Sutter Health announces insurance plans for Modesto region

06/06/2013 4:57 PM

06/26/2013 2:31 PM

Sacramento-based Sutter Health on Thursday unveiled some details of a newly created health plan that marks its inroad into the insurance market.

Sutter Health Plus will offer an assortment of managed-care plans in the Sacramento area and Northern San Joaquin Valley to small and midsize employers, as well as people who buy their own insurance. With the health plan, the nonprofit Sutter will serve as insurer and health care provider.

The plan will be available during the fall open enrollment period and coverage will begin Jan. 1, giving subscribers access to a network of 1,800 Sutter-connected doctors and hospitals in an eight-county area, including Stanislaus and San Joaquin.

The initial rollout does not include the Bay Area or Merced County.

The network of providers for Sutter Health Plus includes Memorial Medical Center of Modesto and Sutter Gould Medical Foundation. In San Joaquin County, St. Joseph's Medical Center and Dameron Hospital of Stockton, as well as Sutter Tracy Community Hospital, will be part of the network, Sutter said.

The HMO plans will require patients to choose a primary care doctor who will direct their care.

Memorial and Sutter Gould will continue to accept major insurance plans. Patients who see Sutter Gould doctors or require treatment at Memorial still can do that with their current insurance.

"This is just another way to access Sutter's health services," said Monica Majors, vice president of sales and marketing for Sutter Health Plus.

Pricing to be revealed in late summer

Sutter will have a portfolio of 12 small-group plans and 25 large-group plans, along with individual plans for families and single adults, Majors said. It will start releasing pricing quotes later in the summer and will launch a Web site this fall to spell out the options, she said.

"It is in response to what employers are asking for in the insurance market," Majors said. "Consumers are wanting high- quality medical care delivered at a more affordable price."

Majors said the health plans will meet the standards of federal health reform law, which prohibits insurers from denying coverage based on pre-existing health conditions. Sutter decided not to market the coverage through California's health exchange. It will be available through brokers who work with employers in the Central Valley or sell insurance to the public.

Steve Nolte, chief executive officer of Sutter Health Plus, said the insurance will enable Sutter to have more direct partnerships with patients and employers that provide health benefits to their workers.

Sutter has doctors and medical facilities serving patients in more than 100 communities in Northern California. Its services previously included a managed-care insurance plan, but it was sold in the 1990s.

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or (209) 578-2321.

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