Planned Hike in Blue Cross Fees Revoked

Under pressure from an insurance consumers’ organization and the state Department of Insurance, Blue Cross of California said Friday that it is revoking a $1,200-a-year increase in premiums for maternity and well-child care benefits for thousands of women who hold policies under the company’s Personal Prudent Buyer Plan.

A Blue Cross spokeswoman, Sharrell Blakeley, said, however, that any future buyers of the Prudent Buyer policies will have to pay at the new, higher rates that were announced in January for those holding individual, as distinct from group, policies.

The spokeswoman said there was no way of telling how many of 55,000 women policyholders would have chosen to pay the extra premiums to keep the coverage they now have.

But, she said, under the revised policy, all of these policyholders will keep their benefits for the indefinite future and will not have to pay anything more than they were paying.

The great majority of health care policyholders in California, as in other states, are insured through group plans offered by employers. Only about 15% are individual buyers.

But individual rates tend to be high. For instance, under the $250 deductible family protection plan offered by Blue Cross, monthly premiums, depending on the age of the head of family, vary between $250 and $484. Annually, that ranges between $3,000 and $5,808.

The Blue Cross spokeswoman did not say what was decisive in the company’s decision to back down from its announced increases for present policyholders, although she acknowledged that the company had received complaints about the maternity and well-child care premium raises from several quarters.

Both the head of the Los Angeles-based Insurance Consumer Action Network and officials of the state Department of Insurance claimed credit for inspiring the rollback.

Steven Miller of the consumer group said he contacted department officials to insist that they act on their own to roll back the premiums if Blue Cross was not willing to do so.

Miller said he overcame departmental reluctance to act by pointing out that many women policyholders might already have been influenced to become pregnant knowing that they were covered by insurance. But Insurance Department officials said they would have acted without Miller’s prodding.

“He wanted us to issue a formal disapproval of the increase and call a public hearing on the issue,” said Jerry Whitfield, a special deputy to Insurance Commissioner Roxani Gillespie. “We decided we could accomplish the same ends by jawboning them down, and that worked.”

The company spokeswoman said, “We are concerned about any misunderstandings on the part of women who are currently pregnant and covered by this plan. We want to emphasize that these women will continue to receive maternity and well-child coverage under the existing plan’s rate schedule.”