PROVIDENCE – Blue Cross & Blue Shield of Rhode Island filed a request with the Office of the Health Insurance Commission on Nov. 19 asking for an average rate increase of 8.1 percent for its direct-pay health insurance plans.
Last year, Blue Cross sought a 10.2 percent increase, which was reduced to 9.5 percent increase in a stipulated settlement issued Feb. 2.
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Direct-pay plans cover more than 14,500 individuals who are not eligible for health insurance through an employer, Medicare or Medicaid. BCBSRI is the only Rhode Island health insurer that provides coverage to this group.
Direct-pay plans are the only current option available for these Rhode Islanders until 2014, when the federally mandated health exchange programs will kick in under national health reform.
If approved, the new direct pay rates will go into effect on April 1. Open enrollment for direct pay will be May 15 to June 15, with an effective date of July 1.
Last year’s proposed rate hike for direct pay customers created a flurry of protest, including a Facebook page by then-gubernatorial candidate and R.I General Treasurer Frank T. Caprio, opposing the rate hike.
This year’s proposed rate hike is 2 percent less than last year’s proposed rate hike, which BSBCRI attributed to its aggressive steps to make health care more affordable. “We’ve committed to keeping hospital payments more in line with inflation. We’re changing the way that we pay doctors, and we’ve reduced our own administrative expenses by more than $15 million,” said Laura Calenda, BCBSRI spokeswoman.
Among the direct pay insurance plans now being offered are the high-risk pool program, officially known as the Pre-existing Condition Insurance Plan for Rhode Island. It offers coverage to people who have been uninsured for at least six months and have one or more of 34 pre-existing medical conditions. The federal government has allocated $13 million to Rhode Island for this program under federal health care reform.
One potential new group that may be in need of health insurance coverage are unemployed workers, who, not having found new jobs, will be losing continued health insurance coverage granted by federal stimulus as their 18-month limit expires.
