Document 323 : Docket No. 99-14 : Hearing Decision : Bureau of Insurance

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

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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)

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ANTHEM INSURANCE COMPANIES, INC.’S MEMORANDUM IN SUPPORT OF OBJECTIONS TO FIRST DISCOVERY REQUEST OF THE CONSUMER INTERVENORS

February 14, 2000

INTRODUCTION

On Monday January 31, 2000, the Consumer Intervenors served on Applicants their First Discovery Request (the "Request"), consisting of 45 requests for information and documents. Counsel for Anthem, BCBSME and the CAHC held two telephone conferences to discuss the Request. Although many clarifications were made, and Anthem has agreed to provide some form of response to many of the very broad questions, the parties did not reach agreement on the scope of the responses to all of the questions. For example, in several instances in which the Consumer Intervenors asked for "all documents related to [topic x] for Anthem [which includes all of Anthem’s subsidiaries]," Anthem has provided a narrative response that gets to the crux of the question without requiring many Anthem representatives in many states to pull together "any and all" of the responsive documents from the states in which Anthem has a presence. Anthem hopes and anticipates that the information provided in its present response to the Request is sufficient, but objects to providing any more information than that already provided.

DISCUSSION

I. General Objections to the Scope and Breadth of the Request

Before considering the merits of Anthem’s remaining objections, it is appropriate to take a step back and consider the information that has already been provided in this case, the timing of the latest discovery requests by the intervenors, and the work that remains to be done up to and including the hearings in this proceeding.

The discovery period has been open since at least the Superintendent’s November 4, 1999 Procedural Order and Notice of Hearing. Prior to being served with the Consumer Intervenor’s Request, Anthem and BCBSME had already been served with and responded to over 150 informational requests from the Superintendent and Attorney General, therein providing narrative responses and thousands of pages of documents related to the issues outlined in the Superintendent’s November 4, 1999 Notice of Hearing. As a follow-up to the Superintendent’s extensive Second Discovery Request, Anthem and BCBSME also participated in a discovery conference with the Bureau and its consultants both to clarify and supplement the responses to the Second Request, and to answer the Bureau’s follow-up questions – a conference to which the Superintendent invited all parties to attend.

Notwithstanding the voluminous information already supplied, in the last four days of the discovery period, Anthem and BCBSME were served with an additional 154 informational requests from the intervenors, many of which contained multiple parts and asked Anthem and BCBSME to generate new analyses. It is important to keep in mind that these intervenors’ requests came after the Superintendent, his staff and expert consultants presumably had already asked all of the questions they deemed sufficient and appropriate to address the relevant statutory inquiries set forth in the Superintendent’s Notice of Hearing. Also, the vast majority of the intervenors’ requests have not stemmed from some late-breaking information. Indeed, Anthem established a repository in December, 1999 containing all of the documents responsive to the various discovery requests and only one intervenor has taken the time to visit the repository to review any of the volumes of information that have been supplied thus far.

Some of the intervenors’ additional requests warrant substantive responses, and Anthem and BCBSME have filed them today. The tangential relevance, if any, of many of the inquiries, however, is outweighed by the burden which would be imposed on the Applicants if they are required to respond with the requests as written. Senior management from both Anthem and BCBSME have devoted countless hours preparing the various filings and responding to the extensive requests from the Superintendent and Attorney General. In addition to running these significant businesses in a challenging health care market, their focus should now be turned toward preparing for the upcoming hearing, not to answering overly broad and burdensome requests not directed to the statutory inquiries at issue.

Anthem and BCBSME’s goal in this proceeding is, and has been, to provide the Superintendent with the information that he and his staff and consultants deem necessary. At this point, the intervenors’ late and voluminous requests are distracting Anthem and BCBSME from that goal and are detrimental to the process.

II. Bases for Specific Objections

A. Definitions and Instructions

Paragraphs A and C of the instructions define "Anthem" and "BCBSME" to include predecessors-in-interest, all subsidiaries, and former employees, consultants, etc. Anthem objected on the basis that the instructions are overly broad, unduly burdensome, and seek irrelevant information. Similarly, paragraph M is overly broad in that it asks Anthem to gather documents and responses from former employees, directors, etc.

