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Maine.gov > PFR Home > Insurance Regulation > Filings > 2011 Anthem Individual Rate Filing Preliminary Notice of Filing

 

STATE OF MAINE
DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

IN RE:

ANTHEM BLUE CROSS AND BLUE
SHIELD 2011 INDIVIDUAL RATE
FILING FOR HEALTHCHOICE,
HEALTHCHOICE STANDARD
AND BASIC, HEALTHCHOICE HDHP,
HMO STANDARD AND BASIC, AND
LUMENOS CONSUMER DIRECTED
HEALTH PLAN PRODUCTS

Docket No. INS-11-1000

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PRELIMINARY
NOTICE OF FILING AND
RELATED PROCEDURAL
MATTERS

 

Superintendent of Insurance Mila Kofman issues this Preliminary Notice of Filing and Related Procedural Matters in the above-captioned proceeding.

I. RATE FILING

Pursuant to Bureau of Insurance Rule Chapter 350(8)(B), notice is hereby given that on January 28, 2011, Anthem Blue Cross and Blue Shield ("Anthem") filed for approval of proposed revised rates for certain of its individual health insurance products, specifically its HealthChoice, HealthChoice Standard and Basic, HealthChoice HDHP, HMO Standard and Basic, and Lumenos Consumer Directed Health Plan products. In its amended filing submitted on February 7, 2011, Anthem proposes revised rates for these products that it asserts will produce an average increase of 9.7%. As of December 31, 2010, there are approximately 11,000 policyholders who will be affected by the proposed rate revisions.1 As identified in its filing, the largest premium increase depending on deductible level and type of contract for the nonmandated HealthChoice, HealthChoice HDHP, HMO Standard and Basic, and Lumenos products is 19.0%. Anthem requests that its proposed rate revisions become effective on July 1, 2011.

II. LEGAL STANDARD OF REVIEW

Pursuant to 24-A M.R.S.A. § 2736(2), my authority under the law is to determine whether Anthem's filing "meets the requirements that rates not be excessive, inadequate or unfairly discriminatory." I am further responsible to determine whether Anthem's filing meets all other requirements of the Maine Insurance Code and regulations promulgated thereunder.

III. PUBLIC HEARING

Pursuant to the authority granted in 24-A M.R.S.A. § 229 and the requirements of 24-A M.R.S.A. § 230, 5 M.R.S.A. § 9052, and Insurance Rule Chapter 350, please be advised that I will be providing separate notice of a public hearing that I will be holding in the abovecaptioned matter. The date, time, and location of such hearing will be provided under that separate notice. I anticipate at this time that the public hearing will be held in early April, 2011. Members of the public are invited to attend the hearing.

IV. PUBLIC COMMENT SESSIONS

In addition to the public hearing, Anthem policyholders and other members of the public may provide sworn testimony or unsworn statements for my consideration at public comment sessions that I am holding at the following times and places:

Orono:

March 14, 2011, beginning at 5:00 p.m.
University of Maine @ 100 DP Corbett Building
Orono, Maine

 

Portland: March 22, 2011, beginning at 5:00 p.m.
University of Southern Maine @ Lee Community Hall,
Wishcamper Center
Portland, Maine

 

Written comments also may be provided for my consideration in this matter as follows:

By E-mail:

 

Sarah.Hewett@maine.gov
By U.S. Mail: Superintendent of Insurance
Attn: Sarah Hewett (INS-11-1000)
34 State House Station
Augusta, Maine 04333

 

All public comments will be made a part of the record of this proceeding. Only sworn testimony will be admitted into evidence. See 5 M.R.S.A. § 9057(3). I will consider unsworn statements or comments for their persuasive value to the extent that they are relevant to facts in the record.

V. INTERVENTION

At this time, the only party to this proceeding is Anthem. At my discretion I may establish a Bureau of Insurance Staff panel as an independent participant, authorized pursuant to 5 M.R.S.A. § 9054(5). Persons wishing to intervene as parties in this proceeding shall file their applications in writing with me no later than 4:00 p.m. on February 18, 2011. If granted party status, an intervenor may immediately commence discovery as provided in Section VII below.

