Health New England Plans Receive Connector Seal of Approval

SPRINGFIELD — The Commonwealth Health Insurance Connector Authority has granted its Connector Seal of Approval to five Health New England plans for sale in Western Mass.

The Connector is the new state agency created by the Massachusetts Health Care Reform Law. The law, passed in 2006, requires all Massachusetts residents to have health insurance starting on July 1, 2007.

Four of the HNE plans range from basic to premier coverage. A fifth plan will be offered exclusively for residents 19 to 26 years old who are categorized by the law as young adults. Premiums for the plans are not yet final, as the state is still sorting out certain details that may affect plan costs.

“The HNE Connector plans give people real options for their coverage,” said Peter Straley, president and CEO of HNE.

“For some, a low premium cost will meet their needs, while for others, a plan with no deductible payments is a better choice. Our plans will cover those ranges.”

Health New England will offer plans in all three categories defined by the Connector: “Basic” plans with low monthly premiums and higher out-of-pocket costs for covered services, “Value” plans with middle-range premiums and out-of-pocket costs, and “Premier” plans with higher monthly premiums and lower out-of-pocket costs. The plans are:

HNE WisePlus. This Basic plan has a deductible of $2,000 for individuals ($4,000 family). Because this plan is a federally qualified high-deductible health plan (HDHP), members can contribute pre-tax dollars into a health savings account (HSA). Money in the HSA can be carried over from year to year, or used to pay for qualified medical expenses.

HNE EssentialMax. This Value plan has a $1,000 individual ($2,000 family) deductible. Doctor’s office visits and prescription drugs are not subject to the deductible. For all other medical covered services, members must pay the first $1,000 in medical expenses. As with other HMO plans, members pay a copayment for covered services.

HNE Principle with the HNE Alliance Network. This Value plan emphasizes the doctor/patient relationship as a partnership in managing care. Preventive care is the primary focus with this plan. Members pay a modest copayment for covered services, and there is no deductible to meet.

HNE HealthMax. This Premier level plan offers a generous level of health benefits. Members have access to HNE’s broad HMO network, and there is no deductible for covered services.

MyHNE. This plan is available for young adults. It carries a $2,000 individual ($4,000 family) deductible. Coverage is limited to $100,000 of medical expenses per year.

In addition, most of HNE’s Connector-approved plans cover preventive care at no out-of-pocket cost to the member.

Straley emphasized that people should consider several factors before purchasing their coverage. “One piece of advice we give everyone is to make an informed decision before you select your plan,” he said.

“What you pay for the monthly premium is an important consideration, but it’s not the only one,” he added. “Members should also look at out-of-pocket costs, which will vary from modest copayments to several thousand dollars, depending on the plan.

Network is another critical piece, he continued. “Where do you have to go to get covered services? With HNE, we’ve been working with the doctors and other health care providers here in Western Mass. for the last 20 years.”

Straley predicted that many people will be confused in the beginning and will seek out advice.

“Because HNE is located right here in Western Mass., we are very accessible,” he said. “Our associates are here to work with individuals and employers to help them determine which plans are right for them.”