Blues plan denied 9.9% rate hike, more explanation needed

In a rare move among insurance commissioners, New Mexico Insurance Superintendent John Franchini outright denied Blue Cross Blue Shield's request for a 9.9 percent rate increase.

Franchini said he rejected the rate hike because BCBSNM didn't provide enough evidence to justify the request, according to the Associated Press. State and outside actuaries helped Franchini conclude that the insurer failed to support the medical trend in its rate request, the New Mexican reports.

BCBSNM's rate increase would have affected about 27,000 policyholders, many of them self-employed, and about 10 "closed block" plans that don't accept new policyholders. As the size of the group in the plan decreases, the costs of medical care are divided among fewer people.

In response, BCBSNM said it will request an Insurance Division hearing so it can justify the premium increase, reports the Albuquerque Journal. "We believe the superintendent's actions are harmful to our company and the competitive environment for health insurance in our state," BCBSNM President Liz Watrin said. She added that the insurer will provide "extensive justification for the rate increase and the underlying economic realities that face our state's residents as a result of medical price inflation."

BCBSNM said it lost $10.1 million on its individual plans last year and $22 million over the previous three years. Its own actuarial studies justified a 24.6 percent premium increase. The insurer also alleged that Franchini has approved its competitors' rate increases, some that were greater than those sought by BCBSNM, without hearing or actuarial review.

To learn more:
- read the Albuquerque Journal and BCBS's hearing request
- read the Associated Press article
- see the New Mexican article