Anthem wants 13% rate hike to offset rising claims, utilization

Anthem Blue Cross and Blue Shield wants to raise premiums by 12.9 percent next year for more than 45,000 individual-market customers in Connecticut.

The state's largest insurer said the rate hike, which requires approval from the Connecticut insurance department, is necessary because of rising claims costs, increasing use of services by members, and state and federally mandated benefit changes, reports the Connecticut Mirror.

"Unfortunately the use of various high cost services including hospital care, new technologies, other expensive diagnostic services, and prescription drugs are increasing--and we owe it to our members to cover those costs and ensure access to a broad network of providers," Anthem said.

It added that the increase will generate the expected 80 percent small group medical-loss ratio, the Hartford Business Journal reports.

According to John Bryson, Anthem's actuarial director for individual products, claims costs are projected to continue rising at nearly 8 percent through next year. He also attributed a 0.53 percent increase in claims costs to various state and federal benefit mandates. Anthem actually decreased the rate hike by 1.5 percent because of changes in administrative expenses, plan mix, medical-loss ratio requirements and "other actuarial impacts," the Mirror notes.

Since the rate request isn't more than 15 percent, it doesn't trigger an automatic public hearing; however, Insurance Commissioner Thomas Leonardi or State Healthcare Advocate Victoria Veltri could request one. Either way, the Insurance Department will review the request and determine whether it should be granted, the CT News Junkie notes.

To learn more:
- read the Connecticut Mirror article
- see the Hartford Business Journal article
- check out the CT News Junkie article

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