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PA Bulletin, Doc. No. 04-827


Blue Cross of Northeastern Pennsylvania and Highmark Blue Shield; Major Medical Community Rated Group Rate; Rate Filing

[34 Pa.B. 2518]

   On April 21, 2004, Blue Cross of Northeastern Pennsylvania and Highmark Blue Shield submitted filing no. 787-MMCR-10/1/04 requesting the Insurance Department's (Department) approval to increase the current approved rates for the Community Rated Major Medical Program. The proposed changes are 12.3% for the Major Medical Program that includes the pharmacy benefit and 26.85% for the program that excludes the pharmacy benefit.

   The following benefit changes are also requested in this filing:

   *  Removing cardiac rehab therapy (outpatient), pulmonary rehabilitation (outpatient), respiratory therapy (outpatient) and skilled nursing facility.

   *  Changing the two times deductible and coinsurance maximum per family to three times deductible and coinsurance maximum per family.

   *  Adding three options of $2,500 maximum, $5,000 maximum and $10,000 maximum for DME, orthotics and prosthetics.

   The projected number of contracts is approximately 13,300. The proposed increase will generate an estimated additional annual revenue of $3,434,849. An effective date of October 1, 2004, is requested.

   A copy of the filing is available on the Department's website: To access the filing, select ''Consumer Information'' on the left side. Under ''General Information,'' click on ''Notices.'' The PDF copy is at the ''Filing.pdf'' link following the name of the filing.

   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, Insurance Department, Insurance Product Regulation and Market Enforcement, Room 1311, Strawberry Square, Harrisburg, PA 17120, within 30 days after publication of this notice in the Pennsylvania Bulletin.

Insurance Commissioner

[Pa.B. Doc. No. 04-827. Filed for public inspection May 7, 2004, 9:00 a.m.]

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