Document 485 : Docket No. 99-14 : Hearing Decision : Bureau of Insurance

NON-CONFIDENTIAL

STATE OF MAINE

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION

BUREAU OF INSURANCE

IN RE: APPLICATION OF ASSOCIATED HOSPITAL SERVICE

OF MAINE, d/b/a BLUE CROSS

AND BLUE SHIELD OF MAINE, TO CONVERT TO A STOCK INSURER AND VOLUNTARILY LIQUIDATE AND DISSOLVE

)

IN RE: APPLICATION OF ANTHEM HEALTH PLAN OF MAINE, INC.,

TO ACQUIRE THE ASSETS OF ASSOCIATED HOSPITAL SERVICE OF MAINE, d/b/a BLUE CROSS AND BLUE SHIELD OF MAINE, AND RELATED TRANSACTIONS

Docket NO. INS 99-14 (CONSOLIDATED)

)

ANTHEM INSURANCE COMPANIES, INC.’S FOURTH SUPPLEMENT TO RESPONSE TO FIRST DISCOVERY REQUEST OF THE CONSUMER INTERVENORS

March 1, 2000

NON-CONFIDENTIAL

By order dated February 25^th, the Superintendent denied the Consumer Intervenors’ Motion to Compel Anthem to respond to certain of the questions posed in the Consumer Intervenors’ First Discovery Request (the "Request"). That order also referenced Anthem’s counsel’s agreement to identify previously filed information that may address the issues raised by question numbers 13, 14 and 24 of the Request. To that end, Anthem Insurance Companies, Inc., on behalf of its subsidiary to be formed, Anthem Health Plans of Maine, Inc., d/b/a Anthem Blue Cross and Blue Shield (collectively "Anthem"), hereby submits its Fourth Supplement to the Request.

The following responses by Anthem are made subject to, and without waiving, the objections filed by Anthem on February 9, 2000. To the extent that any additional responsive documents are located in the future, Anthem reserves its rights to object to producing such documents to the extent covered by the attorney-client and or work product privileges.

Please provide a chart that describes in detail all Anthem purchases of BCBS plans anywhere in the United States from 1993 to date and provide a schedule of premiums for each and every product offered by the seller during the 24 month period prior to the sale and by Anthem in the 24 month period subsequent to the sale. In states where Anthem has less than one year of premium experience, such as New Hampshire and Colorado/Nevada, please state the premiums currently in place and the premiums that Anthem has sought or will seek in the next six months for each and every product offered.

Response:

For the total consideration paid by Anthem for other BCBS plans, please see Anthem’s response to question no. 44 of the Consumer Intervenors’ First Request. For estimates of anticipated premium for Anthem Health Plans of Maine, Inc., please see the Comparative Premium Rate Analysis, Anthem’s pro formas, AN-02051, the support for those projections, AN-02567, and Anthem’s Fifth Supplemental Response to the Second Discovery Request of the Superintendent, question nos. 28, 29 and 30 and the documents referenced therein.

For each purchase identified in response to question number 13, please provide a chart that describes in detail each and every: a) product added and/or dropped; b) increase or decrease in coinsurance rates and/or copayment amounts by item or service and by product; c) increase or decrease in lifetime and/or annual benefit amounts or payments by product; and d) increase or decrease in benefits and/or coverage levels by item or service and by product, for the first 24 months after the purchase. In states where Anthem has less than one year of experience, such as New Hampshire and Colorado/Nevada, please provide the above information as it is currently in effect and any proposed modifications Anthem has sought or will seek in the next six months for each and every product offered.

Response:

Please see the response to question no. 13. Please also see Anthem’s Response to the First Discovery Request of the Attorney General, question nos. 1, 7 and 13 and the documents referenced therein.

Please provide a chart that describes in detail the medical underwriting practices and/or criteria used by the applicants by product and by item or service. Please include in the chart all waiting periods, exclusions of services and items, exclusionary periods, rate and rating variations which are dependent on age, sex, health status and medical condition, used or in effect for each of the calendar years 1997, 1998, 1999 and 2000.

Response:

In addition to the response prepared by Anthem, please see BCBSME’s response to this question; Anthem’s Response to the First Discovery Request of the Provider Intervenors, question no. 11; and Anthem’s Response to the Consumer Intervenors’ First Discovery Request, question no. 34.

