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Around the PIA Western Alliance States

Posted By Administration, Tuesday, August 8, 2017

Alaska — A Rate Decrease Proposed: Primera Blue Cross is Alaska’s only health insurer and it has now asked the department of insurance if it can cut rates by an average of 22%. The company says payments dropped last year as did the use of medical services by its customers.

It may be the only state in the union where a cut takes place.

Source link: Insurance Business America


Arizona — Wrong Way Driving Grant: Arizona apparently has a wrong way driving problem and the Arizona State Transportation Board is going to help with a fix and give a $3.7 million grant to set up thermal camera technology for an early warning system.

This will be the first of its kind in the country.


California — Work Comp Drug Formula: A new prescription drug formula is being considered for California’s workers’ compensation system. If adopted, one in three drugs will no longer require authorization before being dispensed.

Alex Swedlow heads the California Workers’ Compensation Institute. It did the study. He said this is “an important first step to improve the quality of medical treatments and reduce the frictional costs of oversight.”

The whole point is to improve the quality of care.

Source link: Insurance Journal


California — More Purchasing Quake Insurance: The California Earthquake Authority says it ended the second quarter of this year with policy sales up 5.4% from a year ago in the same quarter. The CEA now has 950,000 policies in force and those purchasing insurance is trending upward.

Glenn Pomeroy is the CEO of the CEA said the reason for the increase isn’t a shaking state. In fact, it’s been rather quiet on the earthquake front lately in California. “We’re attributing to it to a sum total, realizing what’s happening collectively out there. You do have the scientific community speaking with a clearer and stronger voice than they have in the past,” he said.

As of the end of 2016 close to 11% of California residents have earthquake insurance.

Source link: Insurance Journal


Idaho — 2018 Health Insurance Rates: The Idaho Department of Insurance has posted proposed health insurance premium rates and the requested increases for plan year 2018 on its website, http://www.doi.idaho.gov/company/ratereview/. Health insurance carriers have submitted their rating information including justifications as well as rating areas. The Department will continue to review the insurance carriers’ submissions. The Department’s only authority is to determine the rates “unreasonable” if the requests do not meet the justification. In past years, the Department has successfully negotiated lower rate increases with carriers to avoid labeling them “unreasonable.” Final rates will be publicly available by mid-September or early October. 

                                                Bronze Silver Gold Overall

Statewide average               21%      50%    18%     38%

Blue Cross of Idaho             6%        40%    12%     28%

BridgeSpan Health Co.       N/A       N/A     N/A      N/A

Mountain Health CO-OP    6%        29%    6%       25%

PacificSource Health          8%        81%    15%     44%

Regence BlueShield ID      51%      51%    N/A      51%

SelectHealth                         27%      69%   25%     48%

“I am deeply disappointed and frustrated to share these rates,” said Department Director Dean Cameron. “I understand how difficult it will be for Idahoans to afford reasonable coverage, especially those without a subsidy.” The Department encourages consumers to carefully review all of their options with a licensed insurance agent whether purchasing coverage on or off the exchange (Your Health Idaho) once the final rates are published.


Silver level plan rate increases

The proposed increases for Silver level plans on the exchange are significantly higher this year, even more than the increases for Bronze or Gold level plans, due to the potential refusal by the federal government to fund the Cost Share Reduction (CSR) mechanism. The CSR requires insurance carriers selling plans through Your Health Idaho to lower deductibles and out-of-pocket maximums on Silver plans for enrollees who earn below 250% of the federal poverty level. “I call on Congress to either repeal the CSR requirement or fund the program,” said Director Dean Cameron. “That action alone would reduce the proposed increase by at least 20% on the Silver plans.” The premium requests for the Silver level plans reflect the cost of the CSR benefits since the carrier is still obligated to provide the benefits regardless of whether or not the program is funded at the federal level.

