Connecticut Insurance Insurance Capital - News, Conversation and Links about Connecticut's Insurance Industry en Copyright 2010 Mon, 20 Sep 2010 11:58:16 -0400 Anthem Stuck In Negotiations With Hartford Hospital, Bristol Hospital Hartford Hospital and Bristol Hospital are at a standoff in their negotiations for compensation rates with Anthem Blue Cross and Blue Shield in Connecticut, the state's largest health insurer.

Hartford Hospital has been negotiating with Anthem since February, said James Blazar, the hospital's senior vice president and chief strategy officer.

"I was optimistic going into Friday," Blazar said. But the two sides do not agree on the hospital's suggested increase in reimbursement rates for medical services. The proposed increase not disclosed. A current three-year contract expires Oct. 31.

Hartford Healthcare notified Anthem of its intent to terminate its participating hospital contracts for Hartford Hospital and Windham Community Memorial Hospital with Anthem effective Oct. 31.

"Anthem has proposed increases to both hospitals that would continue to provide them with reimbursement at a margin over their costs," said Anthem spokeswoman Sarah Yeager. "Anthem is seeking an agreement with the hospitals that will allow our members access to quality health care, while trying to manage the cost of health care and rising premiums."

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Attorney General Asks Insurance Regulators To Reconsider Anthem Rate Hikes
"The department rubberstamped Anthem's ridiculous requests -- some as high as 22.9 percent -- with minimal public scrutiny and input," Blumenthal said.

The Connecticut Insurance Department on Friday said it approved a variety of rate requests by Anthem Blue Cross and Blue Shield In Connecticut. The proposed rates take effect Oct. 1, largely for new customers buying Anthem plans on the individual market rather than people in group plans offered through employers or some other organization.

Anthem and all the state's health insurers submitted rate proposals for the fourth-quarter of the year because federal health reform includes new benefits that insurers must provide starting Sept. 23. However, the actual cost of providing those benefits is a huge debate with federal officials and consumers advocates saying the price change should be 1-to-2 percent while insurers are asking for much more than that. For example, Anthem is asking for as much as 22.9 percent more to some plans just for eliminating annual spending limits on each customer.

"I am deeply disappointed by (the state Insurance Department's) approval without reductions of Anthem's excessive and outrageous rate hikes and call on the department to reconsider," Blumenthal said. "In so far as the companies are falsely blaming the health care reform law, these rate hike requests are particularly unacceptable."

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Rate Hikes Of As Much As 20+ Percent Approved For State's Largest Health Insurer
A spokeswoman for the Connecticut Insurance Department said rate hikes submitted by Anthem Blue Cross and Blue Shield in Connecticut were approved without changes.

The exact rate change for each plan isn't clear because Anthem offers many plans and variations of plans. Some will see large increases related to both added benefits from federal health reform and rising medical costs. The insurer offered some explanation of how much it would have to raise rates to include new benefits starting Sept. 23 as required by federal health reform laws passed in March.

For example, eliminating annual limits for spending on health-plan members will increase the price of Anthem plans from 0.5 percent to 22.9 percent, depending on the plan. Covering the whole cost of preventive care services such as colonoscopies and mammograms will increase premiums by 0 percent to 8.5 percent. And requiring insurers to accept children into individual-market plans regardless of pre-existing conditions will increase rates by 4.8 percent.

All of Connecticut's major health insurers filed proposed rates for new plans, or revised plans, to comply with the new benefits offered Sept. 23. The change largely affects new customers in the individual-market and not those who already have insurance either through an employer or some other group. The required new benefits include:
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Are Women Using Genetic Testing To Predict Breast Cancer? A new national study will look at whether women are using genetic testing to see if they have inherited a greater risk of getting breast and ovarian cancer.

Certain gene mutations can indicate a greater likelihood of getting some cancers. Realizing the greater risk means women can check more regularly to see if they are developing early signs of cancer. But are women seeking out genetic testing, and if not, why not? 

The two-year study will address whether tests are offered to women, and if there are disparities between women of various socioeconomic, racial and ethnic groups. Researchers will also determine the use of risk-reduction and screening services by patients after they are tested.

Funding will be provided by Aetna and conducted by researchers at the University of South Florida and Georgetown University, in collaboration with the American Cancer Society.


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Online Contest To Determine Funding For Groups That Will Improve Children's Health Getting children to eat healthier food and exercise has been a steady campaign for First Lady Michelle Obama as well as health insurers.

The latest effort: an online contest to determine where Aetna Foundation grant money should go to help mitigate childhood obesity.

The competition started today and ends at 5 p.m. Tuesday, Oct. 5. The idea is to have the public vote and decide three charitable organizations from a pre-determined list of 10 to share $100,000 in grant funding. 