DATED: March 1, 2000

_____________________________

James B. Zimpritch, Esq.

Jeffrey M. White, Esq.

Catherine R. Connors, Esq.

PIERCE ATWOOD
One Monument Square

Portland, Maine 04101

(207) 791-1100

Attorneys for Anthem Insurance Companies, Inc

CERTIFICATE OF SERVICE

The undersigned hereby certifies that on March 1, 2000 a copy of Anthem Insurance Companies, Inc.’s Fourth Supplement to Response to the First Discovery Request of the Consumer Intervenors was served by email, United States mail, first class postage prepaid, or, where indicated, by hand delivery, on each of the persons listed below.

Robert S. Frank, Esq.

Harvey & Frank

Two City Center

P.O. Box 126

Portland, Maine 04112

e-mail: frank@harveyfrank.com

(Blue Cross/Blue Shield of Maine)

Judith Chamberlain, Esq.

State of Maine

Department of the Attorney General

6 State House Station

Augusta, Maine 04333-0006

e-mail: judy.chamberlain@state.me.us

(Bureau of Insurance)

William H. Laubenstein, Esq.

State of Maine

Department of the Attorney General

6 State House Station

Augusta, Maine 04333-0006

e-mail: bill.laubenstein@state.me.us

(Office of the Attorney General)

Gregory A. Brodek, Esq.

Duane, Morris & Heckscher, LLP

15 Columbia Street, 4^th Floor

Bangor, Maine 04401-6355

e-mail: gabrodek@duanemorris.com

(Maine Health Alliance)

Joseph P. Ditre, Esq.

Consumer Health Law Program

One Weston Court, Level One

P.O. Box 2490

Augusta, Maine 04338-2490

e-mail: jditre@mainecahc.org

(Consumers for Affordable Health Care Foundation/Coalition)

Michele M. Garvin, Esq.

Ropes & Gray

One International Place

Boston, Massachusetts 02110-2624

e-mail: Mgarvin@Ropesgray.com

(Central Maine Healthcare Corporation; Central Maine Partners Health Plan)

Robert I. Goldman

Maine Council of Senior Citizens

27 Bowery Beach Road

Cape Elizabeth, Maine 04107

e-mail: Rgoldma1@maine.rr.com

(Maine Council of Senior Citizens)

Bonnie Post

Executive Director of the Maine Ambulatory Care Coalition

P.O. Box 390

Manchester, Maine 04351

e-mail: bdpmacc@mint.net

(Sacopee Valley Health Center, Regional Medical Center at Lubec, Eastport Health Care, Inc., and the Maine Ambulatory Care Coalition)

John Dieffenbacher-Krall

Executive Director

Maine People’s Alliance

192 State Street

Portland, Maine 04101

e-mail: MPA@gwi.net

(Maine People’s Alliance)

Gordon H. Smith, Esq.

Maine Medical Association

30 Association Drive

P.O. Box 190

Manchester, Maine 04351

e-mail: gsmith@ctel.net

(Thomas D. Hayward, M.D.,

Maroulla S. Gleaton, M.D.,

And the Maine Medical Association)

Donald E. Quigley, Esq.

General Counsel

465 Congress Street, Suite 600

Portland, Maine 04101-3537

e-mail: quigld@mail.mmc.org

(Maine Medical Center)

Sandra L. Parker, Esq.

John Doyle, Jr., Esq.

Attorneys for MHA, Inc.

150 Capitol Street

Augusta, Maine 04330

e-mail: sparker@themha.org

jdoyle@preti.com

(MHA, Inc.)

Kellie P. Miller, M.S.

Executive Director

Maine Osteopathic Association

693 Western Avenue

Manchester, Maine 04351

e-mail: meosteo@mint.net

(Maine Osteopathic Association)

DATED: March 1, 2000

_____________________________

James B. Zimpritch, Esq.

Jeffrey M. White, Esq.

Catherine R. Connors, Esq.

PIERCE ATWOOD
One Monument Square

Portland, Maine 04101

(207) 791-1100

Attorneys for Anthem Insurance Companies, Inc.