Anthem's members could lose health insurance coverage in Stamford Health system after March 1.

Jan. 17—Members of Anthem Blue Cross and Blue Shield, one of the largest health insurers in Connecticut, are at risk of losing their coverage within the system that includes Stamford Hospital, unless the two organizations reach a new deal in the next month and a half.

Anthem and Stamford Health officials confirmed this week that their contract expired on Dec. 31. But to comply with a state-mandated, 60-day "cooling off period," they said that Anthem members' in-network coverage would continue until March 1 for services provided by Stamford Health, which includes Stamford Hospital and a number of outpatient centers in Stamford and other communities in lower Fairfield County.

"We are actively negotiating in good faith to reach an agreement before March 1," Anthem officials said in a written statement.

In their own statement, Stamford Health officials said that they have been negotiating with Anthem on a new contract for nearly a year.

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"While we remain committed to continuing negotiations in good faith, we need Anthem, Connecticut's largest for-profit health insurance company, to prioritize the needs of its members and the sustainability of our community's health care system in order to reach a resolution," the Stamford Health statement reads. "We urge Anthem to work with us to reach a fair and reasonable agreement."

Stamford Health's statement added that patients seeking more information about the situation can call Stamford Health at 855-775-7898.

In other recent developments at Anthem, which has more than 1.1 million members in Connecticut, in-network coverage has ended at supermarket chain Big Y's pharmacies. Big Y has pharmacies at its stores in Bethel, East Windsor, Ellington, Groton, Killingly, Manchester, Mansfield, Marlborough, Naugatuck, New Milford, North Branford, Norwich, Old Saybrook, Stafford, Stonington, Stratford, Tolland and Torrington.

Anthem officials declined to comment on the reasons for dropping Big Y pharmacies from their network.

Connecticut Insurance Department officials responded this week that some Anthem members' plans, include those procured through the AccessHealth CT marketplace, might remain in Anthem's network.

Insurance Department officials advise consumers to check with their employers, check their insurance ID cards or call the customer number on their insurance cards.

"Fully insured plans for individual and small businesses are not affected," Andrew Mais, the state's insurance commissioner, said in a statement. "Employer self-funded plans that use Anthem as a third-party administrator are affected by the change. It's important for consumers to know what type of plan they have."

Fully insured plans are backed by an insurance policy and provide benefits for a premium paid by the policyholder. The state Insurance Department regulates those plans.

Self-insured plans generally comprise group plans offered by employers, who take on the risk and pay the claims. Employers will generally contract with a third party, often an insurance company, to administer self-insured plans. Those plans are regulated by the U.S. Department of Labor and not the state's insurance department.

For questions about coverage for Anthem members, or any other inquiries, the Connecticut Insurance Department can be reached at [email protected] or 860-297-3900.

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