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Posted on February 8, 2017
by morgan eichensehr

CareFirst Ups Insurance Rate Increase Request For 2017

CareFirst BlueCross BlueShield is seeking a higher rate increase than expected  asking for a 27.8 percent increase to its HMO plan and a 36.6 percent increase to its PPO plan.

Those rates are higher than the initial request CareFirst made of 12 percent and 30 percent increases, respectively.

The new proposed rate increases would bring monthly premium prices for a mid-level plan for a 40-year-old Baltimore resident to between $382 and $478.

CareFirst is one of six health insurers operating in Maryland to request rate increases for individual and small group health plans for the coming year. Cignas requested premium hike of 29.8 percent was the highest requested increase prior to CareFirsts revised request.

According to the Insurance Administration, the new filing was made after a re-evaluation of whats known as morbidity rates. These rates account for frequency of disease in patients, and are factored into what health insurance premiums cost each year.

Nancy Muehlberger, an analyst with the Insurance Administration, said CareFirst had assumed the morbidity rate would stay the same in 2016 as it did in 2015. However, the insurer now expects that rate to increase an additional 15 percent.

At a public hearing before Insurance Administration officials July 6, several parties voiced opposition to companies requests for increased rates  especially CareFirsts requests, which were among the highest even before the new requests were submitted.

The rates filed yesterday directly reflect the cost of providing care to the somewhat older individuals and those with more chronic medical conditions who purchased policies from CareFirst  in particular, the experience of those individuals new to CareFirst in 2016, said CareFirst in a corporate statement. CareFirst has absorbed and continues to absorb substantial losses covering individual [Affordable Care Act] members in Maryland.

The statement noted that the adjusted rates were necessary after considering the unexpectedly large losses the insurance company has experienced this year. The public can also view CareFirsts written reasoning on the health rates website.

Patricia OConnor, deputy director of the Health Education Advocacy Unit of the Attorney Generals office, posted an official comment on the official health rates site expressing concerns about how ever-higher insurance rates could impact consumers and affordability and access to quality health care in the state.

Consumers have recently endured substantial rate increases, along with increasing out-of-pocket expenses for health care,Connor wrote. We submit this trend requires reversal to maintain affordability and access to care in Maryland.

Leni Preston, president of Consumer Health First, a health care consumer advocacy group, said her organization is extremely concerned about the new requests from CareFirst. Preston was present at the initial public hearing and submitted a report to the Insurance Administration which expressed concerns about the morbidity rates CareFirst has used to determine rate increases in the past.

We are going to be looking into the basis for the proposed increase we need to see what the justification is for this, she said. Also with the timing, it being so late into the process, we want to make sure there is adequate transparency and opportunity to comments important that consumers understand the impact.

The Insurance Administration is tasked with reviewing each request and deciding on the final health insurance rates for 2017. Any approved rate increases would impact about 288,000 Marylanders who purchase their own health insurance through the Maryland Health Connection online marketplace.

Because of the new requests, the Insurance Administration is extending the comment period on its health rates website once again, to give consumers and advocates time to consider the new requests, before it makes its final decision on whether to approve the rates. Another hearing will be held on Aug. 15 at 11 a.m. at the Insurance Administrations office.

Administration officials said the final rate plans will be released by early September.

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