Pa. Insurance Dept. to Monitor HealthGuard’s Removal from Lancaster Market

Pennsylvania Insurance Commissioner Diane Koken announced that HealthGuard of Lancaster plans to withdraw its HMO, POS group products and HMO Direct Pay Conversion product from its entire service area, which includes Adams, Berks, Cumberland, Dauphin, Lancaster, Lebanon, Lehigh, Northampton, Perry and York counties.

“With HealthGuard’s decision to discontinue service, we are very concerned about the impact their decision may have on consumers,” said Koken. “Our prime responsibility is to see that the company’s withdrawal is conducted in accordance with law and that consumers are protected. We would like to assure all policyholders that Highmark, HealthGuard’s parent, has agreed to protect the fiscal health of the company during the withdrawal process so that valid claims will continue to be paid.”

By law, subscriber members must be given at least 180 days, prior written notice before the termination of their health insurance coverage. HealthGuard subscribers have additional consumer protections, including the requirement that all small employers with two to 50 employees have the ability to buy health insurance on a guaranteed issue basis from any health insurers actively selling coverage in the small employer market.

HealthGuard, a wholly owned subsidiary of Highmark Inc., currently has 92,000 subscriber members. All members will be receiving communications from HealthGuard regarding its withdrawal decision and other options available through Highmark Blue Shield. All members will be offered a replacement product.

However, there will not be a Highmark HMO product alternative offered. Consumers are encouraged to actively shop for options offered by all health insurers doing business in Lancaster.