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STATE OF MAINE
Superintendent of Insurance Mila Kofman issues this Notice of Pending Proceeding and Hearing in the above-captioned matter. This matter is being consolidated with the ongoing proceeding initiated by the Superintendent under Notice of Hearing and Proceeding issued November 17, 2009, on The MEGA Life and Health Insurance Company’s filing of proposed revised rates for its small group health insurance plans. 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 The MEGA Life and Health Insurance Company (“MEGA”) has filed for approval of proposed revised rates for its individual health insurance plans. MEGA proposes revised rates for these plans that it asserts will produce an average increase of 12.6% for in-force business on its base plans (i.e., without riders). This calculation incorporates a 25% proposed increase on the “scheduled product” (Form 25875-IP ME) affecting approximately 500 insureds, and a 12.3% proposed increase on the “non-scheduled products” (Forms 25876-IP ME, 25948-IP ME, and 25949-IP ME) affecting approximately 11,900 insureds. MEGA’s targeted pricing loss ratio for the in-force base plans is 65.5%. MEGA also proposes rate increases on its in-force riders ranging from 0% to 14.8%, depending upon the rider. In its filing MEGA also includes proposed rates for new business, with a targeted pricing loss ratio of 69.4%. This results in a lower rate change from current rates for this new business. MEGA proposes that the rate change for new business be 17.9% for the “scheduled product” (Form 25875-IP ME), and 6% for the “non-scheduled products” (Forms 25876-IP ME, 25948-IP ME, and 25949-IP ME). For this new business, MEGA proposes that the rate change from current rates on the riders range from 0% to 8.3%, depending upon the rider. MEGA requests that its proposed rate revisions for both in-force and new business become effective on April 1, 2010. 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 February 25, 2010, in the Central Conference Room at the Department of Professional and Financial Regulation, Gardiner Annex, 76 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 MEGA 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 parties to this proceeding are MEGA and the Maine Attorney General. 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 January 11, 2010. 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, 76 Northern Avenue, Gardiner, Maine, or mail them to the Superintendent at the following address:
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 January 13, 2010. 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 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.
Last Updated: September 27, 2010 |
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