STATE OF MAINE
DEPARTMENT OF PROFESSIONAL
AND FINANCIAL REGULATION
BUREAU OF INSURANCE
IN RE: APPLICATION OF ASSOCIATED )
HOSPITAL SERVICE OF MAINE, )
d/b/a BLUE CROSS AND BLUE )
SHIELD OF MAINE, TO CONVERT )
TO A STOCK INSURER AND )
VOLUNTARILY LIQUIDATE AND )
DISSOLVE )
Docket No. INS 99-
IN RE: APPLICATION OF ANTHEM ) APPLICATION FOR
HEALTH PLAN OF MAINE, INC., ) CERTIFICATE OF
TO ACQUIRE TO ACQUIRE THE ASSETS ) AUTHORITY
OF ASSOCIATED HOSPITAL SERVICE )
OF MAINE, d/b/a BLUE CROSS AND )
BLUE SHIELD OF MAINE, )
AND RELATED TRANSACTIONS )
Docket No. INS 99-
INTRODUCTION
Concurrent with the filing of this Application for Certificate of Authority, Anthem
Insurance Companies, Inc. ("Anthem"), in the name of its wholly owned subsidiary
to be formed, Anthem Health Plans of Maine, Inc. (d/b/a Anthem Blue Cross Blue Shield of
Maine) ("Anthem BCBSME"), has filed for approval of the acquisition (the
"Acquisition") by Anthem, through Anthem BCBSME, of substantially all of the
assets and liabilities of Associated Hospital Service of Maine, d/b/a Blue Cross and Blue
Shield of Maine ("BCBSME"), including the transfer of its licenses and permits
and its stock interests in its two HMO subsidiaries, Maine Partners Health Plan, Inc.
("Maine Partners"), and Central Maine Partners Health Plan, Inc. ("Central
Maine Partners").
Specifically, pursuant to 5 M.R.S.A. § 194-A(5) and 24 M.R.S.A. § 2301(9-D), BCBSME
will convert to a stock insurer, whereupon BCBSME will sell and assign, and Anthem BCBSME
will purchase and assume, all Insurance Contracts of BCBSME in force at the Closing,
together with all operating assets of BCBSME used in the operation of its business, and
its stock in, respectively, Maine Partners and Central Maine Partners. Immediately after
the Closing, the policy and contract holders of BCBSME will become policy or contract
holders of Anthem BCBSME, without any break in continuity of benefits and services. In
addition, while BCBSME's ownership interest in Maine Partners and Central Maine
Partners will transfer to Anthem BCBSME, the policy and contract holders of Maine Partners
and Central Maine Partners will continue, without interruption of benefits or service, as
policy and contract holders of those HMOs. At Closing, Anthem BCBSME will acquire
BCBSME's (and, indirectly, Maine Partners' and Central Maine Partners')
then-existing network of physicians and other providers who will continue to provide
service to policy and contract holders.
As part of the Acquisition, Anthem will incorporate Anthem BCBSME, and seeks the
establishment of Anthem BCBSME as a Maine domestic stock health insurer and the issuance
to it of a Certificate of Authority to transact insurance in Maine pursuant to 24-A
M.R.S.A. § 404-413. This Application for Certificate of Authority seeks the permission
of the Superintendent of Insurance for Anthem BCBSME to transact the business of insurance
as a Maine domestic health insurer.
COMPONENTS OF APPLICATION
- Business and Marketing Plan for Maine; Current Operations; Forecast of
Anticipated Results.
- Assumption of Substantially All Assets and Liabilities
Anthem BCBSME is applying to the Bureau of
Insurance for a Certificate of Authority to conduct accident and health insurance business
and to operate a health maintenance organization as a line of business that BCBSME
presently operates, as a for-profit domestic health insurer governed by 24-A M.R.S.A.
At the Closing, BCBSME intends to assign, and Anthem BCBSME intends to assume,
obligations under BCBSME's Insurance Contracts as provided in the Bulk Reinsurance
Agreement, Bill of Sale, and Assumption of Liabilities between BCBSME and Anthem BCBSME
(the "Bulk Reinsurance Agreement") (the proposed form of which is part of the
Initial Consolidated Filing), along with substantially all of the other assets and
liabilities of BCBSME. The then-current BCBSME policy, contract and certificate holders
will receive a certificate from Anthem BCBSME assuming, without modification or
interruption, the health benefits in effect under the terms and conditions of their BCBSME
policy or contract. Anthem, through Anthem BCBSME, intends to continue the direct
insurance, managed care, HMO, third party administration and other health care businesses
conducted by BCBSME and its subsidiaries prior to the Acquisition.
