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NEW: Direct Pay Rate for Health Insurance Will Go Up

Thursday, March 10, 2011


Rhode Island Health Insurance Commissioner Christopher Koller has approved a 1.9% average rate increase for Direct Pay Products.

The rate increase is six percentage points lower than the original request for a 7.9% increase issued by Blue Cross and Blue Shield of Rhode Island (BCBSRI), but slightly higher than was recommended by the Attorney General and case Hearing Officer.

"This Office has to balance the need for solvency of Blue Cross and the lowest rates of increases needed," Koller said. "The rate increases granted here find that balance."

In lowering the rate of increase, Koller eliminated anticipated contributions to reserves, disallowed costs of premium tax on commercial insurance and allocation of costs of publicly purchased vaccines, and reduced Blue Cross trend factors for three of eight medical-sevice categories.

He also ordered Blue Cross to offer no rate increase to the small number of its customers over age 65 in Direct Pay.

Koller noted that Direct pay subscribers, who purchase their insurance without employer contribution, are among the most vulnerable health insurance consumers.

"They stand the most to gain from health care reform," Koller said, "because of federal subsidies and the introduction of more healthy individuals into the market with an individual mandate. In the mean time, careful rate oversight and the efforts of Blue Cross make our individual market considerably healthier than in almost any other state, many of which are experiencing double digit rate increases."

The rate increases are an average — some subscribers will see greater increases and others less — and will go into effect for enrollees renewing their coverage on or after April 1. Blue Cross may accept Kroller's decision or appeal it in Court.


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