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Anthem Blue Cross Blue Shield details Obamacare coverage balancing 'access and affordability'

CONCORD – Anthem Blue Cross Blue Shield officials defended their Pathway program, which uses a narrow network of hospitals and providers for those buying health insurance through electronic marketplace or exchanges established under the Affordable Care Act.

Anthem NH President Lisa Guertin told state senators at a meeting Wednesday the narrower network Pathway plan provides "the best balance of access and affordability."

Several senators questioned why hospitals in their districts were not included in the network, and Guertin said her company looked at geography and distances and not quality of care in meeting all the state standards for accessibility.

With the narrower network, the premium prices of the 11 individual plans and three small-business plans Anthem will offer on the exchanges will be 25 to 30 percent lower, she explained.

Guertin said her company believes most of the exchange customers during the first year will be those individuals between 138 to 400 percent of the federal poverty level who will receive a subsidy from the federal government.

The premiums for the 11 individual plans range from a low of $177 a month to $2,226 depending on age and the level of coverage with deductibles ranging from $1,000 for an individual to $11,500 for a family. Subsidies will lower the premiums for those who qualify.

Anthem is the only insurer to offer general health insurance on the exchange next year and Tuesday received federal approval of its plan.

The exchange begins operation Oct. 1 with policies going into effect Jan. 1, when all individuals and families are required to have health insurance under the ACA.

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