Covered California

Officials don’t find Covered California rates unreasonable
By Chad Terhune
October 3, 2014

California regulators won’t challenge the next round of health insurance rate increases in the state exchange, but insurers’ narrow networks of doctors and hospitals are drawing tougher scrutiny.

The state’s two insurance regulators didn’t find proposed premiums for 2015 individual coverage to be unreasonable among the 10 health plans in the Covered California exchange. These rates also apply to individual coverage outside the state’s Obamacare marketplace.

Those decisions by the California Department of Managed Health Care and the state insurance department clear these rates to be used when open enrollment starts Nov. 15. Rates statewide are climbing 4.2%, on average, in the exchange for 2015.

“After careful and in-depth analysis, the DMHC found that the health plans’ proposed premium rates are actuarially sound,” said Shelley Rouillard, director of the Department of Managed Health Care.

The insurance department said it came to a similar conclusion on rates sought by Health Net Inc., the only company it was reviewing in this case.

But health insurers aren’t off the hook entirely.

Officials added that they are taking more time to examine insurance company lists of doctors and hospitals submitted for next year to ensure patients have adequate access to care.

In response to consumer complaints, the managed-health-care agency has been investigating whether Anthem Blue Cross and Blue Shield of California violated state law by misleading customers about their networks and making it too difficult to get treated.

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