Thousands of Highmark 2019 plan participants and groups to receive checks

After announcing a reduction of Delaware Health Insurance Marketplace rates for the upcoming enrollment year, Insurance Commissioner Trinidad Navarro has more good news for residents who purchase insurance on the Delaware Health Insurance Marketplace, those who purchase Highmark Blue Cross Blue Shield Delaware plans outside of the exchange in the individual market, and for Highmark small group policyholders, announcing more than $21.5 million in rebates for 2019 participants.

“Now, more than ever, we need to make sure that every resident and small business can afford the health insurance they need for their families and employees. These rebates, combined with the ACA health insurance rate reduction for the coming year, do just that,” said Commissioner Navarro. “This is just one of many ways we are working to reduce the cost-of-care our residents experience in the health care system.

For the first time in the history of Delaware’s individual health insurance market, more than $12.6 million will be returned to 19,273 policyholders, with the average rebate being $656. Highmark small groups, often small businesses, will receive more than $8.8 million in cumulative return. 2,779 groups will receive an average rebate of $3,198, with more than 175 groups receiving rebates over $10,000. Employers can consider using these dollars to enhance benefits, reduce premiums for employees in future policy years or provide refunds directly to group health plan participants.

Communications will be sent to policyholders in September and checks for both individual policyholders and small groups will be sent the week of September 21. Those in the individual market with rebate questions can contact Highmark at 800-544-6679. Small group employers with rebate questions can contact their insurance producer, or Highmark at 800-241-5704.

These rebates are required by the Delaware Department of Insurance according to Medical Loss Ratio (MLR) measurements set by the Affordable Care Act, which are meant to ensure that insurers are spending a majority of premiums on health claims and clinical services, not taking those dollars for profit or administrative expenses. The rebate system creates balance when data shows that this ratio was off in a previous year. Not every policy will receive a rebate. MLR review for the 2020 plan year will shine a light on changes in insurance usage due to COVID-19 and will be released in 2021.

On August 31, Commissioner Navarro announced the Delaware Health Insurance Marketplace would see an average decrease in rates of 1% for individual plans. Highmark small group plans will see an average premium decrease of 3%.

DOVER, DE— As a result of multiple consumer complaints, the Delaware Department of Insurance has been made aware of a security breach, involving Summit Reinsurance Services, Inc. (“SummitRe”) and BCS Financial Corporation, both subcontractors of Highmark Blue Cross Blue Shield of Delaware. The breach affects thousands of Delawareans with employer-paid plans. As reported by Karen Kane, Director of Privacy and Information Management for Highmark Blue Cross Blue Shield of Delaware, the breach impacts a total of sixteen current and former Highmark self-insured customers and approximately 19,000 of their members. In response, Commissioner Navarro issued the following statement:

“We are aware of the reported breach. I would like to ensure Delaware consumers that the Department of Insurance takes this matter seriously and is currently investigating how this occurred. I have directed my staff to closely monitor the situation as it develops. Many Delawareans have received mailed correspondence frpom SummitRe explaining the breach (See Attachment). Unfortunately, we fear that many may have misinterpreted or inadvertently discarded the letter as some form of a sales ad (due to the fact that they had not purchased any line of insurance from SummitRe).  If consumers have received a letter from SummitRe regarding this situation and have questions, they may contact the Delaware Department of Insurance at 1-800-282-8611 or 302-674-7300, or by e-mail at consumer@delaware.gov.”

The Commissioner has ordered an investigation into the reported breach. Highmark Blue Cross Blue Shield of Delaware is cooperating with the Delaware Department of Insurance to resolve the matter.

PDF attachment: 19000-de-consumers-affected-by-data-breach-1-13-17

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Contact: Vince Ryan

Office: (302) 674-7303

Mobile: (302) 387-7670

Email: vince.ryan@delaware.gov

DOVER, DE – Insurance Commissioner Karen Weldin Stewart today released Delaware’s Qualified Health Plan average rates for Plan Year 2017.

The Commissioner recommended approval of a 32.5 % average rate increase in the individual market for Highmark Blue Cross Blue Shield of Delaware. The approved average rate increase for the small group market for Highmark’s plans is 2.74%.