Anthem BCBSME anticipates continuing BCBSME's current product offerings. There is
no current plan or intention to change the BCBSME product offerings or product mix as a
result of the proposed Acquisition (although, as noted elsewhere, over time there will be
an integration of some management responsibilities and product offerings as a New England
regional structure is implemented). In order to achieve all of the advantages of a
combined presence in New England, and to better serve customers with employees in multiple
locations, some products may be converted to a standardized product portfolio over time.
The standardized portfolio would be jointly designed by Anthem's Eastern plans to
best meet the needs of its customers while maximizing service and efficiency. Any such new
products would be implemented in accordance with Maine laws and regulations (including
those regarding Bureau of Insurance approvals).
- Future Employment and Business Operations
Consistent with its history of maintaining a strong local presence in the communities
that it serves, Anthem anticipates a significant employment base in Maine after
consummation of the Acquisition. Pursuant to the terms of the Asset Purchase Agreement
between BCBSME and Anthem dated as of July 13, 1999, Anthem will achieve the goal of
substantially proportionate employment levels in the geographic areas in which Anthem
operates, including Maine, subject to such fluctuations as are required to respond to
business conditions in general or substantial changes in relevant Maine laws or
regulations.
Anthem's present intention is that the Maine operations will be coordinated by an
enhanced Anthem East management organization. Anthem East is the functional division of
Anthem that is responsible for all of Anthem's and its subsidiaries' health care
financing, managed care and HMO business in New England. Anthem is open to additional
partners joining its Anthem East region. While additional transactions are a part of
Anthem's New England strategy, the Acquisition is not subject to or conditioned upon
the completion of any other transaction.
Anthem operates with a management system that consists of Corporate, Shared Service,
Regional and State level functions. The "Corporate" functions are generally
performed in Indiana, and include activities such as payroll, treasury and
compensation/benefits design. "Shared Service" functions refers to those
activities which are delivered on a standardized basis under the direction of a single
corporate executive (e.g., information systems and legal), but the employees are
distributed throughout the Anthem services areas. "Regional" services are
managed regionally and include claims and billing and enrollment. Finally, employees are
organized at the "State level" to provide those services for which local
decision making is important, such as sales, provider contracting and the medical
management functions.
Consistent with that approach, Anthem intends that many of the administrative
activities of Anthem BCBSME's business will be managed and conducted out of
BCBSME's existing South Portland, Maine headquarters and that the day-to-day
administrative activities to service Anthem's Maine business will be performed by
persons who are currently employed by BCBSME with the guidance and assistance of Anthem.
These local employees will be responsible for coordinating and overseeing enrollment
activity, supervising educational activities, providing service to accounts, tracking
customer satisfaction, and provider contracting and medical management and will serve as
local contact centers for members, providers, employees and regulatory authorities. In
addition, the marketing of health care coverage to Maine residents will be performed by
local employees.
Additional information about Anthem's historical and current operations, its
business and marketing plans for Maine, and its forecast of anticipated results are
provided in Items 2 and 5 of Anthem BCBSME's Form A.
- Biographical Sketches of Officers and Directors.
Biographical sketches of Anthem BCBSME's and Anthem's officers and directors
are provided in response to Item 3 of Anthem BCBSME's Form A as Exhibit D thereto.
- Character of Management.
Information regarding the character of the management of Anthem and Anthem BCBSME is
provided in response to Item 3 of Anthem BCBSME's Form A and exhibits to that Item.
- Chart of Organization of Holding Company System.
An organizational chart presenting, as of August 31, 1999, the identities of, and the
interrelationships among, Anthem and all of Anthem's subsidiaries and affiliates is
provided in response to Item 2(c) of Anthem BCBSME's Form A as Exhibit C thereto.
- Holding Company Registration Statement.
A copy of Anthem's holding company registration statement, as filed with its
supervisory official in Indiana, is attached hereto as Exhibit A. There are no proxy
solicitation statements.
- Annual Statements of Parent.
A copy of the annual statement of Anthem for 1998 is attached as Exhibit K to Anthem
BCBSME's Form A.
- Statement of Ownership.
- Anthem. As a mutual insurer, Anthem has no voting securities. No individual owns,
holds, or controls 5% or more of the members' voting rights in Anthem, though many of
Anthem's members have granted standing proxies to Anthem's Board of Directors.
Information about Anthem's and Anthem BCBSME's Boards of Directors is provided
in response to Item 3 of Anthem BCBSME's Form A and exhibits to that Item.
