Insurance Rate Increases

Blue Cross and Blue Shield of Florida (aka Florida Blue) has obtained the approval for a rate increase for several of their individual health insurance policies including BlueOptions-PPO-Individual-16842FL007, MyBasic NetworkBlue-PPO-Individual-16842FL008, BlueChoice-PPO-Individual-16842FL009, BlueSelect-EPO-Individual-16842FL012 and MyBasic BlueSelect-EPO-Individual-16842FL013. According to their web site the average increase will be 15.32% effective July 1st, 2013 and will affect 264,850 people. As a Florida Blue customer my rate increased almost 30% ! The reasons driving the dramatic premium increase include a 189.37% increase in costs for inpatient care compared to a 111.07% increase in outpatient care. It's of interest to note that the current Medical Cost Adjustment - the difference between what the insurer thought it was going to pay for medical services and what it actually paid during the current year - DECREASED by 466.64%! For the final rate determination the Florida Insurance Code requires that all individual and small group carriers obtain approval of their premium rates from the Office of Insurance Regulation (OIR). In addition, the Patient Protection and Affordable Care Act, otherwise known as Health Care Reform, requires that all weighted average rate increases in the individual and small group markets that exceed a stipulated threshold (currently 10%), must be assessed to determine if they are "reasonable". For individual and small group carriers issuing coverage in the state of Florida, the federal enforcement agency for the Patient Protection and Affordable Care Act, Health and Human Services (HHS), has delegated the authority to determine if rate increases are reasonable to the OIR. According to the OIR all Florida Blue's rate increases for individual and small group products either do not exceed the threshold, or have been determined to be "reasonable." Anyone who has received his/her new premium notice might have to get used to the new definition for "reasonable" rate increase. Its probably listed in the alternative Wikipedia published by the healthcare industrial complex which pays our politicians and corrupts our public life. Yours Bernd