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DISB Rescinds Health Insurance Rate

Monday, March 8, 2010
The agency rescinds an approved rate increase after investigating a consumer’s complaint about his unusually high health care premium in 2010.

Washington, DC - The DC Department of Insurance, Securities and Banking (DISB) last week issued an order to rescind the health insurance rate increase for a comprehensive major medical policy it had initially approved for CareFirst BlueCross BlueShield. The agency did this after investigating a consumer’s complaint about his unusually high health care premium in 2010. The order provides that affected customers will revert to their previous premiums until CareFirst files and receives approval for a revised rate. The effective date of the new rate shall begin after 90 days of prior notice of the new rates to subscribers.  The order also provided for a refund of any overpayments plus interest. “This is National Consumer Protection Week, and DISB has pursued regulatory measures that keep on protecting consumers’ financial interests,” said DISB Commissioner Gennet Purcell who signed the order March 3, 2010. “Residents can make a difference when they file complaints with the agency, even if they only suspect that the activity is unfair, abusive or excessive.” DISB initially approved a filing for the individual, non-Medigap indemnity health insurance policy in October 2009, where the increased rate was to be in effect from Jan. 1, 2010. However, based on one consumer’s complaint earlier this year, DISB staff requested additional documentation from the insurer, and realized it did not meet specific requirements to warrant such an increase. There was an administrative error made by CareFirst that provided an incorrect ratio, which was used to approve the 35 percent increase. Without the error, the information in the rate filing would not support the requested increase; therefore, the Commissioner rescinded the rates. As of March 7, 2010, the rates that were approved in October are no longer in effect. The insurer should continue charging individuals at the rates they were paying before Jan. 1, 2010, and it should refund any amount charged in excess of the rates charged prior to Jan. 1, 2010, with interest at 5 percent on the excessive amounts charged. IB-RF-01-10 Group Hospitalization and Medical Services, Inc., Rate Filing #1284 DC DISB is a local government regulator for the financial-services industry and consumer protection agency. Residents should feel free to call the agency at (202) 727-8000 to file a complaint about any financial-services provider, to see whether a firm is licensed to do business in the District of Columbia, and to request consumer information or a speaker.