(DOVER, DE) – Insurance Commissioner Karen Weldin Stewart today released Delaware’s Qualified Health Plan rates for Plan Year 2016.  The Commissioner, after review, submitted her approved rates to the Centers for Medicare & Medicaid Services (CMS) in August. CMS has final authority on the rates. CMS concurred with the Commissioner’s recommendations and announced their approval on September 21, 2015.

It is the Commissioner’s duty to evaluate the reasonableness of rates to ensure rates are not excessive, inadequate or unfairly discriminatory.

The Commissioner recommended approval of a 22.4% rate increase in the individual market for Highmark Blue Cross Blue Shield of Delaware, a reduction of 3.0% from Highmark’s June request of 25.4%.  Highmark had made a second request in late August for an additional 8% increase, for an overall rate hike of more than 33% which the Commissioner rejected out of hand.

Aetna Life Insurance Company’s request for a 16% increase in the individual market was also approved. In the small group market, Highmark’s request for a 12.7% increase was granted, as was Aetna’s request for a 6.1% decrease.

“My actuaries took a hard look at Highmark’s submitted rate request, and we were able to reduce it by 3.0%,” said Commissioner Stewart. “But Blue Cross franchisees across the country are making requests for increases of 25% or more, claiming the Affordable Care Act has unleashed pent-up demand by persons who have not seen a doctor for years.  Regulators have been approving significant rate increases throughout the country.”

BCBS plans have requested rate hikes greater than 30% in Oklahoma, Tennessee and Minnesota.  Last month Blue Cross Blue Shield New Mexico pulled out of that state’s healthcare exchange when denied a 51.6% increase.

Commissioner Stewart said, “I’m continuing to meet with other insurance companies to persuade them to join Delaware’s Health Insurance Marketplace and increase competition. Insurers have been discouraged by our state’s high health care costs.” According to a 2013 Wall Street Journal report[1] on health care spending nationwide, Delaware ranks third-highest in prescription drug costs, fourth in the cost of physician and clinical services, and ninth in the cost of hospital care.

The Department of Insurance held public information sessions in each county in June to receive comment on the proposed rate increases. Written comments can be found at the department’s website. The department expects to post all of the rates on their website by October 15, 2015. For details visit the Health Insurance Rate Filings page, http://www.delawareinsurance.gov/departments/rates/ratefilings.shtml

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[1] JOURNAL REPORTS: HEALTH CARE Health-Care Costs: A State-by-State Comparison

By LOUISE RADNOFSKY, Updated April 8, 2013 4:00 p.m. ET, http://www.wsj.com/articles/SB10001424127887323884304578328173966380066

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For Immediate Release

For more information: Frank Pyle @ 302-674-7353

 www.delawareinsurance.gov | Main Office: 302-674-7300

Highmark, Aetna Request Significant Health Insurance Rate Increases
Commissioner Karen Weldin Stewart Vows Vigorous Review

(DOVER, DE) Commissioner Karen Weldin Stewart announced today that she has received rate request filings from Highmark Blue Cross Blue Shield of Delaware and Aetna, Inc. for individual and small group plans to be offered on Delaware’s Health Insurance Marketplace in 2016.  Highmark is asking for a 25.4% increase in the individual market, while Aetna requests a 16% increase. In the small group market, Highmark seeks a 12.7% increase, while Aetna asks for a 6.1% decrease.

“Large rate increase requests like these are occurring in several states across the country and I know they will cause a hardship for many Delawareans,” said Stewart. “The increases are substantial and I’m going to do my best to reduce them. I am instructing my actuaries to examine vigorously Highmark’s and Aetna’s supporting data for the requests.”

Commissioner Stewart also announced that the Insurance Department will conduct public information sessions in June to receive comment on the proposed rate increases.  The sessions will take place at the following locations in the three counties:

Monday, June 15   1:00pm    Del Tech Owens Campus, Georgetown

Monday, June 15   6:00pm    Insurance Department, 841 Silver Lake Blvd., Dover

Tuesday, June 16   6:00pm    Carvel State Office Building, 820 N. French St. Wilmington

Representatives from Highmark and Aetna will be present at each session. Consumers and interested parties may also submit written comments to the Department at ratedivision@delaware.gov for 30 days between June 15 and July 15, 2015.