In drafting its substantive responses and gathering the responsive documents, Anthem responded for itself and, where appropriate its affiliates, and for the present time only, except where otherwise noted. Information from predecessors-in-interest and former employees has no bearing on how the Company is run today, or on how Anthem Health Plans of Maine will be run in the future if this transaction is approved. Even if there were some limited relevance to the information, it is far outweighed by the burden on Anthem to investigate all of these prior affiliations in order to respond in conformity with the literal definitions used by the Consumer Intervenors.

Paragraph L directed that, if Anthem no longer possesses responsive documents, but did at one time, Anthem must provide several pieces of information, including when Anthem last had the document(s), what they did with the documents, and the name of the person that presently has the document(s). In drafting its substantive responses, Anthem provided only documents that it currently possesses and objects to performing the overly burdensome task requested by the Consumer Intervenors. Documents that Anthem no longer possesses have no relevance to how the Company is run today, nor on how Anthem Health Plans of Maine will be run if this transaction is approved. Even if there were some limited relevance to the information, it is far outweighed by the burden on Anthem to investigate all of these prior affiliations in order to respond in conformity with the literal definitions used by the Consumer Intervenors.

Paragraph N requires specific information if/when Anthem claims a privilege in any response. If Anthem objects to any request on the basis of privilege, it will provide a privilege log identifying the privileged documents and objects to the instruction requiring "the name and employment at the time of viewing of each person who has seen the document."

B. Relevance / Scope / Burdensome

"Informational requests shall be relevant to the issues involved in the pending proceeding, and shall not be unduly burdensome or repetitious." Bureau Rule 10(B)(2).

Please provide all documents prepared by or for the Blue Cross and Blue Shield Association and its predecessors relating to its rules, practices, policies, procedures, Articles of Incorporation, and bylaws of the said Association.

Objections:

The request seeks information that is irrelevant to this proceeding; it is overly broad; and it would be overly burdensome to produce and/or obtain the requested information. Documents prepared by or for BCBSA are not relevant to any of the statutory inquiries that are properly before the Superintendent. Anthem has reported in its response to this question that, under Section 8.03(9) of the Asset Purchase Agreement, it is a condition to closing of the proposed transaction that the Blue Cross Blue Shield Association consent to the transfer to Anthem of BCBSME’s right to use the Blue Cross and Blue Shield names and marks, or shall have issued to Anthem primary Blue Cross and Blue Shield licenses for the state of Maine. Anthem has received such consent for each of its prior transactions and does not anticipate any difficulties in obtaining consent for the present transaction. Anthem understands that BCBSME has agreed to provide certain information from the BCBSA licensing and trademark manual. Any information concerning BCBSA beyond this is irrelevant.

Please provide all documents prepared by or for the Blue Cross and Blue Shield Association and its predecessors related to a licensee and/or member: a) operating on a for-profit basis; b) operating as a mutual insurer; and/or c) acquiring, merging or affiliating with other licensees and/or members.

Objections:
Please see objection to Paragraph 1.
Please provide all documents prepared by or for the Blue Cross and Blue Shield Association and its predecessors related to the decision by the Association to allow its members to operate on a for-profit basis and/or to purchase another member.

Objections:
Please see objection to Paragraph 1.
Please provide all documents prepared by or for the Blue Cross and Blue Shield Association and its predecessors related to competition among or between members and/or licensees in or for the same service area or market.

Objections:
Please see objection to Paragraph 1.
Please provide all documents prepared by or for Anthem related to competition between Anthem and members and/or licensees of the Blue Cross and Blue Shield Association in or for the same service area or market.

Objections:
Please see objection to Paragraph 1.

Please provide all documents prepared by or for the applicants related to purchasing any interest in Harvard Pilgrim Community Health Plans. Please describe in detail any and all discussions and/or communications by Anthem with Harvard Pilgrim Community Health Plans or its representatives and/or with any governmental agency having jurisdiction over Harvard Pilgrim Community Health Plans.

Objections:

The request seeks information that is irrelevant to this proceeding. Although Anthem’s financial strength is relevant to this proceeding, Anthem has provided financial statements and pro formas, reflecting Anthem’s significant surplus and financial projections. In the absence of any agreement between Anthem and Harvard Pilgrim, the request is irrelevant.

Please provide all documents between the applicants relating to the status of or requirements on BCBSME to maintain its good standing, membership, trademarks and licenses in and with the Blue Cross and Blue Shield Association from January 1998 to date.

