Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

• No statutes or acts will be found at this website.

The Pennsylvania Bulletin website includes the following: Rulemakings by State agencies; Proposed Rulemakings by State agencies; State agency notices; the Governor’s Proclamations and Executive Orders; Actions by the General Assembly; and Statewide and local court rules.

PA Bulletin, Doc. No. 03-1327

NOTICES

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.]



No part of the information on this site may be reproduced for profit or sold for profit.

This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.