Health-care providers, consumers, and others are expected to turn out in force tomorrow to protest a proposal by UnitedHealthcare of New England to move $36.8 million in profits from Rhode Island to its parent company in Minnesota.

United needs approval from the state to ship out this “extraordinary dividend.” The public has been invited to comment at an informal open meeting, in Providence, the first time such a request has been considered publicly.

Officials are bracing for a crowd. “There may be a lot of people there,” said Matthew Stark, a policy aide to Health Insurance Commissioner Christopher F. Koller. “There’s a lot of concern.”

At a time when insurance premiums are going up and providers say United pays them too little, the idea of so much money pouring out of the state’s health care system is likely to arouse controversy.

Unlike the other two insurers in the state, United is a for-profit company with reciprocal obligations to its parent, United Health Group, and a responsibility to shareholders. Debora M. Spano, United spokeswoman, said the insurer earned its profits through careful management of members’ illnesses and improved technology that makes doctors’ jobs easier. She noted that the money has accumulated over several years.

“We haven’t really made that much money,” Spano said. “We make about 4 percent profit on business in Rhode Island.”

Also, if Koller grants United’s request, the insurer has pledged to devote 10 percent of the $36.8 million to statewide initiatives to develop health-care technology and improve care of chronic illnesses.

Still, health-care providers, in particular, resent the idea of United taking away so much money.

“It’s obscene,” said Steven R. DeToy, spokesman for the Rhode Island Medical Society. He said United has been unwilling to contribute to worthwhile efforts such as the society’s Physicians Health Committee or a project by Blue Cross & Blue Shield of Rhode Island to measure and control spending on radiology services.

“They’re bad corporate citizens,” DeToy said. “All they seem to be interested in doing is what I call the M2M: money to Minnesota.”

DeToy said that Rhode Islanders who spend thousands of dollars a year for coverage from United had a right to expect the money to be spent in state. “We don’t oppose them making a profit,” DeToy said.

Edward J. Quinlan, president of the Hospital Association of Rhode Island, noted that insurers pay the lowest rates in New England to the hospitals in Rhode Island, and that all but one or two hospitals are currently running deficits. “There needs to be a broader discussion here of how we can create a little more of an equitable balance between all the parties,” he said.

A longstanding state law, similar to those in most other states, requires an insurer to obtain special permission to take out “extraordinary dividends,” 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.

United has not asked for an extraordinary dividend for at least nine years. From 1998 to 2003, the state prohibited United from taking any profits, requiring it to build up reserves to protect its solvency. The order came after a rough period in the industry led to the collapse of one health insurer and the departure of another.

But Lauren Conway, United’s director of finance, said the insurer achieved solvency in 2000 and surpluses have been building since then.

In 2004, 2005, and 2006, United took out “ordinary dividends” ranging from $13.4 million to $17.1 million, but still had money left over.

“It’s been sitting there and kind of growing in a very low-interest account,” Spano said. “It’s not working for anybody or being used for anybody. It’s our money.”

Even with the $36.8 million removed, United is in no danger of bankruptcy, Spano said.

Asked whether the money could be used to raise physician reimbursement or lower premiums, Spano said those rates are set by the market. “We are competitive with the market,” she said. “We understand what the market will bear.” She also said United has increased physician payment.

According to the health insurance commissioner’s office, United covers 18.5 percent of insured people in the state (not including state employees and others in self-insured plans); its enrollment has been dropping, while income has increased or held steady.

United allocates 19 cents of every premium dollar to administration, reserves and surplus — several points more the other insurers. The medical society has proposed legislation requiring that number to fall to 15 percent, with 85 percent of all premium dollars going to medical services.

Tomorrow’s meeting — at 5 p.m. at the Department of Business Regulation, 233 Richmond St., Providence — will be unusual in several respects. Requests for extraordinary dividends have been handled confidentially in the past. United agreed to waive confidentiality this year, Stark said, and for the first time ever, the state is seeking input in a public forum. Spano said that Rhode Island appears to be the only state holding such a meeting.

Also, the 2004 law that created the Office of the Health Insurance Commissioner has changed the way the state will evaluate United’s request. In the past, regulators weighed the insurer’s solvency and consumer’s rights, as happens in most states. Now, the health insurance commissioner must also encourage “fair treatment of providers” and work toward improvements in the state’s overall health-care system.

“I don’t know of any other state in the country that has a health insurance commissioner with the responsibilities that we have,” Stark said. The policy issues that Koller must address are “a whole new world for insurance regulation,” Stark said.

Even so, Koller has the power only to accept or reject United’s proposal. If he rejects it, he can’t tell United what to do with the money. United could, however, negotiate amendments to its proposal that might prove acceptable to Koller. “We’re always willing to work with the commissioner,” Spano said.

Koller’s decision is due March 30.

As for the perennial fear that United will pull out of Rhode Island, leaving Blue Cross to control the commercial health-insurance market, both Stark and Spano said it wouldn’t happen.

“We’ve got a strong commitment to the state,” Spano said.

“They’re making money here,” Stark said.

ffreyer@projo.com