Consumers and advocates urged state insurance regulators on Friday to deny a 12.5 percent rate increase proposed by Anthem Blue Cross and Blue Shield, Connecticut's largest health insurer.
The proposed rate increase for individual plans, beginning Jan. 1, would affect nearly 66,200 policyholders, including some who recently purchased their policies through the state's health insurance exchange, Access Health CT.
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"Anthem is only one insurer asking for a rate increase, but it is an insurer that enjoys a large share of the Connecticut market," Jill Zorn, senior program officer for the Universal Health Care Foundation of Connecticut, told the Department of Insurance hearing officer reviewing the rate request. "We urge you to sharpen your pencils and carefully review all input in this rate review hearing, most especially the comments of policyholders who could not be here today."
Zorn said the state owes it to the state's policyholders "not to just rubber stamp Anthem's request to raise premiums."
Anthem was the only established Connecticut insurance company that offered both individual and small group health care plans in the state's health insurance exchange during the recent open enrollment period. It is providing coverage to the bulk of the customers who signed up for private coverage on the exchange.
With its rate increase proposal, Anthem contends it is attempting to strike a balance between being competitive price-wise and remaining solvent and financially stable.
"We must balance the strong competitive pressures against the need to responsibly price our products to ensure that we will remain a leader for the next 75 years, meeting the needs of Connecticut residents for financial security, good health and access to quality care for many years to come," said James Augur, Anthem's vice president of sales.
Michael Bears, Anthem's vice president of actuary, spelled out a number of reasons for the proposed rate increase. The list included higher costs for medical services and pharmaceuticals — especially drugs for treating Hepatitis C — and fees levied by the federal government as part of the Affordable Care Act.
The hearing officer, Paul Lombardo, asked Bears to provide the agency with additional information to justify the proposed rate increase. A final decision on Anthem's rate filing will be made within 30 days after the record of Friday's proceeding is closed. The decision will be posted on the Department of Insurance website.
Besides concerns about the size of the proposed rate increase, some members of the public brought up issues with Anthem's handling of its policies sold on the state's health insurance exchange.
Arleen Block of New Haven testified about how her 26-year-old son received letters from Anthem claiming he had not paid his premium when the insurer never processed the payment. Block said the listing of available medical providers covered by her son's Anthem plan were inaccurate and out-of-date. Additionally, he was erroneously told he needed preauthorization for a prescription drug, a delay that caused him to run out of the medication.
Arvind Shaw, CEO of the Generations Family Health Center in Willimantic, said Anthem has been slow in reimbursing for services. He said his agency is owed about $43,000 but has been paid about $290 to date. Additionally, Shaw said some of his clients' prescription drug claims were erroneously denied.
"I am very concerned for the safety and care of these patients," Shaw said.