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New Hampshire Insurance

Department

Network Adequacy

Public Information ReleaseMarketplace Issuer Networks for the

2016 Plan Year

June 5, 2015

Agenda (Contents)

2016 Marketplace Network Information Slide

New Hampshire Marketplace Preview 3-8

Health Insurance Carrier Network Profiles

Ambetter from NH Healthy Families, offered by Celtic Insurance 9

Anthem Blue Cross Blue Shield of New Hampshire 10

Community Health Options (MCHO) 11

Harvard Pilgrim Health Care of New England 12-13

Minuteman Health 14

Appendix: Hospital & ECP Listing 15

3

Key Dates: 2016 Marketplace Plan Review

April 15, 2015 - Carriers submit plans to Department (QHPs)

August 25, 2015 - Department submits QHP certification recommendations to federal

agency (CCIIO)

September 2015 - CCIIO decides which plans to certify for sale on Marketplace

November 1, 2015 - Marketplace open to public to enroll, view plan details and rates

4

Preview of Marketplace Issuer Networks

All information provided in this presentation has been generated from insurance carrier

applications and is current as of May 2015.

This information does not represent final networks as they will appear on the Health

Insurance Marketplace in 2016. Carriers continually negotiate contract terms with

providers, and State review of these networks may result in changes to provider

contracts or geographic coverage of health plans.

Hospital listings reflect only those hospitals located in NH. Essential Community

Providers (ECPs) are medical care providers who serve predominantly low-income, or

medically underserved patient populations as classified by CMS under 45 CFR 156.235

of the Federal Register.

▪ Ambetter from NH

Healthy Families,

offered by Celtic

Insurance

▪ Anthem Blue Cross

Blue Shield of New

Hampshire

▪ Community Health

Options (MCHO)

▪ Harvard Pilgrim

Health Care of

New England

▪ Minuteman Health

5

▪ Anthem Blue Cross

Blue Shield of New

Hampshire

▪ Assurant Health

▪ Community Health

Options (MCHO)

