TodayHighmark Blue Shield proposes plan rate hikes
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Article RatingHighmark Blue Shield is asking the state Insurance Department for permission to increase rates on 19 individual plans.
The increases would generate $28.5 million in revenue for Highmark and affect 231,114 members statewide, including about 2,540 Cumberland County residents.
“We will try to make our case,” said Highmark spokesman Michael Weinstein. “We agree this is going to be a bite on some people, but health care costs have been increasing double and triple the rate of inflation.”
Highmark is requesting the rate hikes be effective Jan. 1 and that they apply to ClassicBlue Comprehensive Major Medical, Special Care, MedigapBlue and High Deductible Health Plan programs.
The rate increases range from 5.7 percent for MedigapBlue Plan C to 9 percent for the HIPAA $750 deductible and $1,500 deductible plans under the ClassicBlue program.
About 14 of the 19 individual plans listed in a Highmark ad call for a 8.9 percent increase. The ad ran in the Sept. 29 edition of The Sentinel as required by state law.
The ad reports monthly increases for the single rate would increase anywhere from $7.15 for MedigapBlue Plan A to $48.35 for the HIPAA $750 Deductible plan.
All the plans are guarantee-issue, meaning disclosure of medical history is not required before coverage is granted, and all the products are subsidized as part of a three-year-old Community Health Reinvestment Agreement with the state, Weinstein said.
He added rates for the plans would be 15 to 25 percent higher without the subsidies.
Aging population
Weinstein said growth in technology and an aging population are the main drivers behind the requests for rate hikes. Pennsylvania has among the highest incidence of chronic conditions among its elderly population, Weinstein said.
“We feel this is a sound request,” he added. “We look at claims history and trends and, when necessary, we do seek rate increases. As part of our community mission, we try to hold down the increases.”
Weinstein said part of the corporate philosophy of Highmark is to expand health care coverage to individuals who have no other option because other commercial insurers would not offer coverage.
Public comment
Melissa Fox, deputy press secretary for the department, said the state has yet to receive any public comment on the Highmark requests.
Generally speaking, when a rate request is received and posted in the Pennsylvania Bulletin, consumers have 30 days to submit written comments to the department, Fox said. If the public comment period needs to be extended, an extension will be granted.
Fox said the Highmark requests were published in the bulletin on Aug. 23, but the Sept. 29 newspaper ad mentions a deadline of 15 days beyond the 30-day period included in the bulletin. Fox was unable to confirm when the comment period expires.
‘Review clock’
At the close of the public comment period, the “review clock” for the department starts. The department has 45 days to review the filing, which involves having on-staff actuaries review documents Highmark provides to justify the rate hike.
The purpose of the review is to make sure the rate request is not excessive, inadequate or unfairly discriminatory to policy holders, Fox said. At the end of the review, the department could either approve the rate requests, approve the requests but modify the percentage increase, disapprove the requests or request additional information for more review.
Fox said a department ruling on the Highmark requests could take place as early as mid- to late November.
