Harvard Pilgrim Health Care Inc. wants to break into the Connecticut health insurance market, taking on five large health-insurers that dominate the market, which is home turf for four of them — Aetna, Anthem Blue Cross and Blue Shield in Connecticut, Cigna and ConnectiCare.
The other is Minnetonka, Minn.,-based UnitedHealthcare, the nation's largest health insurer, which has a major presence in Connecticut with about 4,200 workers.
Harvard Pilgrim filed an official business plan for regulatory approval in September with the Connecticut Insurance Department. The application to sell insurance in the state is pending approval by state insurance regulators.
For that reason, Harvard Pilgrim declined to say how many workers it plans to hire or move to Connecticut, where the office might be, how much it will spend to build a presence here, and any other details of the plan. The company has a number of jobs open in Hartford, which are posted on Glassdoor.com, Indeed.com and other job sites.
"We have made an initial filing to begin the process required for entering the state," company spokeswoman Mary Wallan said in a prepared statement. "We are working with the Connecticut (Insurance Department), other state officials and key stakeholders to provide them with all relevant information and documentation as part of this process."
Harvard Pilgrim said in its application that it will talk to media about its expansion plans in the first few months of 2013.
It's not just that the company wants to be listed on a public health exchange where health insurance will be sold to individuals starting a year from now for 2014 as part of the Affordable Care Act. Harvard Pilgrim said its sales strategy is to expand relationships with brokers and consultants "who are engaged with Connecticut employers," indicating that it could compete with companies like Aetna and Cigna in selling health insurance to employers for their workers.
Harvard Pilgrim's CEO, Eric H. Schultz has Connecticut roots. He holds a master's of business administration from Yale University's School of Management and two bachelor's degrees in biology and economics from the University of Connecticut.
In its application, Wellesley, Mass.,-based Harvard Pilgrim mentions that it is ranked as the number one private health plan in the U.S. by the National Committee for Quality Assurance.
Initially, Harvard Pilgrim seeks to sell plans in five counties: Hartford, Middlesex, New Haven, Tolland and Windham.
"Also, we may serve additional towns over the borders of other counties if natural hospital referral patterns and sales needs warrant their inclusion," the company said in its application.
The health care company, headquartered in Wellesley, Mass., plans to start a Connecticut nonprofit called Harvard Pilgrim Health Care of Connecticut Inc., which would be a subsidiary based in Hartford. It would be governed by a board of eight to 12 people, including a CEO, chief financial officer, chief legal officer, two consumers, two clinicians and others.
Harvard Pilgrim was created in 1995 with the merger of Harvard Community Health Plan and Pilgrim Health Care. The company has sold health plans in New Hampshire since 1976 and in Maine since 1996.
The company's total membership is 1.2 million people, and it has offices in Wellesley, Mass.; Quincy, Mass.; Worcester, Mass.; Manchester, N.H.; and Portland, Maine.
Harvard Pilgrim employs about 1,100 workers and an additional 800 associates from Dell Services, formerly Perot, who perform claims-related and technology functions for the company.
Last year, the company reported $91.5 million in operating income on $2.8 billion in revenue.