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Excellus, MVP agree to disclose details of rate-hike requests

Rochester Business Journal
October 28, 2011

Following the lead of the United Healthcare Group, Excellus Blue Cross Blue Shield and MVP Health Care have agreed to let New York make details of their rate-hike requests public.

State Department of Financial Services superintendent Benjamin Lawsky announced the decision Thursday. The department several weeks ago notified insurance carriers it would start disclosing the details of the requests.

The move follows New York’s return last year to a policy of reviewing and altering health insurance carrier’s rate increase requests. For more than a decade the state followed a file-and-use system in which timely filed rate hikes automatically took effect with no state intervention.  

Insurance carriers initially objected to having rate-increase details revealed. United Healthcare broke ranks, agreeing to the new policy earlier this week. Excellus, the Rochester area’s largest health insurer, and four other companies—Aetna Inc., HealthNow of New York Inc., Empire HealthChoice and Emblem Health—dropped their objections Thursday.

The Rochester region’s second-largest health insurance carrier, MVP Health Care, had not agreed to have rate-hike details published, Lawsky said in a statement Thursday.

In a statement provided to the Rochester Business Journal  Friday afternoon, MVP spokesman Gary Hughes said that MVP would go along with Lewsky’s request.

“The public interest is best served when there is transparency about the process of setting health insurance premiums. That is why we are voluntarily agreeing to authorize the New York State Department of Financial Services to disclose the full contents of our premium rate application,” Hughes said.

Also identified by Lewsky as still objecting were Capital District Physicians’ Health Plan, Connecticut General Life Insurance Co. and Independent Health. 

Data formerly kept secret and now available are:

  • Money spent in the last two years on medical claims;
  • Actuarial assumptions used to estimate the coming year’s claims expense;
  • The amount of administrative expenses and profits;
  • An accounting of changes in benefits such as co-payments and drug benefits; and
  • An accounting of policies and geographic regions affected by proposed increases and of the number of policyholders affected.

Details of contracts and financial arrangements and contract terms between insurers and providers would not be revealed.
           
(c) 2011 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or e-mail service@rbj.net.
 


 


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