Insurance regulators approved more double digit rate increases Tuesday for two insurance companies, including Anthem, the only company currently participating in Connecticut’s insurance exchange in 2017.
Insurance Department regulators approved rate increases for individuals and small businesses with Anthem both on and off the exchange, and they also approved increases for ConnectiCare’s off-exchange rates for individuals.
Anthem had requested a 26.8 percent rate increase for its individual plans both on and off the exchange, but regulators agreed to a revised average increase of 22.4 percent for its 56,700 customers.
Regulators determined that the company overstated the impact of medical inflation and added in an unnecessary cost for a grace period adjustment for those instances when a member doesn’t pay their premium in the first month of the 90-day grace period offered under the Affordable Care Act.
The Insurance Department also determined that Anthem failed to properly account for the $26 million payment the carrier received as part of the federal risk adjustment program, which requires companies with healthier customers to pay those with sicker customers.
Insurance regulators knocked Anthem’s small group proposal in which the carrier asked for an 11.6 percent increase down to an average of 4.9 percent increase for more than 42,000 members in that market.
The ConnectiCare Insurance Company, which requested a 42.7 percent rate increase in early August, saw its request knocked down to 38 percent for the 37,142 customers in its off-exchange plans.
Regulators determined that the company correctly calculated the increase in medical trend, but overstated the impact of its $26 million payment into the federal risk adjustment program. An Insurance Department actuary estimated that it would cost about $55 per member, per month, when the company had estimated it would cost about $77 per member, per month.
Last week, regulators approved an average 17.4 percent rate increase for ConnectiCare’s on exchange rates. The company immediately filed a lawsuit asking the court to force regulators to consider its proposed 27.1 percent rate increase, but a judge denied the state’s motion to dismiss the lawsuit and the company’s request for a temporary injunction.
On Monday, ConnectiCare asked the Insurance Department to review its proposed 27.1 percent rate request for its nearly 50,000 customers on the exchange. However, three days earlier it informed Access Health CT that it was not participating in the exchange in 2017.
That would leave Anthem as the only insurance carrier participating in the exchange in 2017.
James Wadleigh, CEO of Access Health CT, said there’s a lot of confusion out there at the moment about what’s happening with ConnectiCare.
“Right now, ConnectiCare says they want to be on the exchange,” Wadleigh said Tuesday. “Access Health wants them to be on the exchange.”
However, the company sent its termination notice to Access Health CT last week.
Wadleigh said they are working with the Insurance Department to determine what the process is to ensure they continue to participate, but at the moment Access Health CT is on the sidelines.
“We’re not pushing them off,” Wadleigh said. “We’re waiting to see if the process between them and the state can work out.”