Aetna Life Insurance Company received an average of 22.8 % increase in the individual market and Aetna Health Insurance Company received an average increase of 23.6 %. In the small group market, Aetna Life received an average increase of 15.2 % and Aetna Health received an average increase of 19.7 %.

The Commissioner, after a thorough actuarial review of rate requests submitted by the insurers’ in June, submitted her approved rates to the Centers for Medicare & Medicaid Services (CMS) in August. CMS subsequently conducted a final review of the Aetna Health and Aetna Life requests and concurred with the Commissioner’s recommendations.

The Aetna Health rate reflects a 1.4% reduction of the insurer’s individual rate request made in June, and Aetna Life’s rate is a 1.1% reduction of its June request. In the small group market, Aetna Health’s rate reflects a 3.5% reduction of the original request, and Aetna Life’s rate is 3.4% less than requested.

The Commissioner originally reduced rates requested by Highmark BCBSD and submitted them to CMS. However, CMS urged Delaware and neighboring states to reconsider their submissions and accept Highmark’s original rates as filed. Several BCBS entities have left, threatened to leave, or reduced coverage in other states’ marketplaces for 2017. Aetna recently announced they are leaving the ACA exchanges in eleven different states, but will remain in Delaware for 2017. Given this fluid environment, and to maintain a stable and competitive marketplace in Delaware, the Commissioner and her actuaries agreed with CMS’s analysis and approved the original rates requested by Highmark.

The approved rates are average rates; some consumers may pay more, some less. Under Delaware law, the Commissioner evaluates the reasonableness of rates to ensure they are not excessive, inadequate or unfairly discriminatory.

As always, in all lines of insurance, the Department recommends consumers shop around for their insurance needs. Costs can vary substantially between insurers. For the Marketplace plans, please use only the official sites, https://www.healthcare.gov and http://www.choosehealthde.com.

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 http://www.delawareinsurance.gov/departments/rates/ratefilings.shtml . All 2017 rates with justifications, along with information regarding non-marketplace health plans and on- and off-marketplace dental plans, may be found on the Department’s Rate Filings page: http://www.delawareinsurance.gov/departments/rates/ratefilings.shtml

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Highmark, Aetna Request Substantial Health Insurance Rate Increases for 2017

Commissioner Stewart Announces Public Information Sessions

Dover, DE – Commissioner Karen Weldin Stewart announced today that she has received rate request filings from Highmark Blue Cross Blue Shield of Delaware, Aetna, Inc. and Aetna Life for individual and small group plans to be offered on Delaware’s Health Insurance Marketplace in 2017. Highmark is asking for a 32.5% increase in the individual market, while Aetna, Inc. requests 25.0% and Aetna Life 23.9%. In the small group market, Highmark seeks a 2.7% increase, Aetna, Inc. asks for 23.2%, and Aetna Life requests 18.6%.

“These large rate increase requests are occurring in many states across the country, and I know they will be a burden for many Delawareans,” said Stewart. “The proposed increases are substantial and I’m going to do my best to reduce them. As is the case with every rate request I receive, I am instructing my actuaries to aggressively examine Highmark’s and Aetna’s supporting data for their requests.”

“I remind consumers that these are proposed rates, not final rates,” added Commissioner Stewart, who also announced that the Insurance Department will conduct public information sessions to receive comment on the proposed increases. The sessions will take place at the following locations in the three counties:

Monday, June 20th at 6:00 p.m. Carvel State Office Building
Auditorium/Mezzanine Level
820 N. French Street
Wilmington, DE 19801

Tuesday, June 21st at 11:00 a.m. Delaware Tech Owens Campus
College Theater, Arts & Science Center
21179 College Drive
Georgetown, DE 19947

Tuesday, June 21st at 6:30 p.m. Delaware Department of Insurance
Sussex Conference Room, First Floor
841 Silver Lake Boulevard Dover, DE 19904

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 until July 15, 2016. Comments may also be submitted in writing to:

Delaware Department of Insurance

Attn: Health Insurance Rate Comments

841 Silver Lake Blvd.

Dover, DE 19904

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 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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View the Health Insurance Rate Filings webpage: http://www.delawareinsurance.gov/departments/rates/ratefilings.shtml

www.delawareinsruance.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