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PA Bulletin, Doc. No. 05-1364


Keystone Health Plan Central; Base Rates; Rate Filing

[35 Pa.B. 4031]

   On July 5, 2005, Keystone Health Plan Central submitted base rate filing No. 05-X for the base HMO plan requesting a rate increase of 9.37%. The filing will affect approximately 85,000 members and generate additional revenue of $20.9 million annually. An effective date of January 1, 2006, is requested.

   With this filing, Keystone Health Plan Central will make several changes designed to make a seamless offering of the HMO product with other Capital Blue Cross products. The following changes are due to the systems used by Capital Blue Cross and Keystone Health Plan Central:

   *  Outpatient physical therapy, occupational therapy and speech therapy subject to 30 visits maximum per calendar year.

   *  Cardiac rehabilitation therapy covered for 12 weeks at three visits per week.

   *  Urinary incontinence therapy accumulating towards physical therapy.

   *  Pulmonary rehabilitation accumulating towards physical therapy limits.

   *  Respiratory therapy limited to 30 visits.

   *  Hospice limit increased to $50,000.

   *  Wigs limited to $300 per lifetime.

   *  SNF and Rehab limited to 60 days combined per year.

   *  Rabies vaccine charge ER copay.

   *  Childbirth preparation class reimbursement eliminated.

   A copy of the filing is available on the Insurance Department's (Department) website at www.ins.state. Under the Quick Links section, click on the link ''Rate Filings Published in the PA Bulletin.''

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

   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.

Insurance Commissioner

[Pa.B. Doc. No. 05-1364. Filed for public inspection July 15, 2005, 9:00 a.m.]

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