▪ Harvard Pilgrim

Health Care of

New England

▪ Minuteman Health

▪ Acute care

hospitals in

QHP networks

▪ Acute care

hospitals in

QHP networks

▪ Acute care

hospitals in

QHP networks

▪ 51 Individual

▪ 30 Small Group

▪ 42 Individual

▪ 18 Small Group

▪ 11 Individual

▪ 3 Small Group

New Hampshire Insurance Marketplace Profile

Medical Profile 2014 2015 2016

Number of

Carriers

1 5 5

▪ Anthem Blue

Cross Blue

Shield of New

Hampshire

Number of

Plans

14 60 81

Hospital

Inclusion

16 26 26

▪ Anthem

▪ Delta Dental

▪ Guardian Life

Insurance

Company

▪ Dentegra

Insurance

Company

6

New Hampshire Insurance Marketplace Profile

Dental Profile 2014 2015 2016

Number of

Carriers

3 3

Number of

Plans

22 13 15

▪ 8 Individual

▪ 14 Small Group

▪ 7 Individual

▪ 6 Small Group

▪ 8 Individual

▪ 7 Small Group

▪ Anthem

▪ Delta Dental

▪ Guardian Life

Insurance

Company

▪ Anthem

▪ Delta Dental

▪ Guardian Life

Insurance

Company

4

7

2016 Network Profile – Hospital Coverage

Location of Hospitals in New Hampshire

County Hospital Name # on Map

Belknap Lakes Region General Hospital 1

CarrollHuggins Hospital 2

Memorial Hospital 3

Cheshire Cheshire Medical Center 4

Coos

Androscoggin Valley Hospital 5

Upper Connecticut Valley Hospital 6

Weeks Medical Center 7

Grafton

Alice Peck Day Memorial Hospital 8

Cottage Hospital 9

Littleton Regional Healthcare 10

Mary Hitchcock Memorial Hospital 11

Speare Memorial Hospital 12

Hillsborough

Catholic Medical Center 13

Elliot Hospital 14

Monadnock Community Hospital 15

Southern NH Medical Center 16

St. Joseph Hospital 17

Merrimack

Concord Hospital 18

Franklin Regional Hospital 19

New London Hospital 20

Rockingham

Exeter Hospital 21

Parkland Medical Center 22

Portsmouth Regional Hospital 23

StraffordFrisbie Memorial Hospital 24

Wentworth-Douglass Hospital 25

Sullivan Valley Regional Hospital 26

New Hampshire Hospitals

8

2016 Network Profile – Hospital Coverage

Each hospital appears in at least 2 issuer networks in

2016, with several plans offering coverage at each facility

County Hospital Name # Issuers

Belknap Lakes Region General Hospital 4

CarrollHuggins Hospital 4

Memorial Hospital 4

Cheshire Cheshire Medical Center 3

Coos

Androscoggin Valley Hospital 4

Upper Connecticut Valley Hospital 5

Weeks Medical Center 5

Grafton

Alice Peck Day Memorial Hospital 4

Cottage Hospital 5

Littleton Regional Healthcare 4

Mary Hitchcock Memorial Hospital 4

Speare Memorial Hospital 4

Hillsborough

Catholic Medical Center 5

Elliot Hospital 3

Monadnock Community Hospital 3

Southern NH Medical Center 3

St. Joseph Hospital 5

Merrimack

Concord Hospital 2

Franklin Regional Hospital 4

New London Hospital 4

Rockingham

Exeter Hospital 3

Parkland Medical Center 2

Portsmouth Regional Hospital 2

StraffordFrisbie Memorial Hospital 4

Wentworth-Douglass Hospital 3

Sullivan Valley Regional Hospital 3

Issuer Contracts per Hospital

9

Ambetter from NH Healthy Families, offered by Celtic Insurance

– Granite State Health Plan

Count: 11 Count: 52 Count: 10

Hospitals ECP Contracts Service Area

10

Anthem Blue Cross Blue Shield of New Hampshire

– Pathway X and Pathway X Enhanced



11

Community Health Options (MCHO)

– NH CHO Network



12

Harvard Pilgrim Health Care of New England

– New Hampshire Network & Full HMO

Count: 26 Count: 71(70 in NH Network)

Count: 10


13


– Elevate Health



14

Minuteman Health – MHI Network



15

Appendix – Detailed Hospital & ECP Listings

The Insurance Department provides additional information relating to the

Marketplace on its website under Federal Health Reform:

http://www.nh.gov/insurance/consumers/fedhealthref.htm

http://www.nh.gov/insurance/consumers/fedhealthref.htm

16



Count: 11

Hospitals

County Hospital NameBelknap Lakes Region General Hospital

CoosUpper Connecticut Valley

Hospital

Weeks Medical Center

Grafton

Cottage Hospital

Mary Hitchcock Memorial

Hospital

Hillsborough

Catholic Medical Center

Monadnock Community

Hospital

St. Joseph Hospital

MerrimackNew London Hospital

Franklin Regional Hospital

Strafford Frisbie Memorial Hospital

17



County ECP Name County ECP Name

Belknap Health First FHC - Laconia Site Hillsborough Manchester Community Health Center

Belknap Lake Region General Hospital Hillsborough MCHC Tarrytown

Carroll Saco River Medical Group Hillsborough Mobile Community Health Team Families in Transition

Carroll White Mountain Community Health Center Hillsborough Monadnock Community Hospital

Coos ACHS - Whitefield Hillsborough New Horizons Shelter

Coos Coos Co. Family Health Services Inc. #001 Hillsborough Southern New Hampshire Medical Center

Coos Coos Co. Family Health Services Inc. #002 Hillsborough St. Joseph's Hospital

Coos Coos Co. Family Health Services Inc. #001 Merrimack CAP Belknap Merrimack Co. #001

Coos Coos Co. Family Health Services Inc. #002 Merrimack Franklin Regional Hospital

Coos Indian Stream Health Center Merrimack Health First Family Care Center #001

Coos Upper Connecticut Valley Hospital Merrimack Health First Family Care Center #002

Coos Weeks Medical Center #002 Merrimack New Hampshire Department of Health & Human Services

