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

IN RE:

ANTHEM BLUE CROSS AND BLUE
SHIELD 2009 INDIVIDUAL RATE
FILING FOR HEALTHCHOICE,
HEALTHCHOICE STANDARD
AND BASIC, AND LUMENOS
CONSUMER DIRECTED HEALTH
PLAN PRODUCTS

Docket No. INS-09-1000

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NOTICE OF PENDING
PROCEEDING AND HEARING

 

Superintendent of Insurance Mila Kofman issues this Notice of Pending Proceeding and Hearing in the above-captioned matter.

I. PENDING PROCEEDING

Pursuant to 5 M.R.S.A. § 9052, 24-A M.R.S.A. § 230, and Bureau of Insurance Rule chapter 350, the Superintendent hereby gives notice that Anthem Blue Cross and Blue Shield (“Anthem”) has filed for approval of proposed revised rates for certain of its individual health insurance products, specifically its HealthChoice, HealthChoice Standard and Basic, and Lumenos Consumer Directed Health Plan products. Anthem proposes revised rates for these products that it asserts will produce an average increase of 14.5%. As identified in its filing, the largest premium increase depending on deductible level and type of contract for HealthChoice is17.2%, for HealthChoice Standard and Basic is 7.7%, and for Lumenos is 34.1%. As of November 2008 there are 12,049 policyholders who will be affected by the proposed rate revisions. Anthem requests that these rate revisions become effective on May 1, 2009.

II. PUBLIC HEARING

Pursuant to the authority granted in 24-A M.R.S.A. § 229 and the requirements of 24-A M.R.S.A. § 230, 5 M.R.S.A. § 9052, and Insurance Rule chapter 350 the Superintendent hereby gives notice that she will hold a public hearing in the above-captioned matter beginning at 9:00 a.m. on March 12, 2009, in the Central Conference Room at the Department of Professional and Financial Regulation, Gardiner Annex, 122 Northern Avenue, Gardiner, Maine. Members of the public are invited to attend the hearing.

III. HEARING OBJECTIVE

The purpose of the hearing is to consider whether the revised rates proposed by Anthem are excessive, inadequate, or unfairly discriminatory as set forth in 24-A M.R.S.A. § 2736, and otherwise meet the requirements of the Maine Insurance Code and regulations promulgated thereunder.

IV. INTERVENTION

At this time, the only party to this proceeding is Anthem. At her discretion, the Superintendent may establish a Bureau of Insurance Staff panel as an independent party, authorized pursuant to 5 M.R.S.A. § 9054(5). Persons wishing to intervene as parties in this proceeding shall file their applications in writing with the Superintendent no later than 3:00 p.m. on February 3, 2009. If granted party status, an intervenor may immediately commence discovery as provided in Section V below.

Applicants should either hand deliver their intervention applications to the attention of Pat Galouch at the offices of the Bureau of Insurance, 124 Northern Avenue, Gardiner, Maine or mail them to the Superintendent at the following address:

Mila Kofman, Superintendent
Attn: Pat Galouch
Docket No. INS-09-1000
Bureau of Insurance
Maine Department of Professional and Financial Regulation
#34 State House Station
Augusta, Maine 04333-0034

Only those persons willing to undertake the responsibilities placed upon parties to an adjudicatory proceeding under Maine law and Bureau of Insurance Rule chapter 350 should seek intervenor status.

An applicant claiming intervention as of right pursuant to 5 M.R.S.A. § 9054(1) shall include in the application a statement either explaining how the applicant is or may be, or is a member of a class that is or may be, substantially and directly affected by the proceeding or identifying the applicant as an agency of federal, state, or local government. Applications for permissive intervention pursuant to 5 M.R.S.A. § 9054(2) shall contain a statement explaining and substantiating the applicant’s interest in the proceeding. The Superintendent will not grant late applications without a compelling demonstration of good cause.

Any party that opposes an application for intervention shall file a statement in opposition to the application with the Superintendent by 3:00 p.m. on February 5, 2009. The Superintendent in her discretion may rule on intervention applications at any time, without having to wait for the expiration of the statement in opposition to intervention filing deadline.

V. DISCOVERY

Upon being designated or granted party status in this proceeding by the Superintendent, a party may immediately commence discovery by the issuance of information requests as provided for by Insurance Rule Chapter 350(10). Notwithstanding the timelines established by Chapter 350(10)(B)(4), the period for responding to each information request is hereby set at five (5) business days. In cases where timely objection to discovery has been made and the objection is subsequently overruled by the Superintendent, the requested information shall be provided within three (3) business days of receipt of the Superintendent’s ruling on the objection or such other period as may be provided in that ruling.

VI. HEARING PROCEDURE

The Superintendent will conduct this proceeding in accordance with the provisions of the Maine Administrative Procedure Act, 5 M.R.S.A. chapter 375, subchapter 4; 24-A M.R.S.A. §§ 229 to 236; Bureau of Insurance Rule chapter 350; and any rulings of the Superintendent. All parties to the proceeding have the right to present evidence and witnesses at the hearing and have the right to be represented by counsel. Failure of any party to appear may result in disposition by default with respect to that party. The Superintendent, however, may set aside a default for good cause.

The Department of Professional and Financial Regulation does not discriminate on the basis of disability in the admission to, access to or operation of its programs, services or activities. Individuals in need of auxiliary aid for effective communication in this hearing are invited to make their needs and preference known to Pat Galouch at the Bureau of Insurance, telephone (207) 624-8437, sufficiently in advance of the hearing so that appropriate arrangements can be made.

 

January 16th, 2009 ___________________________________
MILA KOFMAN
Superintendent of Insurance

 

Last Updated: February 12, 2009