The proposed increases to Silver plan premiums would also result in an increase in advanced premium tax credits (APTC) for those eligible and purchasing coverage through Your Health Idaho. Individuals who are not currently receiving APTC are reminded to check for eligibility again this year. “Ironically, Congress may spend more of our federal tax dollars through higher APTC’s than if they funded the CSR mechanism,” said Director Cameron. The Department recommends that all individuals work with a licensed insurance agent to choose the best plan based on their needs.

Carrier participation in Idaho

Idahoans have benefited by having a large number of carriers participating in Your Health Idaho and in the market. While some states grapple to find a single carrier, Idaho has had five carriers participating on the exchange and five carriers participating statewide. For 2018, carrier participation has reduced with the withdrawal of Bridgespan and a reduction of counties served by SelectHealth in Eastern Idaho. (See attached map.)

Department of Insurance seeks comments and assistance from the public

“The proposed rate increases demonstrate the need for changes to the federal law. Idaho’s congressional delegation has been responsive and responsible, but we must help them deliver the message to their colleagues,” said Cameron. “If congress is unable to repeal or replace, I ask that they do the following three things at a minimum to stabilize the market and reduce rates:

  Fund or repeal the CSR mechanism (estimated savings of 20%)

  Fund High Risk Reinsurance Pools, similar to proposals in both bodies of Congress (estimated savings of 10% to 20%)

  Allow true consumer choice of plans, similar to the Cruz amendment, either on or off exchange (estimated savings of 20% to 50% compared to ACA plans)

“The Department and I will continue to work on ideas to reduce costs. We invite the public to comment, ask questions, or share ideas.”

Comments, questions, or ideas can be submitted electronically or mailed to the following:

2018 Rate Comments

Idaho Department of Insurance

PO Box 83720

Boise ID 83720-0043


For questions about this or other insurance-related topics, contact the Idaho Department of Insurance by visiting www.doi.idaho.gov or by calling 334-4250 in the Boise area or 800-721-3272 toll-free statewide. 


Montana — Hub International Purchase: Hub International has purchased the employee benefits and consulting services firm Steve Mariani Insurance. It’s centered in Havre. Mariani will remain with the company.

No terms were announced.


New Mexico — Malpractice Challenge: Four doctors including the American Medical Association president-elect Dr. Barbara McAneny have filed a suit against New Mexico Insurance Superintendent John Franchini. They say he is allowing hospital chains to get money from the state’s malpractice fund when it is underfunded.

The funds were taken by 16 hospitals and a dozen outpatient care outfits from 2009 to recently.

Source link: Insurance Journal


Oregon — From the Oregon Department of Insurance: The Oregon Division of Financial Regulation recently adopted the following rule:

ID 07-2017: Amendment to 2018 standard bronze and silver health benefit plans

Adopt: OAR 836-053-0011

Amend: OAR 836-053-0013

This rule establishes the requirement that the standard bronze health benefit plan be HSA eligible, in order to promote consumer choice. The rule brings the standard bronze and standard silver plans into compliance with federal law by amending the exhibits for the plans for plan years beginning on or after January 1, 2018, to meet federal minimum actuarial value (AV) requirements. The rule further clarifies that the insurer or health care service contractor shall clearly indicate on any applicable plan and benefits template or other plan or product specific filing document that the plan is HSA eligible.

Adopted: July 26, 2017

Effective: July 26, 2017

For more information, please visit the Division's website:



Washington — Job Cuts for Molina: Molina Healthcare is cutting 1,500 jobs as it restructures. The hope is to save $300 million to $400 million a year. It is also leaving the money-losing ObamaCare exchanges in Utah and Wisconsin and is going to bump up rates everywhere else.

A major player in the Affordable Care Act and in Medicaid health plans, the firm fired its CEO Mario Molina and CFO John Molina in May. Part of the financial crisis is laid at their feet when they promised investors lots of new business when ObamaCare was put into place.

It didn’t happen.


Source link: Insurance Business America

Tags:  Around the PIA Western Alliance States  Insurance Content  Insurance Industry  Insurance news  Weekly Industry News 

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