilled nursing services
- Transplant services
- Treatment of temporomandibular joint disorder (TMJD or TMJ)
Anthem states that the listed services still may be subject to copays and other cost shares and will be phased in over time. Annual dollar limits of at least $750,000 will be allowed for plan years from September 23, 2010, to September 23, 2011. Annual dollar limits of at least $1.25 million will be allowed for plan years from September 23, 2011, to September 23, 2012.Annual dollar limits of at least $2 million will be allowed for plan years from September 23, 2012, to January 1, 2014. After January 2014 there will be no lifetime limits and annual dollar limits.
