Excellus seeks double-digit rate increase

Excellus BlueCross BlueShield is seeking to raise premiums in its Utica region next year, in some cases by double-digit percentages.

Rising costs are cited by the company for the requests filed with the state Department of Financial Services Friday.

The health insurer wants to increase 2013 premiums for its most popular community-rated product, HealthyBlue, in a range from 9.9 percent to 12.1 percent. It asked to raise premiums for products like high-deductible health plans by 14.2 percent to 19.9 percent.

Additionally, Excellus also requested a 3.4 percent premium decrease for products such as direct-pay health-maintenance organization and point-of-service plans.

New York state follows a law known as the "Prior Approval" law for community-rated health plans. The Department of Financial Services has the authority to review and approve health insurance premium rate increases before any changes take effect. Community-rated health plans are those for which a large pool of subscribers pay one rate based on the claims of the entire group.

Many employers are either self-insured or use experience-rated plans, which are based on the claims of the business, not a large pool. Prior approval does not apply to experience rated large groups or self-insured health plans.

Medicare Advantage products, administered by Excellus, are under the federal government’s jurisdiction and are not included in the state filing.

The premium increases Excellus is seeking are similar in size to those the company requested last year. Then, Financial Services, after reviewing the proposals, lowered the overall average increase the company had sought from 8.8 percent to 8.32 percent.

The health insurer says it continues to see an increased use of health-care services and higher payments for many of those medical goods and services that together are driving the increased cost for coverage. Trends contributing to higher forecasts of expenses are attributed to rising costs related to such areas as surgeries, emergency services, lab tests and specialty drug prices.

"We aren’t immune to national trends in health care cost increases," said James Reed, senior vice president of Sales and Marketing for Excellus BlueCross BlueShield. "With access to new drugs, new technologies and advancements in medical procedures, people are living longer and surviving diseases, such as cancer or events such as heart attacks, in greater numbers."