The state’s largest private insurer has failed to reach an agreement with the Hartford HealthCare hospital network, meaning that more than 100,000 people covered by Anthem Blue Cross and Blue Shield will have to pay higher out-of-pocket costs for care there.

Starting Wednesday, The William W. Backus Hospital in Norwich and four other hospitals that are part of Hartford HealthCare are considered “out-of-network” for customers of Anthem. Patients can still receive care there, but would be billed directly by the hospital and then would be reimbursed by Anthem at out-of-network care rates. The other hospitals are: Hartford Hospital, including the Institute for Living and Jefferson House; The Hospital of Central Connecticut; MidState Medical Center; and Windham Hospital.

The same change takes effect on Nov. 1 at five additional Hartford HealthCare facilities: Natchaug Hospital; Rushford Center; VNA HealthCare; Southington Care Center; and Jerome Home.

Hartford HealthCare sent letters to 104,500 Anthem customers who have been patients during the last year, warning them that Hartford HealthCare would be considered “out of network” if no contract agreement was reached, said Rebecca Stewart, spokeswoman for Hartford HealthCare. The two sides have been negotiating since the summer.

“We remain open to discussions with Anthem to resolve this impasse,” Stewart said. “We need Anthem to partner with Hartford HealthCare as we transition health care to a value-based model, which focuses on improving quality outcomes, lowering costs and improving access to care for the patients that rely on us.”

Anthem is the state’s largest private insurer, providing coverage for about 1.2 million residents.

Anne Melissa Dowling, deputy commissioner for the state Insurance Department, said the agency is encouraging the two parties to continue negotiating. It has also been communicating with insurance brokers and employers who provide Anthem insurance about making sure that workers continue to be able to get their health care covered either at other hospitals still in the Anthem network or at Hartford HealthCare through a “continuation of care” benefit through the insurer.

“We can’t intervene, but we are extremely disappointed they haven’t come to terms,” she said. “We hope they get back together.”

She noted that emergency care will not be affected. Emergency services at any Hartford HealthCare hospital will be covered as though they are in network.

She urged consumers with questions to contact the Insurance Department and visit the department’s website for information.

Dowling said she did not know the details of the dispute, other than that it had to do with a disagreement over reimbursement rates.

Anthem spokeswoman Sarah Yeager said the insurer’s priority now is to make sure customers have access to health care.

“Our nurse case managers are working closely with our members to transition their care to other high quality in-network hospitals and providers, or continue their care at HHC’s hospitals when clinically necessary,” she said.

Customers can obtain care at hospitals in the Anthem network, she said, including St. Francis Hospital, the Yale-New Haven Health System, and the Western Connecticut Health Network. Lawrence + Memorial Hospital in New London is also in Anthem’s network.

Anthem customers hospitalized at a Hartford HealthCare facility before Oct. 1 but who are discharged after the contract expired Wednesday will have their care covered as in-network, Yeager said. Some Anthem customers have been approved for “continuation of care” benefits enabling them to receive care at Hartford HealthCare, including inpatients receiving treatment for acute conditions, cancer patients receiving surgical or radiation therapy, women in the third trimester of pregnancy and those with chronic conditions receiving active treatment.

Those with short-term conditions such as muscle injuries, bronchitis or who are scheduled for elective surgery do not quality for continuation of care benefits and would pay out-of-network costs for care at Hartford HealthCare, Yeager said.

Stewart said post-surgical care for surgery done at Hartford HealthCare before Oct. 1 would be covered as in-network.

j.benson@theday.com

Twitter: @BensonJudy

More information

Information provided by the state Insurance Department about the effects of the Anthem-Hartford HealthCare contract expiration can be found at http://group.anthem.com/HHC.

Questions can be sent to the Insurance Department at cid.ca@ct.gov. The Insurance Department's consumer helpline can be reached at (800) 203-3447 or (860) 203-3447.

Patients with questions can call Hartford HealthCare at (800) 664-2052 or visit www.SolidFoundationForCare.org.