Applicants should either hand deliver their intervention applications to the attention of Sarah Hewett at the offices of the Bureau of Insurance, 76 Northern Avenue, Gardiner, Maine or mail them to my attention at the following address:

Mila Kofman, Superintendent
Attn: Sarah Hewett
Docket No. INS-11-1000
Bureau of Insurance
Maine Department of Professional and Financial Regulation
#34 State House Station
Augusta, Maine 04333-0034

Only those persons willing to undertake the responsibilities placed upon parties to an adjudicatory proceeding under Maine law and Insurance Rule Chapter 350 should seek intervenor status.

An applicant claiming intervention as of right pursuant to 5 M.R.S.A. § 9054(1) shall include in the application a statement either explaining how the applicant is or may be, or is a member of a class that is or may be, substantially and directly affected by the proceeding or identifying the applicant as an agency of federal, state, or local government. Applications for permissive intervention pursuant to 5 M.R.S.A. § 9054(2) shall contain a statement explaining and substantiating the applicant's interest in the proceeding. I will not grant late applications without a compelling demonstration of good cause.

Any party that opposes an application for intervention shall file a statement in opposition to the application with me by 4:00 p.m. on February 23, 2011. In my discretion I may rule on intervention applications at any time, without having to wait for the expiration of the statement in opposition to intervention filing deadline.

VI. WEEKLY MEETINGS

Except as otherwise noted in this paragraph, parties shall not communicate with respect to this proceeding with me, Bureau of Insurance staff on my hearing panel, or consultants retained by me without notice and opportunity for all parties to be present. Parties may direct questions of a strictly ministerial nature to Sarah Hewett, Legal Secretary. Procedural queries should be directed only to Thomas Sturtevant, Assistant Attorney General and my legal counsel in this proceeding.

In order to facilitate the information gathering (discovery) process and provide parties an opportunity to clarify information responses through open dialogue, I will make available certain staff members and legal counsel to meet with the parties Friday mornings from 10:00 - 12:00. No later than 4:00 p.m. on the Wednesday before a Friday meeting, any party wishing to place issues on the agenda must notify Thomas Sturtevant, Assistant Attorney General, in writing with copies to all parties and to Sarah Hewett, Legal Secretary for the Bureau. If issues arise after the Wednesday deadline, any agenda item added for a late identified issue may be addressed at the Friday meeting or postponed to the following week, at the discretion of Bureau staff. If the late identified issue is not postponed, interested persons will have the opportunity to revisit the issue the following week. All parties and other interested persons may attend the meeting, either in person or telephonically. If no requests for agenda items are received by the deadline for submissions, the Friday meeting will be cancelled, unless otherwise determined by Bureau staff. The first meeting with Bureau staff is scheduled for Friday, February 18, 2011, at the Bureau's offices in Gardiner.

I have hired the consulting firm Compass Health Analytics, Inc. to assist me in this proceeding. Compass Health Analytics shall be deemed my agent and the rules applicable to staff members set forth herein regarding communications shall apply equally to them.

VII. DISCOVERY

Upon being designated or granted party status in this proceeding, a party may immediately commence discovery by the issuance of information requests as provided for by Insurance Rule Chapter 350(10). Notwithstanding the timelines established by Insurance Rule Chapter 350(10)(B)(4), the period for responding to each information request is hereby set at four (4) business days. In cases where timely objection to discovery has been made and the objection is subsequently overruled by me, the requested information shall be provided within three (3) business days of receipt of my ruling on the objection or such other period as may be provided in that ruling.

VIII. PROCEDURE

I will conduct this proceeding in accordance with the provisions of the Maine Administrative Procedure Act, 5 M.R.S.A. chapter 375, subchapter 4; 24-A M.R.S.A. §§ 229 to 236; Insurance Rule Chapter 350; and any rulings I may make in the course of the proceeding. All parties to the proceeding have the right to present evidence and witnesses at the hearing and have the right to be represented by counsel. Failure of any party to appear may result in disposition by default with respect to that party, which I may set aside for good cause.

The Department of Professional and Financial Regulation does not discriminate on the basis of disability in the admission to, access to or operation of its programs, services or activities. Individuals in need of auxiliary aid for effective communication in this hearing are invited to make their needs and preference known to Sarah Hewett at the Bureau of Insurance, telephone (207) 624-8412, sufficiently in advance of the hearing so that appropriate arrangements can be made.

February 8, 2011 _____________________________________
MILA KOFMAN
Superintendent of Insurance

 

1 There is no rate change proposed for the mandated HealthChoice Standard and Basic products (representing less than 100 policyholders).

 

Last Updated: September 27, 2010