"creating a state of universal coverage. ... DirigoChoice insurance plan has opened enrollment for small businesses and self-employed individuals, through a public-private health insurance venture with Anthem Blue Cross and Blue Shield of Maine. More than 1,000 individuals have already enrolled, and coverage is scheduled to take effect on January 1, 2005. In May 2005, the state announced that Dirigo Health will provide coverage for families earning up to 200 percent of the federal poverty level, up from the previous limit of 150 percent. In announcing the news, Governor John Baldacci said that by expanding coverage, the state will save an estimated $10 million in charity care and bad debt for those who previously had no health insurance. For More Information Web site: http://www.dirigohealth.maine.gov/index.htmlContacts: Trish Riley, Executive Director and Adam Thompson, Legislative and Constituent Liaison, Governor's Office of Health Policy and Finance Phone: (207) 624-7442 "

"Governor John Baldacci hopes, however, that under the incoming Obama administration, Maine could get federal Medicaid dollars to match Dirigo premiums paid by employers and individuals, which would help sustain and expand the program. This federal match was originally intended for the program but was rejected by the Centers for Medicare and Medicaid Service (CMS) and is now under appeal."

via http://blog.spn.org/id.3508/detail.asp via http://blog.spn.org/id.3505/detail.asp

This is a good analysis of Dirigo's current (10/07) situation from the perspective of the insurance industry "Anthem has "a different mission, and that's perfectly fine," says Trish Riley, director of the Governor's Office of Health Policy and Finance (GOHPF), which was created by Maine Gov. John Baldacci (D) to develop and oversee Dirigo. "They had financial expectations beyond our budget, and we couldn't meet it," she explains during an interview. The decision to end the contract "was related to that," she says. During the first two years of the program, GOHPF offered experience modification payments (EMPs) to ensure that Anthem made a profit on the program. Riley says that the state legislature "made clear that it didn't like the arrangement. And we couldn't afford to do it again this year.""

" * Contact the BONIVA Reimbursement Hotline at 1-888-587-9438 (Monday-Friday, 9:00 AM to 7:00 PM ET) * The BONIVA Reimbursement Hotline will assist you with‡: o Coding/billing information o Coverage details "

"The “reinsurance facility” is some sort of government-mandated program that forces insurance companies to insure people (like you, and, well, me) whom they don’t really want to insure. It varies by state, but I believe each state has one. The coverage you get sucks and it will cost you an arm and a leg. Did I mention they don’t like you very much? In fact, the only thing they like less than you is the thought of people like you driving around uninsured, because if an uninsured driver goes and hits someone else they do insure, it’s going to cost them even more. (That’s the “uninsured motorist” part of a regular insurance policy.) A little cesspool of superrational thinking in the midst of a dirty business."

"AUGUSTA, Maine — Anthem Blue Cross and Blue Shield will not provide health coverage to Mainers through the state’s Dirigo Health Agency after this year because the two sides could not agree on terms to extend the contract. In a joint statement Wednesday, the two sides said they were unable to agree on acceptable financial terms to extend the contract for one year. Dirigo "is finalizing its plan to transition the program by Jan. 1, 2008, to assure that current members continue to have access to the DirigoChoice product and its subsidies," the statement said. About 15,000 subscribers are enrolled in the DirigoChoice insurance product that’s been administered by Anthem since 2003, two-thirds of them with individual coverage and a third in the group market, said Anthem spokesman Mark Ishkanian. What will happen to those subscribers when 2008 arrives was unclear Wednesday, Ishkanian said, because "we don’t know yet the direction the state’s going to go with the program." But he said Anthem is committed to helping the Dirigo agency make its transition. "We want DirigoChoice to succeed," Ishkanian said. "There are no hard feelings here." Anthem is also obligated to offer a similar insurance product to subscribers now covered under a DirigoChoice plan if they choose to remain with Anthem, but their premiums could go up, Ishkanian added. Dirigo Health was created by the Legislature in 2003 to curb health care costs, broaden access to coverage for thousands of Mainers who lack health insurance and promote health care quality. It is funded in part through savings in the health care system generated through the program. In July, Dirigo’s board of directors determined that the program will save $78 million in its third year of operation. The Maine Association of Health Plans, which represents state’s major health insurers, disputed the figure, saying the savings estimate is excessive. Maine’s major health insurers include Anthem, Aetna, Cigna HealthCare of Maine and Harvard Pilgrim Health Care. Wednesday’s statement by Anthem and Dirigo Health said the two organizations "have worked diligently to make this program a success and feel very good about what has been accomplished over the three years." "We are grateful that Anthem Blue Cross and Blue Shield stepped up three years ago to help make DirigoChoice a reality and that they will work with us closely to transition the program," the Dirigo board’s chairman, Robert McAfee, said in the statement. A message left with Dirigo Executive Director Karynlee Harrington was not immediately returned."

" 1. Who is Eligible? 2. What is Available? 3. What About Pre-existing Conditions? 4. What is DirigoChoice? 5. What are HSAs? 6. How Much Does It Cost? 7. Standardized Major Medical Plans 8. Non-Standardized Plans 9. Standardized HMO Plans 10. Benefit Comparison Charts "

"to meet the needs of local government employees, retirees, dependents and employer groups by providing cost-effective, quality employee benefit programs and superior services. "

"The claimant or his/her representative completes items 2 through 11. The SSA-820-F4 is considered to be a self-help form. "