Court upholds Anthem decision

Posted April 22, 2010, at 9:11 p.m.

AUGUSTA, Maine — Maine Superior Court has affirmed state regulators’ decision to reduce Anthem Blue Cross and Blue Shield of Maine’s proposed rate increase for individual health plans from 18.1 percent to 10.9 percent.

In a decision Wednesday, Superior Court Chief Justice Thomas Humphrey said Maine law does not “expressly entitle insurers to a mandated profit margin.”

Anthem had contended that the 10.9 percent hike allowed by Maine’s insurance superintendent wasn’t enough to provide profit for the company. The 10.9 percent average increase became effective on July 1, 2009.

The judge also said it was not improper for the superintendent to consider the state of the economy and profits from Anthem’s other lines of insurance in making her decision on the proposed increase.

Insurance Superintendent Mila Kofman called the decision “good news for Maine consumers.”

Attorney General Janet Mills, whose office defended Kofman’s decision in court, said Anthem “cannot impose high rate increases on the backs of individual policy holders to maximize its corporate profits.”

“In the past three years alone, Anthem turned over $200 million in dividends to its parent company Wellpoint, one of the largest health insurers in the country,” Mills said.

Anthem’s proposed 22.9 percent increase this year for two individual coverage plans is still pending.

The company hasn’t decided whether it would appeal the ruling.

“We are in the process of reviewing the court’s decision and have not yet determined our next steps,” said spokesman Christopher Dugan. “That said, we stand by our position that filed rates need to both cover the medical costs for our members and allow for an adequate risk margin to cover unanticipated costs.”

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