CareFirst revises request, seeks higher rate increase

CareFirst asks for revised, higher rate increase

CareFirst BlueCross BlueShield said Wednesday that rate increases it requested from the Maryland Insurance Commission earlier this year are not enough to cover costs for its exchange-based plans and that it needs even larger ones.

The state's largest insurer asked the commission in May to allow it to increase rates by 12 percent for the HMO plans it sells on the state's online marketplace and by 30 percent for PPO plans. The rate proposals are for individual plans with coverage beginning Jan. 1.

The insurer refiled its request Tuesday and is now asking for a 27.8 percent increase on its HMO plans and a 36.6 percent increase on its PPO plans.

It made the decision to seek higher rates after reviewing claims from the first five months of the year that showed higher costs than the original request was based on, the company said in a statement.

"The rates filed [Tuesday] directly reflect the cost of providing care to the somewhat older individuals and those with more chronic medical conditions who purchased policies from CareFirst — in particular, the experience of those individuals new to CareFirst in 2016," the company said.

The revised request comes well into the commission's process for considering rate increases. The commission held a public hearing this month that attracted more than 50 speakers, said spokeswoman Tracy Imm. A hearing will be held Aug. 15 to consider the latest request.

"We want to make sure people have public input," Imm said. "It has to be an open process. We can't have a decision without getting everyone's input."

Critics have said that CareFirst's original request was too high and that many policyholders would not be able to afford it.

The advocacy group Consumer Health First commissioned a study of the rates proposed by CareFirst and two other insurers that requested rate increases. In the study, presented at the first hearing, the group criticized CareFirst's rate setting and said it must not be doing a good job of controlling costs.

"We are not pleased," said Leni Preston, president of Consumer Health First, about the new rate proposal. "To bring in this request so late in the process does not allow consumers and consumer advocates to respond appropriately. We are going to be taking a very hard look at this."

CareFirst said it has experienced large losses that give it little choice.

"CareFirst has absorbed and continues to absorb substantial losses covering individual (Affordable Care Act) members in Maryland," the CareFirst statement said. "We have refiled rates out of necessity to stem unexpectedly large losses from our experience year to date, and attempt to ensure that premiums cover health care costs for these members."

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