PROVIDENCE — Throughout two hours yesterday evening, 25 people voiced their feelings about UnitedHealthcare of New England, and not one had a nice thing to say.

Invited to address United’s request to ship nearly $37 million in extra profits to its Minnesota parent, speaker after speaker — nearly all health-care providers — lashed out at the insurer, telling Health Insurance Commissioner Christopher F. Koller and his Health Insurance Advisory Council that United pays doctors too little, hassles them about every penny, gives poor service to customers, and neglects the community.

Dr. Peter Pogacar discusses his diagnosis with Melissa Lamothe, mother of Nolan Lamothe, 13 months, after his exam. He has an ear infection. Pogacar, a pediatrician, was among those who testified at last night’s hearing regarding UnitedHealthcare.

The Providence Journal / Kathy Borchers

Dr. Michael D. Fine, a Pawtucket family physician, called United’s profits “extorted income” from underpaid doctors.

Dr. Barry W. Wall, president of the Rhode Island Medical Society, said that United’s profitability “gives every appearance of exploiting the Rhode Island market” and reflects their “corporate greed.”

Dr. Elizabeth B. Lange, a Providence pediatrician, said United pays doctors “subsistence fees” that discourage new practices from opening here.

“Not only do they underpay,” said Alan Tavares, of the Rhode Island Partnership for Home Care, “they find every possible way not to pay.”

Attorney General Patrick C. Lynch sent a letter calling United’s request “obscene and unconscionable.”

Even Governor Carcieri — who in 2005 switched state employees to United coverage and recently extended that contract — entered the fray with a letter calling United’s request “unwise and unhelpful” and recommending that the money instead be used to increase reimbursement rates to providers.

United is seeking state permission to take out $36.8 million in “extraordinary dividends” — profits beyond the “ordinary” profits already taken. Although such permission has long been required, this year United’s request is being considered by the Office of the Health Insurance Commissioner and the Health Insurance Advisory Council, both created by a 2004 law.

That law came in reaction to perks for executives and allegations of corruption at Blue Cross & Blue Shield of Rhode Island. But yesterday, speakers held up the once-maligned Blue Cross, a nonprofit company, as a paragon of social responsibility.

“Only one insurer in this state is committed to primary care —Blue Cross & Blue Shield of Rhode Island,” said Dr. Mark D. Jacobs, a Smithfield internist and president of Coastal Medical, a large group practice. “Only one insurer has been interested in rewarding doctors for doing the best care … and that is Blue Cross Blue Shield.”

Blue Cross and United are the only Rhode Island-based health insurers serving the commercial market. The state’s third insurer, the nonprofit Neighborhood Health Plan of Rhode Island, covers only people on the state Medicaid program.

In a PowerPoint presentation at the outset of the meeting, Stephen J. Farrell, United’s chief executive officer, described the extraordinary-dividend request as his attempt to help Rhode Island by getting access to money that has been languishing in a low-interest bank account.

“We were looking for ways in which we could contribute,” Farrell said. “…To have that money sit there and do nothing is a big waste.”

As part of his proposal, Farrell offered to devote 10 percent of the $36.8 million to supporting primary-care doctors in caring for the chronically ill and advancing statewide efforts in health information technology. (The remaining 90 percent would go to United’s parent company, United Health Group.)

United, Farrell noted, already spends $41 million a year in Rhode Island in wages, taxes and municipal bonds.

In response to questions from council members about physician reimbursement, Farrell said that United has “every intention of addressing our fee schedule” regardless of what happens with the dividend request.

Farrell said most of the surplus money accumulated from 2000 to 2002, during a time when the state had barred United from taking out any profits to protect its solvency after a period of losses. But the insurer was making money during that time and in subsequent years.

United took out “ordinary dividends” of $16.5 million in 2004, $13.4 million in 2005 and $17.1 million in 2006, while the surplus from earlier years earned about 4.5 percent interest in a bank account.

An extraordinary dividend is defined as profits that exceed either 10 percent of the insurer’s surplus or the net income from the insurer’s operations in the previous year. Long-standing law requires insurers to win state permission for such dividends, but never before has the state sought public input on such a request.

And that input was fierce. Farrell listened to it without expression.

Celia Gomes McGillvary, associate director of the Rhode Island Health Center Association, noted that United pays providers 10 percent less than Blue Cross, but its premiums are not 10 percent lower.

Michael Noonan, president of Physical Therapy Services of Rhode Island, said that until recently United has paid physical therapists 40 percent to 60 percent below Blue Cross rates. “It’s an outrage,” he said.

But he said even more “horrific” was being a United subscriber. When his daughter underwent treatment for alcohol abuse, Noonan said he spent months fighting for coverage and still has not received all the money.

Many speakers took the occasion to suggest possible uses for United’s profits other than enriching shareholders. Susan Orban of the Washington County Coalition for Children spoke of dire needs for mental-health services for children.

Dr. Stanley H. Block, medical director of the Providence Community Health Centers, said that inner-city health care for the poor is “crumbling.”

“I urge you to insist that United invest in the community health centers,” Block said. “There is such a vulnerable population that is not going to get care.”

Dr. K. Nicholas Tsiongas noted that no matter how the question of the extraordinary dividend is decided, the state will still face the “intolerable contradiction” that thousands of people are without health-care coverage while millions of dollars in profits are streaming out of state. “I think the people of Rhode Island are ready to say there really is no room in Rhode Island for a for-profit insurer,” Tsiongas said.

Koller, the health insurance commissioner, can only accept or reject United’s request. He cannot tell United what to do with its profits. But he and United can together reach agreement on how to disburse the money. His decision is due March 30.

ffreyer@projo.com