1476 Highmark Inc. d/b/a Highmark Blue Cross Blue Shield; direct pay ClassicBlue major medical program; rate filing

Highmark Inc. d/b/a Highmark Blue Cross Blue Shield; Direct Pay ClassicBlue Major Medical Program; Rate Filing

[33 Pa.B. 3697]

   By filing no. 1-PMM-03-HBCBS (Department ID no. A71611001), Highmark Inc. d/b/a Highmark Blue Cross Blue Shield requests approval to increase its premium rates for its Direct Pay ClassicBlue Major Medical Plan (Western Region). The filing requests an increase of 40.3% or $48.27 per contract per month. This will affect about 4,100 contract holders and produce additional annual premium income of about $2.3 million. For HIPAA and Health Coverage Tax Credit eligibles, the filing requests an increase of 60.0% or $71.87 per contract per month. This will affect about 3,600 contract holders and produce additional annual premium income of about $3.1 million.

   In addition to the increase in premium rates, the following changes are being made to the ClassicBlue Major Medical Plan:

   *  The current overall $750 deductible will be separated into a $250 deductible for prescription drug benefits and a $500 deductible for other major medical services.

   *  The prescription drug coinsurance will change from 80% to 70%.

   *  A $25,000 calendar year prescription drug maximum per member is being added.

   *  A prescription drug minimum copay of $10 and a maximum of $100 is being added.

   *  The prescription drug benefit will become closed formulary and hard mandatory generic.

   *  The physical therapy benefit will change from unlimited visits to 15 visits per calendar year.

   *  The speech and occupational therapy benefits will change from unlimited visits to 15 visits per calendar year.

   The requested effective date of the change is January 1, 2004.

   Copies of the filing are available for public inspection during normal working hours, by appointment, at the Insurance Department's regional offices in Harrisburg and Pittsburgh.

   Interested parties are invited to submit written comments, suggestions or objections to Rashmi Mathur, Actuary, Bureau of Accident and Health Insurance, Insurance Department, 1311 Strawberry Square, Harrisburg, PA 17120 within 30 days after publication of this notice in the Pennsylvania Bulletin.

M. DIANE KOKEN,   
Insurance Commissioner

[Pa.B. Doc. No. 03-1476. Filed for public inspection July 25, 2003, 9:00 a.m.]