MA SG Rate Filing

Massachusetts Small Group Rate Filing Updates

June 24, 2010 - Massachusetts State Appeals Board Votes in Favor of Harvard Pilgrim Health Plan

After the Division of Insurance rejected the Massachusetts Association of Health Plans' original appeal, the MAHP filed a suit against the DOI. In the latest development, the Massachusetts State Board of Appeals - who will also be hearing the other MA health insurers' appeals - has sided with Harvard Pilgrim Health Care in agreeing that the rates they had originally filed with the state to charge small groups were in line with what they needed to charge in order to fulfill their financial obligations to providers.

This many not be the end of the story, as the Attorney General does have the opportunity to appeal the decision in Suffolk Superior Court. However, if the insurers ultimately do win out there are likely to be immediate and possibly even retroactive rate implications for small groups.

To read the full article from Boston.com, click here.

Injunction Sought by MAHP Denied - April 13, 2010

A Suffolk Superior Court judge yesterday blocked a request by the Massachusetts Association of Health Plans (MAHP) for an injunction regarding the recent DOI ruling capping small group base rates at 4.8% for April 1, 2010. The rejection of the injunction is not the end of the line. MAHP is now appealing the ruling to the DOI. If the appeals are rejected, MAHP is expected to sue in court.

Massachusetts Small Group Rate Filing Update - April 1, 2010

On Thursday, April 1, 2010, through emergency regulation, Governor Patrick and the Massachusetts Division of Insurance disapproved 235 of the 274 rate increases filed by health insurers for small businesses that became effective April 1, 2010. The disapproval is directly aimed at the base rates that insurers file with the Division of Insurance, which the carriers then use to formulate the premium rates that are charged to employer customers.

This ruling directly impacts small groups in Massachusetts (under 50 employees) who renewed on or after April 1, 2010. Those who renewed on April 1st may recognize relief in the form of lower premiums. As the carriers need to catch up to the legislation, premium relief will be retroactive to April 1, 2010 and it may take a couple of billing cycles for the credit to appear.

The DOI issued letters to the carriers yesterday outlining the reasons for the disapprovals.

In addition, the regulation requires that ongoing carriers file small-group rates 30 days before their effective date and that additional actuarial information be included with the proposed rate changes allowing the Division of Insurance to perform an in-depth evaluation of the proposed rate changes.

For more information visit www.mass.gov/doi.

Please contact your Longfellow representatives with any questions.

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