For details, visit

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Senator Dodd Says Insurers' Proposed Rate Hikes Are "Reprehensible And Dishonest" U.S. Senator Chris Dodd lashed out at insurers Wednesday after reports of proposed rate hikes of as much as 20 percent in some cases, which insurers partly attribute to federal reform.

"Connecticut families have suffered from skyrocketing health insurance prices and the industry's abusive practices for far too long," said Dodd, a Democrat. "To now try to attribute a more than 20 percent proposed rate hike to the new health care reform law after years of continually proposing comparable double-digit rate hikes in Connecticut is both reprehensible and dishonest. Should these new rates take effect, there is no doubt that many Connecticut families will be severely impacted and could join the ranks of the uninsured across the country. I urge the state to thoroughly review this request and use the $1 million in federal funding it was recently awarded under the new health care reform law to protect Connecticut consumers and families and prevent these unreasonable rate hikes."

Dodd was among U.S. Senators who worked to pass federal health reform laws which were passed and signed into law by President Obama in March.

Connecticut Insurance Commissioner Thomas Sullivan has said the state Insurance Department will review rate requests "with the same level of vigor and scrutiny that we have employed in the past."

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Connecticut's U.S. House Delegation Pushing Regulators To Hold Line On Insurance Rate Hikes Proposals to raise health insurance rates by more than 20 percent in some cases led Connecticut's entire U.S. House delegation to ask insurance regulators to remain vigilant against excessive rate hikes.

In a Sept. 14 letter to Insurance Commissioner Thomas Sullivan, the five U.S. House representatives said, "While we understand that requiring additional benefits may come with some extra costs, empirical evidence suggests that the costs for these specific changes are relatively low, and in some cases negligible."

"In light of the pending deadline for these insurance reforms, we would encourage you to remain vigilant of excessive rate increase requests by insurance providers that surpass expected costs of these changes," the letter said, signed by Democrats Joe Courtney, Rosa L. DeLauro, Jim Himes, John B. Larson and Christopher S. Murphy.

What's changing is federal health reform will require insurers to provide certain benefits starting Sept. 23, or to comply with federal guidelines for grandfathering existing plans. Insurers must eliminate annual and lifetime limits to spending for members; children will not be denied coverage regardless of a pre-existing condition; young adults may choose to stay on their parents' plan until they reach age 26.

Sullivan replied, "The Connecticut Insurance Department will continue to review premium rate requests with the same level of vigor and scrutiny that we have employed in the past.  While some of the new requirements under health care reform have already been adopted into Connecticut law, such as dependent coverage, several have not. As a result, when benefit levels are increased it is not unexpected to see commensurate increases in premium levels.  The Department will utilize all the tools made available through health care reform and the recently awarded premium rate review grant to ensure that consumers are protected and that Connecticut continues to enjoy a competitive marketplace. 

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Health Insurance Rate Proposals Fuel Clash Over Whether Premiums Are Justified Or Wildly Inflated

Health insurers are asking for immediate rate hikes of more than 20 percent in Connecticut for some plans, citing rising medical costs and federal health reform laws as reasons.

Both issues -- the new federal health care reform and rising medical costs -- are significant drivers of the increases, according to filings by insurers with state regulators that were reviewed by The Courant.

It remains to be seen how much of the requests will be approved. Many people might not see an increase before Jan. 1, and these proposed changes would largely affect new business, mostly in the individual market.

But the overall price shift is the clearest indicator yet of what customers and employers can expect when health insurers submit proposed 2011 rates in late October and November. The current round of price requests launches a clash between insurers who say the increases are justified and consumer advocates and government officials who say the numbers are wildly inflated.

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Health Insurers Ask For Rate Hikes Of More Than 20 Percent In Connecticut, Citing Medical Costs, Federal Reform here for the full story about health insurance premiums in Connecticut.

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Health Insurers Come Under Fire By HHS As Reform Provisions Prompt Rate Increases
Health insurers filing rate increases effective as early as the fourth quarter, starting Oct. 1, take into consideration new requirements by federal health reform. September 23 marks six months since Congress passed the sweeping changes to healthcare law and ushers in a number of provisions such as:

* Young adults will be able to stay on their parents' plan until they turn 26.
* All new plans must cover preventive services including mammograms and colonoscopies without charging a deductible, co-pay or co-insurance.
* Prohibiting insurers from rescinding coverage for an error in an application or a technical mistake.
* A way to appeal insurance company decisions in an external review process.
* Eliminating lifetime limits, which is a maximum dollar amount an insurer would pay for medical care of a particular person during his or her life, such as $250,000 or $1 million.
* Similar to lifetime limits, the law also bans annual limits.
* Prohibits insurers from denying coverage to children under 19 for having a pre-existing condition.

Here is a copy of Sebelius' letter:

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