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Health Guide Contacts

Insurance Company Information

On the following pages you will find specific information on the companies listed in this brochure such as mailing address, the number of insured lives, and customer service phone numbers with hours of operation.

Executive Compensation - For the Maine domestic health insurers (Aetna Health, Anthem Health Plans and CIGNA HealthCare), you will find executive compensation listed for the senior managers and directors. The information is filed with the Bureau of Insurance in accordance with the guidelines of the National Association of Insurance Commissioners. “Insurers that are part of a group of insurers or their holding company system may report amounts paid to officers and employees of more than one insurer in the group or system either on a total gross basis or by allocation to each insurer.” CIGNA has listed compensation that appears specific only to the Maine company while the other two companies appear to have listed total compensation for all companies within their group.

Other Financial Information - You may also find extensive financial information by viewing a company’s 10K form (annual report) or 10Q form (quarterly report) on the U.S. Securities and Exchange Commission’s web-site. The U.S. Securities and Exchange Commission’s Electronic Data Gathering, Analysis, and Retrieval (EDGAR) system provides access to compensation and other financial information for publicly traded parent corporations of health insurance carriers. All companies, foreign and domestic, are required to file registration statements, periodic reports, and other forms electronically through EDGAR. Anyone can access and download this information for free. On this web site http://www.sec.gov/edgar.shtml you will find links to a complete list of filings available through EDGAR and instructions for searching the EDGAR database.

Medical Loss Ratios - Included in this brochure are the medical loss ratios by type of health insurance for Maine’s domestic health insurers.

General Company Information

Accreditation

What is Accreditation?

A company receives accreditation when they meet specific standards established by the rating organization. Organizations that review health insurers and HMOs for accreditation look at some or all of the following areas: access to care; quality of care; utilization review; customer rights; preventive health services; and the efficiacy, efficiency, appropriateness, availability, timeliness, and continuity of health care. Several organizations perform reviews and have specific accreditation standards. Two of the major accreditation organizations are the National Committee on Quality Assurance (NCQA) and the American Accreditation Healthcare Commission (URAC).

What is NCQA?

NCQA's accreditation program includes selected performance measures in such key areas as member satisfaction, quality of care, and access to needed care with good customer service. To learn more about NCQA accreditation and to get more detailed information about how a plan is rated, visit NCQA's Health Plan Report Card on their web site at www.ncqa.org.

What is URAC?

The American Accreditation Healthcare Commission's (URAC) accreditation program is intended to promote quality and accountability for health care organizations. To receive URAC accreditation, managed care organizations must demonstrate quality in both their organizational structure and operations by delivering high quality services to their members in claims review processing, complaints and grievances, and case management. For more information you can visit URAC's web site at www.urac.org.

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