HCAN Truth Squad and Anthem

Health Care for America Now! held a press conference today, in an effort to get answers from Anthem Health Plans of Maine about their skyrocketing profits.

According to a report by the Northwest Federation of Community Organizations titled Insuring Health or Ensuring Profit?, Anthem Health Plans' annual net (profits) income have almost doubled between 2004 and 2007.

Anthem's net income in 2004 was $40.0 million, in 2007 it was $75.7 million, a 89.2 percent increase. How many of you have seen your premiums increase over the course of those years? How many of you have had to drop your insurance because your premiums have increased beyond affordability?

Anthem's per member per month profits have increased from $11.07 per member to $20.45 per member. That means that everyone who is insured by Anthem Health Plans is a $20.45 profit to the company. Is this right? What do they do with these profits? Anthem's membership has increased only by 2.4 percent.

The Health Care for America Now! Coalition is concerned that Anthem may be denying reasonable claims, and therefore we request an answer to these questions:

How many claims did you receive and what percentage of them did you deny in 2003-2007?

What percentage of these denials were for lack of medical necessity, pre-existing condition exclusion, experimental treatment, lack of prior authorization, or other reasons?

HCAN is concerned that Anthem enrollees are struggling with the increasing cost of basic necessities such as health care and insurance, while Anthem's per-member per-month profits have grown by 84.8 percent since 2004. Therefore we request an answer to this question:

For each year between 2002 and 2007, what percentage of health care claims costs has been borne by your company, and what percentage has been borne out-of-pocket by enrollees in the individual, small group and large group markets, respectively?

For each of your products, how much have you raised premiums each year for the past five years?

HCAN is concerned that there may be disproportionate representation of people of color, seniors, women and low-income people in Anthem's insurance plans that provide the least benefits and therefore we request an answer to this question:

What is the demographic breakdown of enrollment in each of your products by age, race/ethnicity, household income, gender or geography?

In 2007, Anthem Health Plans of Maine reported $75.7 million in dividends to its parent company. We are concerned that these profits are far above and beyond a healthy profit margin and offer no benefits to Mainers who are struggling to get by in our difficult economic climate. Therefore we request an answer to these questions:

For the past five years, how much has your company sent in dividends to your parent company? What was this money used for and how does your company determine how much it will send in dividends?

What is the complete compensation package for your top five executives?

After the press conference at the State House, HCAN went to Anthem's office in Augusta and demanded answers to these questions.

HCAN was stonewalled by the secretary. We didn't expect anything different. We were told we could not leave the questions but had to contact Anthem's spokesperson directly in order to make arrangements with him to get the questions to him.

The secretary did give HCAN his phone number. Outside Anthem's office, we called the spokesperson, got his voicemail and cell number, and left a message. We then tried his cell and left a message there too.

Check out Channel 6's report on the press conference and the action with Anthem. http://www.wcsh6.com/news/local/story.aspx?storyid=91259&catid=2