Delaware turns down rate hike requests from health insurer

Delaware’s insurance commissioner has rejected a request from Highmark Blue Cross Blue Shield for a 15 to 17 percent increase for several of its health plans.

 

Karen Weldin Stewart declined one rate increase, and pared back others to 9.9 percent.

“Fifteen to 17 percent is a pretty high rate increase for some people to absorb,” saidLinda Nemes, assistant director of market regulation with the state insurance department.

When an insurance company wants to raise consumer prices by more than 10 percent, usually that rate hike must be reviewed by the federal government. But the insurance coverage under review in Delaware, known as  “grandfathered” plans, is not governed by the usual Affordable Care Act rules. In most cases, shoppers bought the coverage on their own without help from an employer.

“It’s a smaller group than it used to be, because many individuals in this group purchased ACA-compliant plans through the exchange last year,” wrote Kelly Housen DeAngelis, a Highmark spokeswoman, in an email detailing the plans.  “We are working with these members to let them know what other plans are available to them – we offer a mix of plans that provide consumers with choice at various price points. We are also working to help keep health care costs down.”

Highmark does not plan to appeal the commissioner’s decision or to cancel the plans at this time.

The rate hikes will affect about 3,300 plan holders.

Each person’s monthly premium costs are calculated based on many factors including age. Nemes said for the plans under consideration, the base rates prior to Highmark’s request ranged from about $125 to $364. The range with the allowed 9.9 percent increase is $137 to $401.

Erin Ninehouser, education and outreach director with the Pennsylvania Health Access Network, says rate review is one tool states can use to make sure health insurance is affordable.

In Pennsylvania, she said, the system is not consumer friendly.

“So you can’t right now find on any state Web site any sort of comparison over the years on rate increases submitted, if they were reduced or approved,” Ninehouser said. “That information is just not available in any kind of useful way to the public.”

She said the public has no way to prove that requested increases are unreasonable, excessive or unfairly discriminatory.

Health advocates say states such as Ohio and Colorado have more transparent rate review systems.