Objections:
Please see objection to Paragraph 1.

Is there any correlation between the sale price and premiums to be charged by Anthem? Please state all assumptions underlying the correlation. Please quantify in dollars the effect that increasing the sale price may have on premiums for each million dollars that the price is increased over and above the total consideration stated in the Asset Purchase Agreement dated July 13, 1999.

Objections:

The request seeks information that is irrelevant to this proceeding; it is overly broad; and it would be overly burdensome to produce and/or obtain the requested information.

After consultation with counsel for CAHC, Anthem has answered the first 2 parts of the question and the Consumer Intervenors agreed to strike the final part of the question.

Please provide all documents prepared by or for Anthem related to the preparation of the attached Anthem policyholder notice in Kentucky (see Attachment "A").

Objections:

The request seeks information that is irrelevant to this proceeding; it is overly broad; and it would be overly burdensome to produce and/or obtain the requested information. The 1993 transaction in Kentucky simply has no bearing on the present proposed transaction. That transaction involved a merger where no "cash" was to be paid. Also, the dispute surrounding the funding of the trust foundation in Kentucky arose in the absence of a clear statutory guidance as to the effects of the transaction. In the Kentucky merger, allocation of funds to a trust would have reduced reserves, and Anthem so notified its policyholders. By contrast, the present transaction is an acquisition with a specific dollar amount being paid for the BCBSME assets and a specific statutory mechanism for allocating the proceeds. In other words, unlike in Kentucky, the net purchase price will go to the trust fund and that will not reduce the Maine BCBS reserves.

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.

Objections:

The request seeks information that is irrelevant to this proceeding; it is overly broad; it would be overly burdensome to produce and/or obtain the requested information and Anthem is under no obligation to prepare additional analyses in response to information requests from intervenors. As reflected in Anthem’s substantive response to question no. 11, premiums are based on a number of factors that are specific to each region. Moreover, the question seeks to draw a comparison between the pre-transaction premiums and the post-transaction premiums. In many cases, Anthem would not have pre-transaction premiums data with which to compare. But even if it did, in order to make a meaningful comparison, the Superintendent would have to see evidence reflecting the premiums charged by all of Anthem’s competitors in each state for the relevant periods as well (i.e., were any premium increases post-transaction out of line with premium increases for other competitors in the specific region?).

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.

Objections:

Please provide all documents related to Anthem’s plans to gain marketshare in New England from January 1997 to the present. Please provide all documents prepared by or for Anthem related to the desirability to be in the New England market.

Objections:

The request refers to "all documents related to Anthem’s plans to gain marketshare in New England for the past three years. To the extent Anthem’s goal in a particular region is to gain marketshare, nearly every document Anthem has created from 1997 forward would be responsive to this request. In response to questions from the Attorney General, Anthem provided documents related to its integration plans for the East Region. With its substantive filing in response to the Consumer Intervenors’ request, Anthem has filed today additional integration documents that were recently generated following an integration steering committee meeting. To the extent the request seeks information beyond the integration plans already produced in response to the Attorney General’s discovery requests and those provided today, the request seeks information that is irrelevant to this proceeding; it is overly broad; and it would be overly burdensome to produce and/or obtain the requested information.

Please provide all documents prepared by or for Anthem and/or BCBSME from January 1998 to the present related to the financial condition of competitors of Blue Cross and Blue Shield plans in Connecticut, Maine, New Hampshire, Rhode Island and Massachusetts.

Objections:

Please provide all documents prepared by or for Anthem related to demutualization from 1995 to date.

Objections:

The request seeks information that is irrelevant to this proceeding and it is overly broad. Anthem has, from time to time, analyzed whether its corporate missions and goals are best achieved as a mutual company. To date, Anthem continues to be a mutual company. Moreover, if the proposed transaction is approved, the subsidiary to be formed, Anthem Health Plans of Maine, d/b/a Anthem BCBS, will be a for profit stock company, not a mutual insurer.

Please provide all documents prepared by or for Anthem Insurance Companies, Inc. of Indiana related to the positive or negative effects a demutualization of Anthem Insurance Companies, Inc. of Indiana would have on insureds in Maine and any other state in which Anthem operates. Please describe in detail what persons would receive stock, dividends, assets, or anything of value and in what proportions if Anthem Insurance Companies, Inc. of Indiana were to demutualize under current Indiana law. Please provide all documents prepared by or for Anthem Insurance Companies, Inc. of Indiana related to lobbying efforts by Anthem Insurance Companies, Inc. of Indiana in connection with the passage of Senate Bill 33, affecting Indiana Code sections 27-9-1, et seq.