Coos Weeks Medical Center #003 Merrimack New London Hospital

Grafton ACHS - Franconia Rockingham Cross Roads House

Grafton ACHS - Warren Rockingham Families First / St. Vincent de Paul

Grafton ACHS - Woodsville Rockingham Families First Health Center

Grafton Ammonoosuc Community Health Services #001 Rockingham

Feminist Health Center of Portsmouth, Inc. d/b/a Joan G. Lovering Health

Center

Grafton Cottage Hospital Strafford Goodwin Community Health

Grafton Dartmouth Hitchcock Plymouth Strafford Horne Street Elementary School

Grafton Mary Hitchcock Memorial Hospital Strafford Woodman Park Elementary School

Hillsborough Child Health Services Sullivan Charlestown Family Medicine

Hillsborough Families In Transition-FIT Sullivan Newport Health Center #001

Hillsborough Granite State Internal Medicine-001





Hillsborough Greater Manchester Mental Health

Hillsborough Harbor Care Clinic and Wellness Center

Hillsborough Harbor Care Health and Wellness Center

18


– Pathway X Enhanced and Pathway X Enhanced

Hospitals

Count: 21

County Hospital NameBelknap Lakes Region General Hospital

Carroll Huggins Hospital

Memorial Hospital

Cheshire Cheshire Medical Center

Coos

Androscoggin Valley Hospital


Upper Connecticut Valley

Hospital

Grafton

Alice Peck Day Memorial

Hospital

Cottage Hospital


Hospital

Littleton Regional Healthcare

Speare Memorial Hospital

Hillsborough


Southern NH Medical Center

Elliot Hospital

St. Joseph Hospital

MerrimackFranklin Regional Hospital

New London Hospital

Rockingham Exeter Hospital

Strafford Wentworth-Douglass Hospital

Sullivan Valley Regional Hospital

19


– Pathway X Enhanced and Pathway X Enhanced

County ECP Name County ECP NameBelknap CAP Belknap Merrimack Co. #002 Grafton Newfound Family Practice

Belknap Health First FHC - Laconia Site Grafton PPNNE-West Lebanon

Belknap Lake Region General Hospital Grafton Speare Memorial Hospital

Carroll CAP Belknap Merrimack Co. #003 Grafton Speare Primare Care

Carroll Huggins Hospital Hillsborough Child Health Services

Carroll Memorial Hospital, The #002 Hillsborough Elliot Hospital

Carroll Saco River Medical Group Hillsborough Greater Manchester Mental Health

Carroll White Mountain Community Health Center Hillsborough Harbor Care Clinic and Wellness Center

Cheshire PPNNE-Keene Hillsborough Harbor Care Health and Wellness Center

Coos ACHS - Whitefield Hillsborough Hillsboro Family Health

Coos Androscoggin Valley Hospital Hillsborough Lamprey Health Care Nashua

Coos Coos Co. Family Health Services Inc. #001 Hillsborough Manchester Community Health Center

Coos Coos Co. Family Health Services Inc. #002 Hillsborough MCHC Tarrytown

Coos Coos Co. Family Health Services Inc. #002 Hillsborough Monadnock Community Hospital

Coos Indian Stream Health Center Hillsborough PPNNE-Manchester

Coos Upper Connecticut Valley Hospital Hillsborough Southern New Hampshire Medical Center

Coos Weeks Medical Center - Lancast Hillsborough St. Joseph's Hospital

Coos Weeks Medical Center #001 Merrimack CAP Belknap Merrimack Co. #001

Coos Weeks Medical Center #002 Merrimack Concord Hospital Family Health Center

Coos Weeks Medical Center #003 Merrimack Franklin Regional Hospital

Coos Weeks Medical Center-Whitefield Merrimack Health First Family Care Center #002

Coos Weeks Medical Center-Whitefield Merrimack New London Hospital

Grafton ACHS - Franconia Rockingham Families First Health Center

Grafton ACHS - Warren Rockingham Feminist Health Center of Portsmouth, Inc. d/b/a Joan G. Lovering Health Center

