Document 69 : Docket No. 99-14 : Hearing Decision : Bureau of Insurance

STATE OF MAINE
DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE
34 STATE HOUSE STATION
AUGUSTA, ME 04333-0034

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

And

Application of Anthem Health Plan of Maine, Inc.	Maine Ambulatory Care Coalition's
To Acquire the Assets of Associated Hospital Service	Response to Superintendent's Letter
of Maine, d/b/a Blue Cross and Blue Shield of Maine,	Regarding 24-A MRSA §§4203-4204
and Related Transactions	Filing Requirements Dated
	November 15, 1999

Now comes the Maine Ambulatory Care Coalition (MACC), in response to the Superintendent's letter dated November 15, 1999 regarding filing requirements under 24-A MRSA §§4203-4204, stating as follows:

1. MACC understands that applicants would like to avoid the need to make a separate filing under 24-A MRSA §§4203-4204 because of the intact transfer of HMO Maine.

2. The MACC takes no position on requiring Anthem to make the filings required by §§4203-4204 and recognizes that Anthem, BCBSME and the State may incur additional costs in carrying out the administrative process of refiling materials and the value of that exercise may be outweighed by the cost.

3. MACC feels strongly that the Superintendent and all parties must have the authority to inquire about Anthem's ability and plans to meet the requirements of the Maine HMO Act, including §§4203-4204, if the proposed transaction is approved. While MACC has concerns about multiple issues concerning Anthem's intended operations, we have special interests in Anthem's ability and commitment to provide services for rural and underserved populations and their intended relationships with essential community providers.

5. Therefore, we support the Maine Medical Association's motion to replace paragraph III (26) of the Notice of Hearing of the Superintendent of Insurance with:

"(26) whether, after the proposed change of control, Anthem Health Plan could satisfy the requirements for the issuance of a certificate of authority under the Maine HMO Act. (24-A MRSA §§4203-4204).

If the Superintendent finds he cannot protect his interests and those of the parties to consider and make findings on issues of Anthem's compliance with the Maine HMO Act, particularly 24-A MRSA §§4203-4204, MACC submits that 24-A MRSA §§4203(1) provides ample authority for the Superintendent to require Anthem to complete the filing and approval requirements of the Maine HMO Act as an element of this proceeding.

__________________________________________

Bonnie Post, Executive Director