Lawmakers to question WellPoint: Indiana House panel expected to put insurer, state regulators on the spot over premium hikes [The Indianapolis Star]

Feb. 17--IN CALIFORNIA, Regulators Asked For -- and received -- an agreement from Indianapolis-based health insurance giant WellPoint to delay hefty premium increases on its individual health insurance plans.

In Maine, state regulators are planning public-comment sessions on WellPoint/Anthem premium increases on individual plans to take effect in July. Maine lawmakers also are pushing for Congress to investigate Anthem's rate hikes in their state.

But in Indiana, where some Anthem members have reported premium increases as high as 38 percent, lawmakers see no such action coming from Indiana regulators.

"States have tried to battle these" increases, said House Speaker B. Patrick Bauer, D-South Bend. "Our state did not."

Today, Indiana lawmakers are expected to turn up the heat on regulators and WellPoint.

Acting Indiana Insurance Commissioner Doug Webber and a representative from Anthem are scheduled to appear this morning before the House Insurance Committee to talk about premiums. Rob Hillman, president of Anthem Blue Cross and Blue Shield of Indiana, also is scheduled to attend the hearing.

Committee Chairman Craig Fry, D-Mishawaka, has criticized rate increases on Anthem individual plans. Last week, he said it's time to re-examine the authority and role of the Indiana Department of Insurance when it comes to keeping watch over a large health insurer such as WellPoint.

Webber, chief legal counsel and acting commissioner for the Indiana Department of Insurance, said he's ready to hear what lawmakers have to say. "I'm receptive, if they have ideas or suggestions."

WellPoint said it is responding to concerns about the rate increases in Indiana. Company spokeswoman Kristin Binns said Tuesday that Anthem will use an independent actuarial firm to review all new and pending premium-rate filings for the Indiana individual market in 2010.

"We understand and strongly share our members' concerns over the rising cost of health-care services and the corresponding adverse impact on insurance premiums," Binns said in a statement.

The Indiana Department of Insurance has approved WellPoint rate increases that will take effect March 1. The department already uses independent actuaries to verify that all premium increases on individual plans are warranted.

But, unlike in Maine, Indiana's insurance regulators have no system for public comment before premium increases are enacted. Individual consumers may file a complaint with the department, which then triggers a review process.

Webber said Indiana uses a model-regulation benchmark from the National Association of Insurance Commissioners for price increases on individual plans that at least 55 percent of each premium dollar be spent on health benefits.

California -- where individual Anthem customers reportedly are facing premium increases as high as 39 percent -- requires individual plans to pay at least 70 percent of each premium dollar for benefits.

But Webber said requiring that sort of payout could hurt competition. "If you move that loss ratio too high, companies will not put a product out. They will close up the products they do have," he said.

Congress also is turning up the heat. WellPoint on Tuesday canceled its annual investor day, scheduled for Feb. 23, to instead focus on preparing for questions on premiums it will face Feb. 24 from the U.S. House Energy and Commerce Subcommittee on Oversight and Investigations.

WellPoint, which provides benefits to about 34 million people, is the nation's largest commercial insurer in terms of membership. WellPoint's Anthem has about 2.8 million members in Indiana, with less than 5 percent of those purchasing individual policies.

But those individual Anthem policies -- the main option of coverage for those who don't have coverage through work, or are not eligible for government plans such as Medicare -- have become the center of a growing controversy.

President Barack Obama, looking to renew his push for health-care reform, criticized WellPoint for the hefty California hikes. And U.S. Health and Human Services Secretary Kathleen Sebelius said she wasn't buying WellPoint's explanation that the increases in California were due to a bad economy and rising health costs.

Some customers of individual Anthem plans in Indiana say they can't understand how their premiums could jump so much in one year.

Bob Fuhs, a self-employed residential contractor from Indianapolis, said he was surprised to see his premiums jump from $182.07 a month to $247.20 effective Jan. 1 -- an increase of 36 percent for an individual plan that includes a $5,000 in-network deductible before coverage kicks in.

"I can't fathom that," said Fuhs, 53.

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

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