Monday, September 20, 2010

Insurance Commissioner Wayne Goodwin: "Strong Encouragement", Cooperation Led to Historic, Huge NC Health Insurance Refund


North Carolina's state Commissioner of Insurance, Wayne Goodwin, today held a major press conference at his Raleigh office.

Joining him at the surprise press conference was Brad Wilson, CEO of Blue Cross Blue Shield of North Carolina.

Goodwin announced that expert actuaries in his office had discovered and determined, in the course of their regulation of the insurance company, that the federal Affordable Care Act freed up $155.8 million in contract reserves for return to policyholders.
"I strongly encouraged Blue Cross to refund all of the money back to policyholders and, after very thorough and rigorous review and negotiations, the company agreed. I commend Mr. Wilson and the BCBSNC Board of Directors for agreeing with this outcome and also the Department's proposal to reduce the rate filing Blue Cross Blue Shield had made," said Insurance Commissioner Goodwin.
He and Wilson described the day's revelations a "win-win" for policyholders and all involved.

For more information, go to the official press release from North Carolina's Department of Insurance. In part, it said:
The refunds will be issued by the end of the year to policyholders who had Blue Advantage or Blue Options HSA for Individuals policies in force as of March 23, 2010, the date the federal law was enacted. Refunds will be proportional to premiums paid and will be equivalent to more than 1.5 months of premiums. Customers may receive lower or higher amounts depending on their specific premium rates. For example, for an average policyholder's monthly premium of about $380, the refund would be approximately $690.

"I'm pleased that the Department and Blue Cross were able to identify a way for $155.8 million to go back into consumers' wallets," said Commissioner Goodwin. "I'm also glad that we were able to negotiate a lower-than-requested rate adjustment that will save $14.5 million in future premiums for policyholders."
Insurance Commissioner Wayne Goodwin later made it clear that but for this cooperation and decision reached by the insurer and the state agency, there would have been at least two court cases, the result of which would have certainly delayed by years any refund at all.
"Having this refund now is the right thing to do now. Policyholders and households need these significant refunds without any delay," said Goodwin. "I believe our work makes for quite an economic stimulus for the State - $155.8 million is nothing to sneeze at and will help families during the upcoming holiday season and end-of-year bills coming due for hundreds of thousands of Tar Heel consumers."
WUNC Public Radio, State Government Radio, TimeWarner News 14, the Progressive Pulse Blog of NC Policy Watch, the News & Observer, WTVD-Channel 11, WRAL-TV and other media provided various viewspoints throughout the day.

For publication on September 21, USA TODAY reported on another point made by Insurance Commissioner Goodwin:
"I hope other state insurance regulators across the country look into whether these same excess contract reserves exist in the holdings of health insurance companies doing business in their states," he said. "Whether $1 or an historic amount like $155.8 million as in North Carolina, perhaps consumers and policyholders in other states are due refunds, too," Goodwin posited.
And as USA TODAY reported above, "Steve Larsen, who heads insurance oversight at the U.S. Department of Health and Human Services, said there may be others. "I really do think there may be a bigger issue at work here," he said."

North Carolina's insurance chief will ask the 2011 General Assembly for greater regulatory authority regarding health insurance.
"As our elected state Insurance Commissioner,I will continue fighting for stronger consumer protections ... Having these additions tools reinforce the value of state-based insurance regulation over purely federal regulation," concluded Goodwin.

2 comments:

Wayne Goodwin said...

The USA TODAY article had several errors in it. The most concerning one that needed correction is this: BCBSNC was not overcharging on the policies involved with this refund. BCBSNC charged approved rates by the state insurance regulator. All that happened was that the "life reserves" were no longer needed due to passage of PPACA, and both Insurance Commissioner Wayne Goodwin and BCBSNC agreed that all of those "excess reserves" had to be returned to the policyholders. The phrase "excess reserves" does not equate with overcharging or unlawful rates.

Tony said...

According to the market-research group Datamonitor, medical inflation is the reason for yearly increases of 8% in health insurance premiums. The steady progress in the development of new drugs, therapies and equipment used to diagnose medical conditions and the resulting costs are an obvious reason for this. This is understandable and everyone wants the latest in diagnostics and treatments. Equipment becomes obsolete with time and invariably the very words newer and improved mean a rise in cost.