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Three health insurers post profits

Quarter shows rebound after earlier losses

By Hiawatha Bray
Globe Staff / November 14, 2009

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Three of the four largest health insurers in Massachusetts swung back to profitability in the third quarter, after all four posted second-quarter losses.

Blue Cross and Blue Shield of Massachusetts Inc.’s HMO Blue subsidiary lost $3 million. But as a whole, the Boston firm earned $17.1 million in the quarter on revenue of $1.6 billion. That’s off 70 percent from the same period last year, but much better than the second quarter of 2009, when Blue Cross-Blue Shield lost $33.6 million. The company has lost a total of $53.2 million so far this year.

The insurer’s chief financial officer, Allen Maltz, placed much of the blame on unusually severe outbreaks of influenza in February, June, and September, in addition to the rise of the H1N1 flu pandemic. “We have all the normal seasonal flu expenses, and then we have H1N1 on top of that,’’ said Maltz.

In addition, the economic downturn has caused many older workers to stay on the job instead of retiring. That means the average age of employees at companies that offer Blue Cross-Blue Shield plans has risen. “An increase in the average age of the population leads directly to increased medical costs,’’ said Maltz.

Tufts Health Plan in Watertown posted net income of $22.1 million on revenue of $644.5 million. That’s an improvement over the $17.3 million earned in the same period last year. During the first nine months of the year, the plan earned $8.8 million on revenue of $1.9 billion, but during the second quarter, Tufts lost $204,000. Chief financial officer Umesh Kurpad said membership in the plan increased 5 percent between January and September, and stands at about 730,000.

Harvard Pilgrim Health Care in Wellesley reported net income of $13.6 million on revenue of $684.1 million, compared to a $2.3 million loss in the second quarter, and income of $23.8 million in the third quarter of 2008. Harvard Pilgrim’s membership of about 1 million increased only about 1 percent from a year ago. In the first nine months of 2009, the insurer earned $8.3 million on revenue of $2 billion.

Fallon Community Health Plan in Worcester reported a $13.4 million loss for the third quarter, on revenue of $283 million, compared to a $5.7 million profit last year. So far, the plan has lost $16.3 million in 2009, on $831 million in revenue.

“Our results show that we’re not immune to the economic challenges Massachusetts is facing,’’ said chief financial officer Charles Goheen in a prepared statement.

Goheen cited as factors inadequate medical reimbursements from state and federal governments, higher-than-expected insurance claims, and a continued increase in medical care costs.

Hiawatha Bray can be reached at bray@globe.com.