According to Title 18 of the Delaware Code, insurance companies may not charge rates that are “excessive, inadequate or unfairly discriminatory.” The staff at DOI reviews rate filings and independent actuaries retained by DOI review the supporting data to see if the rate changes are justified by the circumstances as presented by the insurance companies. The rate requests and the insurers’ justifications will be posted at www.delawareinsurance.gov during the 30-day comment period. The Commissioner reviews the actuaries’ findings and the public comment and works with the insurers to arrive at a rate.  That rate is submitted to the Centers for Medicare & Medicaid Services (CMS) for subsequent review. CMS must follow its own regulations and Delaware law before finally approving or denying the requests.

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For immediate release
Contact Jerry Grant 302-674-7303

Important Deadline Approaching April 30; Beware of Scams

​Dover, DE –The open enrollment period for the Health Insurance Marketplace, www.healthcare.gov, ended on February 15; however, some people may qualify for a special enrollment period (SEP) going on right now. If you owe a fee with your taxes for not having qualifying health coverage in 2014, and you don’t yet have health insurance for 2015, you may still be able to get coverage for this year. Time to apply is limited; this special enrollment period ends on April 30.

“If you don’t have health insurance in 2015 you’ll risk having to pay the fee again next year,” said Insurance Commissioner Karen Weldin Stewart. The fee for people who don’t have coverage increases in 2015 to $325 per person or 2% of your household income – whichever is higher. Eighty percent of people who apply for financial assistance received some level of support to help pay for monthly premiums.

If you owe the fee for not having qualifying coverage in 2014, you may still be eligible to enroll in 2015 coverage if all of these apply:

• You didn’t know until after open enrollment ended on February 15, 2015 that the health care law required you and your household to have health coverage, or you didn’t understand how the requirement would impact you and your household;
• You owe the fee for not having coverage in 2014; and
• You aren’t already enrolled in 2015 coverage through the Health Insurance Marketplace or outside the Marketplace.

Healthcare.gov states that, “You don’t need to have filed your 2014 taxes before enrolling with this SEP—you just have to owe the fee.” The website further states, “If any person in a household meets the criteria for this SEP, everyone in the household can enroll with it.” Please note: Even if you get 2015 coverage through the SEP, you still owe the fee for 2014.

Other special enrollment periods are available throughout the year if you experience certain life changes, such as having a baby, getting married, or losing your existing health coverage. To see if you qualify, please visit www.choosehealthde.com or www.healthcare.gov.

Small businesses can apply for Small Business Health Options Program (SHOP) coverage for their employees any time, all year long.

Fraud, scams and harassment: If you try to obtain a health insurance policy outside of the open enrollment period which complies with the Affordable Care Act, you will probably find very few options. Nevertheless, within the past week the Department of Insurance’s Consumer Services division has received several complaints about harassing phone calls from callers trying to sell limited benefit plans to consumers, sometimes insinuating that the callers’ plans qualify as full health insurance coverage. It most likely does not comply.

There have also been recent reports of scammers calling and impersonating IRS agents, telling people that they need to pay fines or enroll in a plan immediately. Remember, the IRS does not generally conduct business via telephone and you should never give out personal information to anyone if you are suspicious of the call or feel pressured to “act immediately”. Never provide your social security number or credit card number to anyone who demands it.

If you are contacted by an agent who is selling a legitimate insurance product, he or she is required by law to provide you with the name of the insurance company that the agent is representing, and the agent’s ID number. If you request that information, and the alleged agent will not provide it, then the call is almost certainly a scam. Before you purchase any benefit plan or insurance policy, you are encouraged to call the Delaware DOI Consumer Services division at 1-800-282-8611 to verify that the agent is licensed to sell insurance policies in Delaware. For more information about health insurance topics please visit www.delawareinsurance.gov.

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Contact:  Jerry Grant

(302) 674-7303

DOVER, DE – The Holidays are quickly approaching and most people have already begun shopping, decorating or planning a trip to see family or friends over the coming weeks. Take some time today to review your insurance coverage and to ensure that you, your family, and your home are prepared for the colder weather and other perils that occur more frequently during this time of the year.

Holiday gatherings for most people include indulging in great food and drinks. With all of that extra cooking and baking going on there’s just more potential for a fire. According to the Insurance Information Institute, the average home fire claim costs $34,306. A claim after a fire would likely be lower for renters, since they are only insuring the contents of their rented home or apartment, but many renters do not realize that their belongings are likely not covered by their landlord’s insurance.