Grafton ACHS - Woodsville Rockingham Lamprey Health Care #001

Grafton Alice Peck Day Memorial Hospital Rockingham Lamprey Health Care #002

Grafton Ammonoosuc Community Health Services #001 Rockingham PPNNE-Derry

Grafton Cottage Hospital Rockingham PPNNE-Exeter

Grafton Dartmouth Hitchcock Plymouth Strafford Goodwin Community Health

Grafton Littleton Regional Healthcare Sullivan Charlestown Family Medicine

Grafton Mary Hitchcock Memorial Hospital Sullivan Newport Health Center #001

Grafton Mid-State Health Center – Bristol Sullivan PPNNE-Claremont

Grafton Mid-State Health Center Plymouth Sullivan Valley Regional Hospital

20


– NH CHO Network

Count: 26

HospitalsCounty Hospital NameBelknap Lakes Region General Hospital

CarrollHuggins Hospital

Memorial Hospital


Coos


Upper Connecticut Valley Hospital


Grafton

Alice Peck Day Memorial Hospital

Cottage Hospital


Mary Hitchcock Memorial Hospital


Hillsborough


Elliot Hospital

Monadnock Community Hospital


St. Joseph Hospital

Merrimack

Concord Hospital


New London Hospital

Rockingham

Exeter Hospital

Parkland Medical Center

Portsmouth Regional Hospital

StraffordFrisbie Memorial Hospital

Wentworth-Douglass Hospital


21


– NH CHO Network

County ECP Name County ECP NameBelknap Health First FHC - Laconia Site Hillsborough Monadnock Community Hospital

Belknap Lake Region General Hospital Hillsborough Northeast Rehabilitation Hospital - Nashua

Belknap Littleton Regional Healthcare- Dental Center Hillsborough Northeast Rehabilitation Outpatient Center - Nashua

Carroll Huggins Hospital Hillsborough PPNNE-Manchester

Carroll Memorial Hospital, The #004 Hillsborough Southern New Hampshire Medical Center

Carroll White Mountain Community Health Center Hillsborough Southern New Hampshire Medical Center

Cheshire Cheshire Medical Center Hillsborough St. Joseph's Hospital

Cheshire PPNNE-Keene Hillsborough Synan, MD, Thomas, Granite State Internal Medicine

Coos ACHS - Whitefield Hillsborough Wingate, Nashua Eye Associates, PA

Coos Androscoggin Valley Hospital Hillsborough Zinnes, MD, Robert, Primary Care of Hudson

Coos Coos Co. Family Health Services Inc. #001 Merrimack Concord Hospital Family Health Center

Coos Coos Co. Family Health Services Inc. #001 Merrimack Franklin Regional Hospital

Coos Coos Co. Family Health Services Inc. #002 Merrimack Health First Family Care Center #002

Coos Indian Stream Health Center Merrimack New London Hospital

Coos Upper Connecticut Valley Hospital Rockingham Exeter Hospital

Coos Weeks Medical Center #002 Rockingham Families First Health Center

Grafton ACHS - Franconia Rockingham Feminist Health Center of Portsmouth, Inc. d/b/a Joan G. Lovering Health Center

Grafton ACHS - Warren Rockingham Lamprey Health Care #001


Grafton Alice Peck Day Memorial Hospital Rockingham Northeast Rehabilitation Hospital - Pease

Grafton Ammonoosuc Community Health Services #001 Rockingham Northeast Rehabilitation Hospital - Salem Main Hospital

Grafton Cottage Hospital Rockingham Northeast Rehabilitation Outpatient Center - Londonderry

Grafton Dartmouth Hitchcock HIV Program Rockingham Northeast Rehabilitation Outpatient Center - Pelham

Grafton Littleton Regional Healthcare Rockingham Northeast Rehabilitation Outpatient Center - Plaistow

Grafton Mary Hitchcock Memorial Hospital Rockingham Northeast Rehabilitation Outpatient Center - Salem - Stiles Road

Grafton Mid-State Health Center – Bristol Rockingham Northeast Rehabilitation Outpatient Center - Windham

Grafton Mid-State Health Center Plymouth Rockingham Portsmouth Regional Hospital

Grafton North Country Primary Care Rockingham PPNNE-Derry

Grafton PPNNE-West Lebanon Rockingham PPNNE-Exeter

Grafton Speare Memorial Hospital Strafford Frisbie Memorial Hospital

Hillsborough Catholic Medical Center Strafford Goodwin Community Health

Hillsborough Child Health Services Strafford Wentworth-Douglas Hospital

Hillsborough Elliot Hospital Sullivan Charlestown Family Medicine

Hillsborough Harbor Care Health and Wellness Center Sullivan Newport Health Center

