June 24, 2018
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Maine health insurance companies say they have won final approval for upcoming marketplace

By Lindsay Tice, Sun Journal

LEWISTON, Maine — Officials from Maine Community Health Options and Anthem Blue Cross and Blue Shield say their companies have both won final approval from the federal government to post health insurance plans on the Affordable Care Act marketplace.

Maine Community Health Options, based in Lewiston, is the state’s first health insurance co-op, a nonprofit group governed for and by members. Anthem is the state’s largest insurance company and it has partnered with MaineHealth, the state’s largest health care organization, to offer its plans.

Any individual or small group can buy from the marketplace, also known as an exchange. However, individuals who have federal subsidies can only use them in the marketplace and some small businesses will only get a tax break if they buy through the marketplace.

The Maine Bureau of Insurance approved both MCHO and Anthem for the marketplace in July. Anthem’s plans were controversial because they featured a narrow network that strictly limits which doctors and hospitals patients can use. Anthem since has asked to install a similar narrow network for individual insurance plans sold outside the marketplace as well.

The Centers for Medicare and Medicaid Services must give final approval before plans can be listed on the upcoming marketplace.

The Maine Bureau of Insurance could not confirm federal approval late Monday. A CMS spokesperson said the federal agency has not yet released which plans have been approved for the marketplace.

But Maine Community Health Options and Anthem officials both said Monday that their companies have received approval.

About 124,500 Mainers now have individual or small-group health insurance plans, and another 133,000 have no insurance. Those 257,500 people are the ones most likely to be affected by the marketplace, by choosing it for themselves or working for an employer who chooses it. However, Maine Bureau of Insurance officials believe far fewer people than that will go through the marketplace.

The marketplace is slated to start open enrollment Oct. 1. Insurance plans will go into effect Jan. 1, 2014.

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