Highmark Inc. requests raising insurance rates, premiums
By: Health Insurance
Submitted: 2009-10-16 12:11:26 | Word Count: 537
Highmark Inc. has filed 15 separate rate increase requests with the state Insurance Department on health care products that will impact 70,500 subscribers in Western Pennsylvania and increase premiums by nearly $36 million.
The products are for individually insured, lower-income consumers who need insurance, but aren't able to afford policies with more features. Such products in Pennsylvania only are available through the nonprofit Blue Cross Blue Shield companies, said Highmark spokesman Michael Weinstein.
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"We basically are the insurer of last resort for these people, who are under 65 years of age, and who earn too much to be eligible for Medicaid, but can't afford an extensive program that many people have," Weinstein said.
Any premium changes approved by the Insurance Department will go into effect Jan. 1, said spokeswoman Melissa Fox. The rate requests are in the middle of a public comment period, after which the department has up to 45 days to review them.
Statewide, the premium increases will impact 223,000 Highmark subscribers, and are needed because the programs are expensive to operate, Weinstein said.
The average premium increases requested for the products range from less than 1 percent to more than 30 percent per month, or from 39 cents to $136.30 per month, according to data filed with the state.
Highmark attempts to subsidize the premiums to bring down the cost, Weinstein added. "This year, we've provided $75 million in subsidies statewide to these programs," he said.
Highmark insures more than 3.5 million residents statewide, and 2.5 million in the 29-county Western Pennsylvania region.
About 48,000 of the 70,500 area individuals affected by the proposed increases are covered by Medicare supplemental programs, so-called Medigap insurance, Weinstein said.
The remainder, about 22,000 subscribers, are in numerous individual programs that don't require any medical screening or medical questionnaire to be filled out, which can lead to more extensive usage of services and more expensive premiums.
Public hearings for rate increases are held at the discretion of the Insurance Department and are determined on a case-by-case basis, Fox said. She added a public hearing on a rate increase hasn't been held for what she characterized as "quite some time."
"We check three things when we look at rate requests," Fox said. "We make sure the rates aren't excessive, inadequate or unfairly discriminatory."
The Insurance Department can move three ways concerning a rate case: approve the new rate as submitted, reject it totally or approve a new rate with modifications.
According to state law, unless formal action is taken by the state prior to Oct. 29, the filings are approved as is.
