Anthem Blue Cross has agreed to reduce the average increase to 9.1%, from 9.8%, and to impose the increase July 1, rather than April 1, according to officials at the California Department of Insurance.
Anthem Blue also has agreed to wait until July 1 to increase co-payment and deductible amounts. Anthem Blue had originally talked about imposing the benefits structure changes April 1.
The change affects about 600,000 California residents who have individual and family health insurance coverage from Anthem Blue.
The changes do not affect rate increases and benefits changes affecting members of Anthem Blue’s California health maintenance organization (HMO) plans. In California, the Department of Managed Health Care regulates HMO plans.
Executives at Anthem Blue’s parent, WellPoint, Indianapolis (NYSE:WLP), said during the company’s 2010 earnings call that they had been successful at adjusting individual and family rates in most states outside California.
In California, California Insurance Commissioner Dave Jones does not have the authority to reject what he believes to be excessive health insurance increases. Instead, he has been trying to use his authority to review health insurance rate increase notices for errors to get large insurers to make some changes.
Jones says in a statement about the Anthem Blue decision that the effect of the rate increases and benefits changes originally proposed would have amounted to an average
total increase of more than 16%.
The changes Anthem Blue has agreed to will save the affected policyholders about $40 million, Jones estimates.
“One of the more troubling aspects of the [original] proposal was that some deductibles would have gone up in the middle of the calendar year,” Jones says. “Someone could have spent enough out-of-pocket to have met their deductible in April, only to be told in June that a medical visit would not be covered because their deductible amount had increased in the middle of the year.”
C. Boorady, an analyst at Credit Suisse, New York, says the California announcement is good news for WellPoint and its investors, because it means WellPoint can increase individual rates in California, even if at a somewhat lower rate than it had hoped.