Anthem – Hartford Healthcare Dispute Update – Agreement Reached (11-18-17)
Public Forum on the Hartford Healthcare/Anthem Dispite sponsored by the Office of the Healthcare Advocate
OHCA – Session Five – Northeast CT
Wednesday, November 15, 2017
6:30 – 8:00 p.m.
Generations Family Health Center
40 Mansfield Ave.
Willimantic, CT 06226
(Local Co-Sponsor: Community Health Center Assoc. of CT & Generations Family Health Center)
In response to UConn-AAUP members and retirees caught up in a dispute between Anthem and Hartford Healthcare and who are facing the loss of access to their doctors and mounting medical costs, SEBAC on 11/3/17 sent a letter to Hartford Healthcare CEO Elliott Joseph.
In the letter, SEBAC urges Harford Healthcare to stop using its patients – and our members – as pawns in a power grab to rake in even more profits and gain even more market share in the healthcare arena at the expense of patients and their families.
“Our members’ disappointment in such an attitude from an organization whose mission it is to care for people and their families cannot be overstated,” Daniel Livingston on behalf of SEBAC writes in the letter.
“Indeed, we doubt that many of Hartford Healthcare’s dedicated doctors and health care professionals support this cavalier approach to their patients…Hartford Healthcare’s patients are its life blood, and its moral responsibility.”
SEBAC leaders specifically questioned Hartford Healthcare’s refusal of Anthem’s offer to pay Hartford Healthcare reimbursements under the current rates, with a commitment to retroactively compensate HartfordHealthcare for any increase in the rates that is agreed to in the next contract.
Click Here to read the full letter from SEBAC Chief Negotiator Dan Livingston
Per the 2017 SEBAC Agreement, the adoption of a design structure that encourages treatment choice of high quality, high value providers includes a listing of preferred providers, preferred sites of service and a smart shopper program. Please see below for links that members can use to determine those services. Note, however, that if an Anthem member selects a Hartford Healthcare Provider, until the dispute ends that member should confirm coverage by calling the number on the back of their card, and following the prompt that allows them to check with a live person immediately and make sure the physician is still in network.
From the Comptroller’s Office:
For United you should not have to login, don’t know why that is happening. To avoid the login issue, they should go here, which describes the tiering and how to find the docs, so it might be better anyway:
For Anthem the lists are here:
There is also a link to their provider lookup tool within the PDF as well as a listing of all tier 1 providers and preferred site of service facilities.
United folks should use the Oxford lookup tool and look for the two blue hearts “premium” designation – see description below:
Visits to “Preferred”/Tier 1 PCPs and Specialists (those with 2 full blue hearts) in the state of Connecticut will have a $0 copay; visits to non-“Preferred” (less than 2 full blue hearts) specialists not in one of the above specialties, or visits to Participating providers outside of the state of Connecticut will have a $15 copayment.
*Note: Non-HEP members utilizing a Tier 1 provider will be required to meet their $350 In-Network deductible prior to services being covered at $0 copay.
It’s easy to find a “Preferred”/Tier 1 provider. Just click the Local (Tri-State) Network Provider Search link below, and then click on “Find a Physician or Facility.” In your search results, simply look for the blue hearts.
You can also look up site of service locations on our website by clicking here:
From Office of the State Comptroller to CT Health Plan Members ( 10/19/17)
From the Office of the State Comptroller To Affect Members (9/27/17)