1327 Highmark Inc. d/b/a Highmark Blue Cross Blue Shield; filing no. 1-GRT-03-HBCBS; experience rated group (including demographically rated groups) trend factors update; rate filing
Highmark Inc. d/b/a Highmark Blue Cross Blue Shield; Filing No. 1-GRT-03-HBCBS; Experience Rated Group (Including Demographically Rated Groups) Trend Factors Update; Rate Filing [33 Pa.B. 3238] Highmark Inc. d/b/a Highmark Blue Cross Blue Shield is requesting approval to increase the insured full allowance and leveraged claim trend rates for its Master Group (Blue Cross Hospital), Blue Shield Medical/Surgical, Group Major Medical, Comprehensive Major Medical, Primary Care Gatekeeper Designated, Open Access and Nongatekeeper Preferred Provider Organization Medical Organization Medical Programs. These trends will apply to the demographically rated and experience rated business. This filing will apply to client notification dates on or after August 1, 2003, for new business and October 1, 2003, for renewals.
The average impact due to the requested additional increases in trend factors for each product is summarized as follows:
Current Approved Requested Annual Impact Trend Factor @ Trend Factor @ of Trend Number of Full $0 Deductible: $0 Deductible: Trend Increase in Product Risk Contracts In-Network In-Network Increase Millions
POS $ in Millions Community Blue POS
(Small Network with
Gatekeeper)53,691 14.0% 20.0% 6.00% $14.64 Direct Blue
(Open Access)24,292 14.0% 20.0% 6.00% $6.97 Select Blue POS
(Primary Care
Designated Gatekeeper)157,059 14.0% 20.0% 6.00% $44.62 Community Blue Direct
(Small Network w/o
Gatekeeper)25,953 14.0% 20.0% 6.00% $7.15 POS Total 260,995 6.00% $73.38 Traditional Blue Cross 18,888 12.0% 19.0% 7.00% $4.39 Blue Shield 18,804 11.0% 20.0% 9.00% $2.76 Major Medical 19,684 18.0% 28.0% 10.00% $1.86 Traditional Total 8.05% $9.01 Comprehensive 16,028 15.0% 20.0% 5.00% $3.98 Nongatekeeper PPO 53,705 14.0% 19.0% 5.00% $13.35 Total Impact 388,104 5.9% $99.72 In addition, these trends will be used for the Cost Plus groups with 119,000 contracts having an impact of $27 million.
The increases in the trend factors for the other deductibles and out-of-network are comparable to the $0 deductible in-network trend increases.
Copies of the filing are available for public inspection during normal working hours, by appointment, at the Insurance Department's regional offices in Harrisburg.
Interested parties are invited to submit written comments, suggestions or objections to Bharat Patel, Actuary, Insurance Department, Accident and Health Bureau, Office of Rate and Policy Regulation, 1311 Strawberry Square, Harrisburg, PA 17120 within 30 days of publication of this notice in the Pennsylvania Bulletin.
M. DIANE KOKEN,
Insurance Commissioner[Pa.B. Doc. No. 03-1327. Filed for public inspection July 3, 2003, 9:00 a.m.]
