AUGUSTA, Maine — Maine Superintendent of Insurance Mila Kofman this week ruled on a proposed increase in monthly health insurance premiums by Anthem Blue Cross and Blue Shield of Maine, granting the Indiana-based company an average 14 percent increase for its nongroup individual policies. That’s lower than the 23 percent increase Anthem had requested for the period of July 1, 2010, to June 31, 2011.
An Anthem spokesman said Friday that the company, which could appeal the decision in court, is still reviewing the superintendent’s findings.
The smaller increase will do little to relieve Mainers struggling to afford nongroup coverage. Under the 14 percent increase approved this week, for example, a single, 35-year-old adult with no children and a $2,250 annual deductible could pay as much as $509 a month for basic health care coverage. A married couple with two children could pay almost $1,300 a month for the same coverage plan.
The new rates will take effect Oct. 1 and be modified to reflect Anthem’s originally requested start date of July 1. About 11,000 Mainers will be affected by the rate increase.
In her decision, Kofman found that Anthem’s original request was both “excessive” and “unfairly discriminatory.” The smaller increase she granted would result in an acceptable cost increase for Mainers enrolled in Anthem’s individual, nongroup policies, she said.
Kofman faulted Anthem’s request on several counts, including its projections for increased cost and amount of health care services demanded by consumers.
“The failure to provide accurate data impairs the ability to conduct meaningful review, and Anthem must take steps to prevent such problems in the future,” Kofman stated in her decision.
Kofman’s latest ruling comes after months of public hearings and analysis by both insurance bureau staff as well as a private actuarial firm. It grants Anthem an estimated 0.5 percent profit margin, as opposed to the 3 percent increase the company had requested.
Last year, Kofman denied Anthem any built-in profit margin at all in its individual plans. Anthem’s court challenge to that stern ruling was denied, upholding Kofman’s decision and winning her national media attention.
Citing the continued “extreme financial hardship for subscribers and the extreme financial health of the company,” this week’s ruling takes a similarly pro-consumer tone.
Anthem spokesman Christopher Dugan said in an e-mail Friday afternoon that the company is reviewing Kofman’s decision and would have no further comment at this time.