Objections:
The request seeks information that is irrelevant to this proceeding and it is overly broad. See Anthem’s objection to question no. 18.

Please provide all documents related to Anthem’s description of itself as a "for profit mutual" or its operations as "for profit" from 1990 to date.

Objections:

Please describe the applicants’ efforts or plans to gain marketshare in each state or jurisdiction with regard to products such as life, health, disability or administrative services from January 1997 to the present.

Objections:

The request seeks information that is irrelevant to this proceeding; it is overly broad; and it would be overly burdensome to respond. Subject to and without waiving these objections, Anthem has provided a narrative response.

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.

Objections:

Please provide the number and rate of prior authorization requests made from January 1998 to the present to the applicants. Please also include in the response, the number and rate of prior authorization requests reversed on appeal for the same period. Please also estimate the dollar value of those services authorized as a result of appeals during that same time period.

Objections:

Please provide a schedule of the five procedures and/or services most frequently denied by the applicants from January 1998 to date. Please provide an estimated dollar value per procedure or service.

Objections:

Please provide all documents related to the rapid disenrollment rates (i.e., disenrollment within six months of enrollment) for Anthem’s Medicare HMO products.

Objections:

In which states did Anthem offer Medicare HMO and/or Medicaid HMO products from January 1997 to date? Has Anthem terminated or proposed to terminate any such product offering in any state during that period? Please state which product(s) and in which state(s) such termination or proposed termination has occurred or may occur. If Anthem intends to offer a Medicare HMO product and/or a Medicaid HMO product in any state, please identify which state, which product(s), and when the product(s) will be offered.

Objections:

Please provide all documents related to prescription drug formulary or formularies used by the applicants for each product offered. Please describe in detail the formulary development, evaluation and/or review process(es) used by the applicants?

Objections:

The request seeks information that is irrelevant to this proceeding; it is overly broad; and it would be overly burdensome to produce and/or obtain the requested information. After consultation with counsel for CAHC, subject to and without waiving these objections, Anthem has provided the formulary and described the makeup of the committee charged with developing the formulary.

During calendar years 1998 and 1999, please state how many of the applicants’ insureds were insured or covered on a secondary basis by another health insurance plan – private or public?

Objections:

The request seeks information that is irrelevant to this proceeding; it is overly broad; and it would be overly burdensome to produce and/or obtain the requested information. It is unclear what the Consumer Intervenors are getting at with this question, but even it had some relevance, it is outweighed by Anthem’s burden in attempting to respond to the question. This is not the type of information that Anthem compiles on a regular basis.

Has Anthem terminated or proposed to terminate non-group product offerings in any state during calendar year 1998, 1999 or 2000? If yes, please specify in which state and when such termination was or will be effective. For each non-group product termination, state how much time in days insureds were given as notice of termination. Please provide a sample of the notice for each non-group product termination.

Objections:

In which state(s) does Anthem impose or anticipate imposing waiting or exclusionary periods for prescription drugs, durable medical equipment or supplies, and mental health services? Please provide all documents related to the waiting or exclusionary period(s) for each of these items and services.

Objections:

Please provide a list with the names, addresses and phone numbers of the pharmaceutical benefits manager(s), the durable medical equipment or supply manager(s), and the mental health benefits manager(s) which administer the applicants’ prescription drug, durable medical equipment and supplies, and/or mental health benefit programs. Please state the termination dates for contracts with all such managers. Please state which manager(s) Anthem intends to employ in Maine during calendar years 2000, 2001 and 2002.

Objections:

Please provide a list with the names, addresses and phone numbers of the independent review organizations (IROs) with which Anthem and BCBSME have contracted and/or intend to contract during the calendar years 1998, 1999, and 2000. Please provide the total number of appeals made to each of these IROs during the calendar years 1998 and 1999. How many appeals were denied in each of those years? Provide a redacted copy of a decision by each of the identified IROs for each of the calendar years 1998 and 1999.

Objections:

Provide all documents prepared by or for Anthem and BCBSME which define or provide definitions of the terms "medical necessity", "medically necessary", "short term therapy", "case management", "experimental treatment", "clinical trial" and "emergency" in effect during the calendar year 1999 for each state in which Anthem operates.

