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Maine.gov > PFR Home > Administrative & Enforcement Actions > INS 06-1000 : Hearing Decision

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

 

IN RE:

ANTHEM BLUE CROSS AND BLUE
SHIELD 2007 INDIVIDUAL RATE
FILING FOR HEALTHCHOICE AND
HEALTHCHOICE STANDARD
AND BASIC PRODUCTS

Docket No. INS-06-1000

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DECISION AND ORDER

 

By Decision and Order dated November 9, 2006, then Superintendent of Insurance Alessandro A. Iuppa denied the request of Anthem Blue Cross and Blue Shield (“Anthem”) for approval of its rate filing for 2007 individual HealthChoice, HealthChoice Standard, and HealthChoice Basic products. Thereafter, by Decision and Order dated November 14, 2006, Superintendent Iuppa approved revised 2007 rates for individual HealthChoice, HealthChoice Standard, and HealthChoice Basic products.

By the November 9, 2006 Decision and Order, the Superintendent granted Anthem’s request to make a later compliance filing to include an adjustment to the approved rates for the savings offset payment (“SOP”) if one is assessed by the Dirigo Health Agency (“DHA”) in 2007. See November 9, 2006 Decision and Oder, Section (IV)(G) at p. 14. DHA has decided to assess an SOP beginning in July 1, 2007. By submission dated April 13, 2007, Anthem filed revised rates that have been adjusted by the amount of the SOP, to be implemented beginning with the July 2007 individual HealthChoice, HealthChoice Standard, and HealthChoice Basic renewals. The Superintendent finds that Anthem’s April 13, 2007, filing is consistent with the November 9, 2006 Decision and Order, and hereby ORDERS that Anthem’s filing of April 13, 2007, is APPROVED, effective July 1, 2007. Rates hereby approved are to be effective on such a date as will assure a minimum of 30 days prior notice to policyholders.

This Decision and Order is final agency action of the Superintendent of Insurance, within the meaning of the Maine Administrative Procedure Act, 5 M.R.S.A. § 8002(4). It may be appealed to the Superior Court in the manner provided for by 24-A M.R.S.A. § 236, 5 M.R.S.A. §§ 11001 through 11008 and M.R. Civ.P. 80C. Any party to the proceeding may initiate an appeal within thirty days after receiving this notice. Any aggrieved non party whose interests are substantially and directly affected by this Decision and Order may initiate an appeal within forty days of the issuance of this decision. There is no automatic stay pending appeal. Application for stay may be made in the manner provided in 5 M.R.S.A. § 11004.

PER ORDER OF THE SUPERINTENDENT OF INSURANCE

 

Dated: April 24, 2007 ___________________________________
ERIC A. CIOPPA, Acting Superintendent of Insurance

 


 

 

Last Updated: January 16, 2014