Hartford Business Journal

www.HartfordBusiness.com • April 23, 2018 • Hartford Business Journal 17 lowed by UnitedHealthcare (529,000 members), ConnectiCare (497,117 members) and Aetna (497,117 mem- bers), according to Hartford Business Journal's Book of Lists. Schultz said his team has worked for nearly four years to build up its network of providers, which he thinks is on par with its competitors. That's important because consumers often want to see more doctors in a cover- age network — even though that can increase costs — to ensure they can access their pre- ferred physicians. Jason Madrak, vice president of Harvard Pilgrim's Connecticut market, said that has helped the company pursue new business. "We're ladder- ing up continu- ally now that we have this mature network and a nice array of products," Madrak said. "We're starting to get that mid- market growth, 100 to 500 lives, and there's quite a few of those types of businesses here in the state." Shelly Sweatt, vice president and general counsel of Newtown-based benefits broker TR Paul Inc. and presi- dent of the Connecticut Association of Benefit Brokers, said she has seen first- hand the progress Harvard Pilgrim has made building its network here. TR Paul has offered Harvard Pil- grim's policies since the insurer debuted in Con- necticut, and Sweatt recalls that its list of in- network doctors was small at first. "I would say that definitely was their biggest hurdle initially," Sweatt said. "I do believe their network has hit a certain critical mass." At least for some clients, she said, Harvard Pilgrim's not-for-profit status could be a deciding factor. "I think that sets them apart," she said. Madrak said that having a more mature network also means Harvard Pilgrim wants to start shifting toward more value-based contracts that offer providers financial incentives to pro- duce better health outcomes. It's something Harvard Pilgrim has done extensively in its home state, where about 70 percent of its con- tracts include doctors or hospitals taking some level of financial risk. "I think we're at the point now [in Connecticut] where these types of con- versations are happening," Madrak said. Small group outlook The small group insurance market is no stranger to rate hikes. One major cost for some insurers, including Harvard Pilgrim, has been the Affordable Care Act's risk adjust- ment program, which forces carriers with a higher percentage of healthier customers to pay insurers with sicker patients, with the aim of stabilizing pre- miums across the broader popula- tion. It was that very program that helped put another not-for- profit health in- surer in Connect- icut, HealthyCT, out of business in late 2016, after a $13.4 million risk adjustment payment jeopar- dized its financial position. Harvard Pilgrim has cited the program as a driver of its finan- cial losses over the past several years, as well as a reason it has asked state regulators for rate hikes, including a 17.3 percent average increase on nearly 12,000 Con- necticut small group customers for the 2018 plan year. Schultz said tiered network health plans — which steer customers toward a specific tranche of usually lower-cost providers — have more potential to keep costs down, and he is also optimistic about the evolution of value-based contracting. But federal policy will play a key role in the prices small companies pay for insurance, Schultz said. He has his eye on sev- eral things that concern him, including the effective repeal of Obamacare's individual coverage mandate late last year, and proposed federal rules that would allow states to permit insurance policies that don't adhere to Obamacare's cover- age requirements, which tend to increase premiums. Such developments could split off healthier portions of the risk pool from sicker populations, driving up costs for the latter, Schultz said. "People like the concept of it, but it will split up that small-employer mar- ket, and some (employers) would end up seeing rate increases," he said. The Harriet Beecher Stowe Center in Hartford has named Briann G. Greenfield as its new executive director. Greenfield will begin work on June 18, succeeding Executive Director Katherine Kane, who will retire on May 11 after serving about 20 years in the post, the museum said. Greenfield will arrive in Hartford after working for the New Jersey Council for the Humanities, where she served as executive director since 2014. During her time there, she led the council's development and implementation of new programming and improved its financial stability and operating efficiency, officials said. She has also served as a history professor and as founding director of the master's in public history program at Central Connecticut State University for 13 years. She earned her Ph.D. and master's degree in American Civilization from Brown University and a bachelor's degree in history from the University of New Hampshire. The Stowe Center's board of trustees said it identified Greenfield through a nationwide search. Wheeler Clinic in Hartford has received a $100,000 grant aimed primarily at improving children's dental care and developing best practices for dental and primary care integration. The money will also support startup dental staffing, purchasing equipment and a community dental outreach and education program. The grant is among four in Connecticut from The Delta Dental of New Jersey Foundation, which has awarded nearly $1 million this year to 34 nonprofit organizations in New Jersey and Connecticut to increase access, provide education or expand the dental health care they currently provide to children, developmentally disabled persons and senior citizens, as well as to support various community events and programs that promote the importance of good oral health. The Hartford Foundation received a $50,000 grant from the Travelers Foundation for its Respond-Rebuild- Renew Fund to help meet the needs of individuals and families relocating to Greater Hartford following natural disasters. Nonprofit Notebook NONPROFIT PROFILE The Children's Museum 950 Trout Brook Drive, West Hartford | thechildrensmuseumct.org Mission: To support the community in engaging its various stakeholders in activities that foster lifetime learning. Top Executive: Michael Werle, Executive Director Services: Interactive science and nature museum for children. FY 2017 SUMMARY 2016 2017 Total Employees 70 74 Total Assets $1,572,447 $2,224,630 Total Liabilities $329,697 $399,116 REVENUES Contributions & Grants $760,359 $1,271,699 Program Service Revenue $1,078,623 $1,173,859 Investment Income $6,508 $8,277 Other $32,510 $36,976 Total $1,878,000 $2,490,811 EXPENSES Grants $0 $0 Member Benefits $0 $0 Salaries/Employee Benefits $1,067,358 $1,141,482 Fundraising Fees $0 $0 Other $775,874 $797,561 Total $1,843,232 $1,939,043 Margin $34,768 $551,768 TOP PAID EXECUTIVES (FY 2017) Base salary Comp. & Benef. Michael Werle, Executive Director $108,000 $108,000 Source: Guidestar IRS 990 Tax Form Harvard Pilgrim's CT Customer Base "Honestly, we aren't at a point where we're reacting to it. The best thing you can do is watch this in a very measured way so you know how to best compete, either as an innovator or a fast-follower." Eric Schultz , CEO, Harvard Pilgrim Health Care on the current mega-mergers in the health insurance industry. 0 10,000 20,000 30,000 40,000 CT Members 2015 2016 2017 22,558 24,108 32,102 Source: Harvard Pilgrim; CID

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