Objections:

The request seeks information that is irrelevant to this proceeding; it is overly broad; and it would be overly burdensome to produce and/or obtain the requested information. Subject to and without waiving these objections, Anthem has provided a narrative response. As reported in its substantive response, this request is particularly irrelevant because Anthem is assuming the BCBSME policies and, accordingly, any relevant definitions of the above terms would relate to those contracts.

How many of the applicants’ insureds have requested case management services for each of the calendar years 1998 and 1999? How many of the applicants’ insureds have received case management services for 30 or fewer days, 31 – 60 days, 61 - 90 days, and more than 90 days during each of those two years?

Objections:

Please provide all documents prepared by or for the applicants related to criteria used or in effect for the purpose of determining whether someone qualifies and/or continues to qualify for case management services for each of the calendar years 1998 and 1999. Please provide the aggregate number of case management services requested and the aggregate number of case management services denied by the applicants during those two years. How many of those denials were appealed to the applicants? How many were reversed on appeal by the applicants? Please provide one redacted copy of an Anthem decision and one redacted copy of a BCBSME decision denying case management services for each of the calendars years 1998 and 1999.

Objections:

Please provide all documents used by the applicants for the purpose(s) of identifying and/or subrogating costs to other insurers or coverage sources – public or private.

Objections:

Please state in detail the applicants’ practices and/or policies as primary and/or secondary payer where the insured is also covered by Medicare and/or Medicaid.

Objections:

Please provide the applicants’ complaint ratios for the calendar years 1998 and 1999 and the methodologies for calculating such ratios. Please provide a detailed explanation where the ratio for complaints exceeds marketshare during that time period.

Objections:

In response to question no. 7 of the Attorney General’s Second Discovery Request, Anthem provided the complaint ratios for Kentucky, Indiana, Connecticut and Ohio. See also Document Numbers AN-02568 to AN-02575. To the extent the request seeks information beyond that already provided in response to the Attorney General’s discovery requests, the request seeks information that is irrelevant to this proceeding; it is overly broad; and it would be overly burdensome to produce and/or obtain the requested information.

Please provide all documents used by the applicants which state the criteria for covering experimental treatment or transplants services?

Objections:

Please provide a chart that describes in detail the total amount of consideration paid by Anthem for Blue Cross and Blue Shield plans in New Hampshire, Connecticut, Ohio, Kentucky, and Colorado/Nevada. Please include in your response the date of closing for each sale and the total number of insureds for each plan on the closing date. For each of these purchases, please describe in detail any and all increases in the total amount of consideration paid over and above the total amount of consideration stated in the Asset Purchase Agreement or Purchase and Sale Agreement for that particular purchase. Please describe in detail each and every reduction and/or downward adjustment ordered or agreed to by Anthem to the total amount of consideration stated in the Asset Purchase Agreement or Purchase and Sale Agreement for that particular purchase.

Objections:

Please provide a list of all lawsuits or litigation initiated against Anthem by name, court, jurisdiction and state where filed from January 1997 to the present where the total amount of damages and/or benefits sought and attorneys fees exceeds or may exceed $1,000,000. Please provide a detailed description of the nature of the litigation and the amount entered in judgment against and/or agreed to in settlement of such litigation.

Objections:

In response to question no. 57 of the Superintendent’s Second Discovery Request, Anthem provided information on all cases with a reserve greater than $250,000. See Confidential Version of Anthem’s First Supplement to Response to Superintendent’s Second Discovery Request, confidential document numbers AN- 01969 to AN-01985. To the extent the request seeks information beyond that already provided in response to the Superintendent’s discovery requests, the request seeks information that is irrelevant to this proceeding; it is overly broad; and it would be overly burdensome to produce and/or obtain the requested information.

DATED: February 14, 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 February 14, 2000 a copy of Anthem Insurance Companies, Inc.’s Memorandum in Support of Objections 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.

Attorney for MHA, Inc.

150 Capitol Street

Augusta, Maine 04330

e-mail: sparker@themha.org

(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)

Edward Miller

Executive Director

American Lung Association of Maine

122 State Street

Augusta, Maine 04330

e-mail: emiller@mainelung.org

(American Lung Association of Maine)

DATED: February 14, 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.