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WellPoint’s New York rate hike to face scrutiny

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WellPoint Inc.’s request to raise rates on small-business health plans in New York by as much as 28 percent will face increased scrutiny because of new U.S. regulations, the state’s top health insurance official said.

Federal rules released Tuesday tell state regulators to view rate-increase proposals of more than 10 percent as “initially unreasonable,” Louis Felice, head of New York’s Insurance Department’s health bureau, said in a telephone interview.

Indianapolis-based WellPoint’s Empire Blue Cross Blue Shield unit asked for premiums of 20 percent to 28 percent higher for more than 216,000 people in plans at businesses with 50 or fewer employees, Felice said. WellPoint, the biggest U.S. health insurer by enrollment, lost several rate-increase battles this year including in California, Connecticut and Maine.

In California, its request for an average 25 percent boost in premiums on plans for individuals was cut to 14 percent.

States will be able to reject insurer rate increases, while the federal government will be limited to only publishing data on the premiums, according to the U.S. Department of Health and Human Services, which is writing the rules.

State officials can choose to bar insurers with a pattern of rate increases that the law labels as “unreasonable” from new insurance exchanges that will be set up as part of funding coverage for 24 million newly insured individuals. The 10 percent threshold will change after 2011 to a state-by-state measurement based on the history of health costs in each state, according to the agency.

The insurance exchanges set up by the law that President Barack Obama signed in March will offer tax credits for people to buy private coverage by 2019. Starting this year, insurers must provide state and federal regulators with a written justification for any raised premium rates.

The administration estimates that as much as 70 percent of insurance offered in the small group and individual market will exceed the 10 percent threshold and will be subject to review.

Insurers are also subject to rules requiring the companies to spend at least 80 percent of premium revenue on patient care or rebate the difference to customers. Insurers as of 2014 won’t be able to reject people based on pre-existing conditions, and won’t be allowed to vary premiums widely based on people’s age or health status.

The rules define an “unreasonable” increase as one that lowers the percentage of premiums being spent on customers’ care below the 80 percent threshold, or that isn’t based on substantial evidence that health costs are rising, the agency said.

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  1. The Fringe! Plus, the simple fact that there are so many local faves in such close proximity to each other.

  2. I remenber, watching the toll road, being built, through South Bend, when I was 10 years old. I believe, back then that it was estimated, that the toll road, would be paid for in 20 years and then it would be free. I am now 71, what happened? Since the power is in the people, by that, I mean that, we the people are in total control of everything. I, suggest that no one ever use the toll road again, let it go broke. We the people can control the price of everything, from groceries to gas, if we would just do it. If we don't pay the asking price, the sellers will lower the price and if we wait awhile, they will lower the price to what we accept as reasonable. I would like to know why a highway like interstate 94, is so well maintained, a much better highway, than the toll road, but has no tolls. I would also like to know why, a sitting governor, with a term limit, maximum of eight years, can lease, public property, for 75 years. Even though I have transponders in both of my trucks and will not be affected by the increase, I have been and will contine to avoid using the toll road. I make many trips from northern Indiana to Chicago, every year, and I prefer the better highway, I94!

  3. Coming from her background,she should be used to those kinds of advances! Menard probably figured it was ok to tuck a buck!

  4. I'm still waiting for the list of available, high quality apartments in the Village.

  5. This criminal masquerading as a lawyer obviously has serious issues. He’s been proven by his own testimony to be a pathological liar and probably has a personality disorder as he seems to be constructing a reality around himself. He places no value on truth, honesty or loyalty as evidenced by what he has done to his clients and his own family. And by the demands and lies he has made in court, it is evident he feels entitled to do and say whatever suits his purpose and everyone else is expected to nod obediently and believe him because he is, after all, Bill Super Lawyer; or BS lawyer for short. This millionaire wanna-be no longer owns anything of value; he squandered it and put everything he had into foreclosure. He has no money, house, car, boat or vacation home left to show for what he earned or what he stole. He’s just another loser without morals who will be doing time. I’m certain all of his courtroom shenanigans are antagonizing his poor victims. As Lamar said, his behavior and claims in court have been outrageous. The judge needs to be more than concerned; he needs to be judicial and end this nonsense.

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