A Message from the CEO
Amid the ongoing healthcare affordability crisis, we at Community Health Options remain committed to bringing solutions to lower costs while improving health. That means helping our Members access preventive care and cost-effective treatment options. And it means partnering with providers to bring out the best in Maine for Maine people and employers.
Like many parts of the country, we experienced a steep rise in claims costs in 2025. In response, we examined all aspects of our operations and applied meaningful cost reductions. Though we also had to raise premiums, we have focused on lowering total claims costs, while at the same time working to increasing access to care. In short, we continued to stretch every premium dollar entrusted to us by our Members and group business clients to improve health outcomes at a lower total cost of care. To this end,
- We negotiated with willing providers and health systems to secure rate improvements, leading to our agreement with Northern Light Health to create new North Star plans for northern Maine and to lower costs for Members across all our plans.
- Our product and provider teams expanded our site of service program, lowering copays for X-rays, advanced imaging and labs for our Members, along with expanding virtual urgent care for all Members at $0 out of pocket on the basis of avoiding more expensive downstream costs.
- Our pharmacy team saved more than $3 million by transitioning to biosimilar treatments to stem the skyrocketing costs of certain specialty medications. These alternatives to name brands deliver on health outcomes while helping to manage costs.
Those efforts are powered in large part by our teams, who work daily to support Members as they navigate complex treatments, access preventive services and review claims statements. Our commitment is to make sure our Members can get care in the right setting, at the right time and for the best possible price. Affordability isn’t just a talking point at Community Health Options. It’s personal; as a nonprofit rooted in Maine, our Members and the clients we serve are our neighbors.
In 2026, we are building on these foundations while continuing to deliver on our core nonprofit mission—to ensure we put our Members first in everything we do—with the accountability, benefits and service our Members and business clients expect.