Lindeen Finds Blue Cross Rate Increases Unreasonable

csimt 2016, Insurance, Press Release

HELENA – Montana Commissioner of Securities and Insurance Monica Lindeen announced today that following an extensive rate review process, her office has found the rates filed for health insurance in the individual and small-group marketplaces by Health Care Services Corp. (doing business as Blue Cross Blue Shield of Montana) to be unreasonable. This is the first time that such a finding has been issued.

Blue Cross initially proposed average rate increases of 65.4 percent for health insurance plans purchased in the individual marketplace. Following the intensive rate review process, which included public hearings in Helena and Billings, an analysis by an independent actuary and comments from the public, Blue Cross re-filed its rates with an average increase of 58.4 percent in the individual marketplace. It lowered its requested increase in small group rates from 32.3 percent to 28.9 percent.

Lindeen said the decrease in Blue Cross’ filed rates did not adequately address her concerns and that its overall rate increases in the individual and small-group marketplaces were still unreasonable. Blue Cross has challenged that finding.

“We took a good hard look at Blue Cross Blue Shield’s financial data and found that these increases were simply not reasonable,” Lindeen said. “Our insurers need to charge premiums high enough to pay all their claims and stay in business, but some of Blue Cross’ rates for 2017 go beyond that goal. It is Montana workers and families who will pay the price if they cannot find more affordable plans.”

The details that outline the finding of unreasonable rate increase were provided to Blue Cross on August 19. Under Montana law, Blue Cross has 30 days to respond to the notice during which the details of the finding remain confidential. CSI asked Blue Cross to waive the 30-day confidentiality period, but Blue Cross denied the request. The details of the finding will be public on September 19.

About 80 percent of Montanans in the individual marketplace receive tax credits to offset the cost of premiums. Those who receive tax credits may not see major increases, even with plans that are raising their rates the most. But for the approximately 35,000 Montanans who earn too much for the tax credit, the rate increases could present serious financial challenges.

The other two major health insurers in the individual and small-group marketplaces have filed rates with lower increases.  The average rate increases for the Montana Health COOP are 30.7 percent in the individual marketplace and 2 percent in the small-group marketplace. For Pacific Source, the average rate increase is 27.6 percent in the individual marketplace and 6.4 percent in the small-group marketplace.

Lindeen encourages Montanans facing large rate increases in the individual marketplace to shop around during the open enrollment period for 2017 plans. Open enrollment begins November 1. Montanans can check their eligibility for premium tax credits and cost sharing reductions at www.healthcare.gov.

The Montana Legislature passed the law creating the rate review process in 2013. The Commissioner of Securities and Insurance has the ability to conduct a review of the insurers’ proposed rates, bringing transparency and accountability to the process, but the Commissioner does not have the authority to reject rates. The finding of “unreasonable rate increase” will be posted on the Commissioner’s website (www.csimt.gov), on federal websites and on the insurer’s own website.  These findings provide consumers with additional information to consider when they make their health insurance decisions.

The final individual and small-market rates are below.