Hillsborough Lamprey Health Care Nashua Sullivan PPNNE-Claremont

Hillsborough Manchester Community Health Center Sullivan Valley Regional Hospital

Hillsborough MCHC Tarrytown

22



Count: 26

HospitalsCounty Hospital NameBelknap Lakes Region General Hospital


Memorial Hospital


Coos


Upper Connecticut Valley Hospital


Grafton

Alice Peck Day Memorial Hospital

Cottage Hospital


Mary Hitchcock Memorial Hospital


Hillsborough


Elliot Hospital

Monadnock Community Hospital


St. Joseph Hospital

Merrimack

Concord Hospital


New London Hospital

Rockingham

Exeter Hospital

Parkland Medical Center

Portsmouth Regional Hospital




23



County ECP Name County ECP NameBelknap Health First FHC - Laconia Site Grafton Speare Primare Care

Belknap Lake Region General Hospital Hillsborough Child Health Services

Carroll Huggins Hospital Hillsborough Families In Transition-FIT

Carroll Memorial Hospital, The #003 Hillsborough Greater Manchester Mental Health

Carroll Saco River Medical Group Hillsborough Harbor Care Clinic and Wellness Center

Carroll White Mountain Community Health Center Hillsborough Harbor Care Health and Wellness Center

Cheshire PPNNE-Keene Hillsborough Hillsboro Family Health

Coos ACHS - Whitefield Hillsborough Lamprey Health Care Nashua

Coos Ammonoosuc Community Health Services #002 Hillsborough Manchester Community Health Center

Coos Androscoggin Valley Hospital Hillsborough MCHC Tarrytown

Coos Coos Co. Family Health Services Inc. #001 Hillsborough Monadnock Community Hospital

Coos Coos Co. Family Health Services Inc. #002 Hillsborough New Horizons Shelter

Coos Coos Co. Family Health Services Inc. #001 Hillsborough PPNNE-Manchester

Coos Coos Co. Family Health Services Inc. #002 Hillsborough Southern New Hampshire Medical Center

Coos Indian Stream Health Center Hillsborough St. Joseph's Hospital

Coos Upper Connecticut Valley Hospital Merrimack Concord Hospital Family Health Center

Coos Weeks Medical Center - Lancast Merrimack Franklin Regional Hospital

Coos Weeks Medical Center #001 Merrimack Health First Family Care Center #001

Coos Weeks Medical Center #002 Merrimack Health First Family Care Center #002

Coos Weeks Medical Center #003 Merrimack New London Hospital

Coos Weeks Medical Center-Whitefield Rockingham Cross Roads House

Coos Weeks Medical Center-Whitefield Rockingham Families First / St. Vincent de Paul

Grafton ACHS - Franconia Rockingham Families First Health Center

Grafton ACHS - Warren Rockingham

Feminist Health Center of Portsmouth, Inc. d/b/a Joan G.

Lovering Health Center


Grafton Alice Peck Day Memorial Hospital Rockingham Lamprey Health Care #002

Grafton Ammonoosuc Community Health Services #001 Rockingham PPNNE-Derry

Grafton Ammonoosuc Community Health Services Mt. Mooselauke Rockingham PPNNE-Exeter

Grafton Cottage Hospital Strafford Goodwin Community Health

Grafton Dartmouth Hitchcock Plymouth Strafford Horne Street Elementary School

Grafton Littleton Regional Healthcare Strafford Woodman Park Elementary School

Grafton Mary Hitchcock Memorial Hospital Sullivan Charlestown Family Medicine*Full HMO network only

