Feb. 13--Indiana's Department of Insurance on Friday said it is confident that it has the regulatory process necessary to make sure the premium increases faced by those with individual health-insurance plans are justified.

The assurance comes as customers of Anthem individual plans have expressed outrage over recent premium increases of up to 38 percent.

The department has received six formal complaints from Anthem customers about premium increases on individual plans in 2010. Those complaints will trigger further review of those rate hikes, which already have been approved by the state.

Anthem customers in California reported similar increases, prompting a probe by insurance regulators in that state. The move was seized upon by President Barack Obama as a chance to reinvigorate his drive for health-care reform.

Anthem is part of Indianapolis-based WellPoint, the nation's largest commercial insurer in terms of membership.

The Indiana Department of Insurance said that as part of its standard review of rate increases, it uses an independent actuary to make sure those increases are justifiable.

"That is a process that happens on every premium increase in Indiana," said Doug Webber, acting commissioner and chief legal counsel for the department. Commissioner Carol Cutter is on medical leave.

Every premium hike has gone through that independent review before an insurer passed it on to a holder of an individual plan. Officials from the Department of Insurance said that at times, the actuary will find the insurers' planned increase to be too high and negotiate a lower rate.

"We have a productive working relationship with the commissioner's office," WellPoint spokeswoman Kristin Binns said. "We are open and transparent with sharing data, and we plan to continue doing that."

The California Department of Insurance said it uses in-house actuaries to review individual premium increases to make sure at least 70 percent of premiums goes toward benefits.

After it received what it said were "numerous complaints from irate Californians describing how Anthem's proposed rate increases would cripple them financially," the California department has ordered an independent actuary to review those policies, instead of the usual in-house review.

WellPoint, in a letter to U.S. Health and Human Services Secretary Kathleen Sebelius, blamed factors including a weak economy for leaving it with a risk pool that is less healthy and more costly.

Experts say individual policyholders can see their rates increase sharply over time as healthy members leave the group, leaving more members who are less healthy with high medical costs.

The increased cost of health care is what is driving rate increases and is indicative of the need for health-care reform, Binns said. "But it has to be reform that addresses the root cause," she said.

She added that reform should include a mandate that people buy health-care coverage in order to spread out risk and costs for all.

The state Insurance Department noted that a group in an individual insurance plan may have an average increase of 20 percent. But individual members within that group could see vastly different increases, depending on factors such as age, gender and choice of benefits -- for instance, a older member may have a 30 percent or greater increase while a younger member has a 10 percent increase.

An individual's personal claim history does not affect premiums. "This is not auto insurance," said Robyn Crosson, chief deputy commissioner of company compliance for the department.

Complaints about health insurers may be filed with the state Insurance Department at www.in.gov/idoi.

Call Star reporter Daniel Lee at (317) 444-6311.

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