- Anthem BCBSME. Anthem BCBSME is to be wholly owned by Anthem East, Inc., which is in
turn a wholly owned subsidiary of Anthem.
- Capital and/or Surplus Requirements.
Immediately after Closing, Anthem BCBSME will have paid-in capital stock and free
surplus in amounts at least equal to that of BCBSME prior to Closing. In satisfaction of
24-A M.R.S.A. § 410, Anthem BCBSME will be capitalized with at least $1,000,000 in
paid-in capital stock and $1,000,000 in initial free surplus. These amounts will be funded
through Anthem's available working capital. Anthem is not obtaining any third-party
financing in connection with the Acquisition.
- Security Deposit.
Pursuant to 24-A M.R.S.A. § 412(1), Anthem BCBSME agrees to make and maintain a
deposit with the Superintendent of $100,000 in securities the Superintendent deems
eligible for deposit under 24-A M.R.S.A. § 1253.
- Policies To Be Issued.
A list of policies and products currently offered by BCBSME is attached as Exhibit E to
Anthem BCBSME's Form A. As stated in Item 5 of the Form A, Anthem BCBSME expects to
offer the same range of products after the Acquisition that BCBSME offers today. No
significant changes to BCBSME's (and Anthem BCBSME's) product families are
expected in the near future beyond those already identified in Item 5 of Anthem
BCBSME's Form A.
- Appointment of General Agent.
Pursuant to 24-A M.R.S.A. § 413(6) & 421, Anthem hereby agrees to cause Anthem
BCBSME to appoint James B Zimpritch, its Clerk, to serve as its agent to receive service
of legal process issued against it in Maine. After incorporation of Anthem BCBSME, Anthem
BCBSME will provide to the Superintendent a copy of such appointment along with proof of
the agent's consent to the appointment and a copy of a resolution of the board of
directors of Anthem BCBSME, showing that those officers who executed the appointment were
duly authorized to do so on behalf of the insurer.
- Proposed Articles of Incorporation.
The proposed Certificate of Organization of Anthem BCBSME is attached hereto as Exhibit
B.
- Proposed Bylaws.
The proposed Bylaws of Anthem BCBSME are attached hereto as Exhibit C.
- Maine Life and Health Insurance Guaranty Association.
Anthem BCBSME agrees to participate in, and comply with the membership requirements of,
the Maine Life and Health Insurance Guaranty Association, to the same extent as any other
similarly situated commercial insurer. Anthem also agrees to transition into the Guaranty
Association in the manner that the Superintendent determines appropriate during the course
of this proceeding.
- Management Agreements.
A form of the Intercompany Services Agreement, which will govern the relationship
between Anthem and Anthem BCBSME, is attached in response to Items 2 and 12(c)(ii) as
Exhibit B to Form A.
- Stock Offerings; Mergers or Consolidations; Tender Offers Made to Acquire Other
Insurers.
As a new insurer, Anthem BCBSME has been involved in no mergers or consolidations, and
has made no stock offerings or tender offers to acquire other insurers within the
preceding three years.
- Business Name.
Anthem BCBSME will not use a business name deceptively similar to that of any insurer
currently holding a valid certificate of authority. Anthem BCBSME has reserved the use of
the names "Anthem Health Plans of Maine, Inc." and "Anthem Blue Cross and
Blue Shield of Maine."
- Application Fee.
Pursuant to 24-A M.R.S.A. § 601(1)(A), Anthem, on behalf of Anthem BCBSME, submits
with this Application the required $1,000.00 fee. When requested by the Superintendent,
Anthem shall, on behalf of Anthem BCBSME, submit the $100.00 for issuance of the
Certificate of Authority.
SIGNATURE
Anthem Insurance Companies, Inc. has caused this application to be duly signed on its
behalf in the City of Indianapolis and State of Indiana on the day of September, 1999.
ANTHEM INSURANCE COMPANIES, INC.
[SEAL] By:___________________________________
Name: David R. Frick
Title: Exec. Vice President and Chief
Legal and Administrative Officer
Attest:
___________________________________
Signature of Officer
___________________________________
Title
CERTIFICATION
The undersigned deposes and says that he has duly executed the attached application
dated September 15, 1999, for and on behalf of Anthem Insurance Companies, Inc.; that he
is the Executive Vice President and Chief Legal and Administrative Officer of such company
and that he is authorized to execute and file such instrument. Deponent further says that
he is familiar with the instrument and the contents thereof, and that the facts therein
set forth are true to the best of his knowledge, information and belief.
______________________________________
Name: David R. Frick