Grafton Mid-State Health Center – Bristol Sullivan Newport Health Center #001

Grafton Mid-State Health Center Plymouth Sullivan PPNNE-Claremont

Grafton Newfound Family Practice Sullivan Valley Regional Hospital

Grafton Speare Memorial Hospital

24


– Elevate Health

Count: 16

Hospitals

County Hospital NameCheshire Cheshire Medical Center

Coos



Hospital


Grafton


Hospital

Cottage Hospital


Hospital

Hillsborough

Monadnock Community

Hospital

Elliot Hospital


MerrimackNew London Hospital

Concord Hospital

Rockingham Exeter Hospital




25


– Elevate Health

County ECP Name County ECP NameCheshire PPNNE-Keene Rockingham PPNNE-Derry

Coos ACHS - Whitefield Rockingham PPNNE-Exeter

Coos Ammonoosuc Community Health Services #002 Strafford Goodwin Community Health

Coos Androscoggin Valley Hospital Strafford Horne Street Elementary School

Coos Coos Co. Family Health Services Inc. #001 Strafford Woodman Park Elementary School

Coos Coos Co. Family Health Services Inc. #002 Sullivan Newport Health Center #001

Coos Coos Co. Family Health Services Inc. #001 Sullivan PPNNE-Claremont

Coos Coos Co. Family Health Services Inc. #002 Sullivan Valley Regional Hospital

Coos Indian Stream Health Center

Coos Upper Connecticut Valley Hospital

Coos Weeks Medical Center - Lancast

Coos Weeks Medical Center #001



Coos Weeks Medical Center-Whitefield


Grafton ACHS - Franconia

Grafton ACHS - Warren

Grafton ACHS - Woodsville

Grafton Alice Peck Day Memorial Hospital

Grafton Ammonoosuc Community Health Services #001

Grafton Ammonoosuc Community Health Services Mt. Mooselauke

Grafton Cottage Hospital

Grafton Dartmouth Hitchcock Plymouth

Grafton Mary Hitchcock Memorial Hospital

Hillsborough Greater Manchester Mental Health

Hillsborough Hillsboro Family Health

Hillsborough Monadnock Community Hospital

Hillsborough PPNNE-Manchester

Merrimack Concord Hospital Family Health Center

Merrimack New London Hospital

26


Count: 12

Hospitals

County Hospital Name


Memorial Hospital

Coos



Hospital


Grafton


Hospital

Cottage Hospital



HillsboroughCatholic Medical Center

St. Joseph Hospital

Strafford Frisbie Memorial Hospital

27


County ECP NameCarroll Huggins Hospital

Carroll Memorial Hospital, The #006

Carroll Saco River Medical Group

Carroll White Mountain Community Health Center

Coos Androscoggin Valley Hospital

Coos Coos Co. Family Health Services Inc. #001

Coos Indian Stream Health Center


Grafton Alice Peck Day Memorial Hospital

Grafton Ammonoosuc Community Health Services #001

Grafton Cottage Hospital

Grafton Littleton Regional Healthcare

Grafton Mid-State Health Center – Bristol

Grafton Mid-State Health Center Plymouth

Grafton Speare Memorial Hospital

Hillsborough Community Council of Nashua

Hillsborough Granite State Internal Medicine -1

Hillsborough Granite State Internal Medicine -2

Hillsborough Harbor Care Health and Wellness Center

Hillsborough Lamprey Health Care Nashua

Hillsborough Mental Health Center Of Greater Manchester

Merrimack Health First Family Care Center #001

Merrimack Health First Family Care Center -2

Merrimack Jessica Stern

Rockingham Families First Health Center

Rockingham Lamprey Health Care #001

Rockingham Lamprey Health Care #002

Rockingham Southern New Hampshire Internal Medicine Associates Pc

Strafford Goodwin Community Health

28

• The public is welcome to comment on the

proposed networks.

• Comments should be emailed to

[email protected] or mailed to the New

Hampshire Insurance Department, c/o Danielle

Barrick, 21 Southc Fruit St., Suite 14, Concord,

NH, 03301.

• Comments are due by August 14, 2015, and may

be shared publicly.

Thank You

Contact Information

New Hampshire Insurance

Department21 South Fruit Street, Suite #14

Concord, NH 03301

[email protected]

Phone: (603) 271-2261

Fax: (603) 271-1406

TTY/TDD: 1 (800) 735-2964

www.nh.gov/insurance

6/11/2015

mailto:[email protected]

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