While the kitchen remains the number one place where fires start in the home, holiday decorations and space heaters greatly increase the chances for fires if you aren’t careful. Never leave candles or space heaters unattended and keep them away from flammable objects. If you have a live Christmas tree, be sure to water it often. Get rid of old strings of lights that get hot and could cause a fire. According to statistics from Allstate Insurance, the median cost for a home fire caused by a Christmas tree is more than $100,000! Christmas trees burn hot and fast, so a tiny spark can become a huge fire in mere minutes. When plugging in lights and decorations outside, do not overload outlets or use substandard extension cords.

Allstate Insurance found that theft claims went up by 7 percent during the holidays, which makes sense since our houses and cars are often filled with expensive gifts. When shopping, keep gifts in your car out of sight and, when possible, schedule package deliveries for times when you will be home. Some people send deliveries to their workplace so they can sign for, and accept, deliveries during the work day.

Be sure to notify your insurance company if you buy high-value items, like jewelry, art or electronics. There are usually limits on how much the policy will pay for specific categories of items. If an item is worth a lot of money you should ask your agent about scheduling an endorsement (also referred to as a “rider”) to better protect your investment should an item be stolen or damaged in a fire, etc.

In today’s world of Twitter, Facebook and Instagram, remember that it’s not always a good idea to overshare the details of when your family will be away visiting Grandma. Don’t make it easy on thieves to come steal presents bought with your hard-earned money.

If you’re hosting a party, remember to serve alcohol responsibly and do not let intoxicated friends or family drive home. When the weather brings snow and ice be sure to clear sidewalks and put down salt or de-icer, if necessary. Homeowners and renters insurance policies both provide liability coverage if someone is injured on your property, but know the limits of your policy.

Don’t forget that it’s also open enrollment time for health insurance plans on the Health Insurance Marketplace (Healthcare.gov). All plans purchased through the Marketplace will expire on December 31, 2014, no matter when your coverage began in 2014. If you would like to re-enroll, change plans or sign up for health insurance for the first time you can do so until February 15, 2015. However, anyone who wants a plan to be effective starting on January 1, 2015, needs to sign up or re-enroll by December 15, 2014. For more information about your health insurance options visit www.choosehealthde.com or www.healthcare.gov.

If you have health insurance through your employer your open enrollment period may be going on now, or may begin soon. Pay close attention to the deadlines and be sure to give yourself plenty of time to review your options. There’s much more to consider than the monthly premium alone. Make sure you review the deductible; sometimes paying a little more in premiums will make for a much lower deductible.

If you are traveling, be sure to take your health insurance information with you. Always keep a record of your medications, and if you’re flying, it’s usually safer to keep medicine in your carry-on since luggage can sometimes be lost for days—if not forever. Remember, if you need to seek medical care and you’re out-of-network you will likely be subject to higher co-pays and/or deductibles. If you need medical care for a non-emergency issue find a local urgent care clinic or medical aid unit, which will typically be cheaper than an ER visit.

For more information about insurance visit www.delawareinsurance.gov

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For more information: Jerry Grant 302-674-7303

Two Additional Health Insurance Plans Now Available on the Marketplace

 Commissioner Stewart Announces Federal Renewal of Highmark Multi-State Options

 DOVER, DE–Insurance Commissioner Karen Weldin Stewart is pleased to announce that the U.S. Office of Personnel Management, OPM, has certified two multi-state health plans to be sold on the Delaware Health Insurance Marketplace for Plan Year 2015. OPM advised the Commissioner that contracts have been signed with the Blue Cross and Blue Shield Association, on behalf of its local plans, to renew two additional health insurance options under the federal Multi-State Plan Program.

The two plans increase the number of plans offered on the 2015 Marketplace to 25, four more than this year’s choices. Multi-state plans may be sold only through the Health Insurance Marketplace and must include the essential health benefits offered on all Marketplace plans. Enrollees in Multi-State Plans are eligible for the same income-based savings as enrollees in other Marketplace plans.

All 25 plans are available until the close of open enrollment, February 15, 2015. If you want coverage to begin on January 1, 2015, you must enroll or re-enroll in a plan by December 15, 2014.  For more information, go to www.choosehealthde.com.

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For more information contact Jerry Grant at 302-674-7303