Share this article

print logo


Individuals and businesses covered by health maintenance organizations will pay 7.6 percent to 13.1 percent more for medical insurance next year.

State regulators announced rate increases today for all three local HMOs, and in one case the increase was higher than what the insurer sought.

The rulings from the state Insurance Department will take effect Tuesday and will affect nearly 350,000 Western New York families.

Community Blue, the HMO owned by Blue Cross of Western New York, received an 8.3 percent increase instead of the 1.2 percent increase the company requested.

Independent Health asked for a 7.9 percent increase but received a 7.6 percent increase.

Health Care Plan also received a lower-than-requested increase. The insurer asked for 13.7 percent and received 13.1 percent.

In all three cases, the state pointed to the HMOs' financial condition in approving the increases. For example, Community Blue was projecting a $9.9 million underwriting loss next year, even with its requested increase.

HMOs, which usually cost more than most medical insurance plans, generally require personal physicians' consultations prior to approval of specialized medical care. They also offer a wider variety of options not available
in more traditional plans.

When the HMO increases are translated into dollars, they mean:

Community Blue members will pay $100.15 a month for single coverage, up from $92.81. Family coverage will increase from $250.61 to $270.41.

Independent Health members will pay $86.94 a month for Gold Plan single coverage, up from $81.46. Family coverage will increase from $220.35 to

Health Care Plan members will pay $90.47 a month for basic single coverage, up from $79.50. Family coverage will increase from $204.32 to $232.51.

A state spokeswoman said no decision has been made on increases sought by Blue Cross and Blue Shield. She said a decision could be made by Monday.

Blue Shield, with 200,000 members, is seeking an average 17.1 percent increase. Blue Cross wants a 6 percent increase to cover its 428,000 members.

The state granted the non-profit insurers rate increases last January. If the proposed increases are approved, Blue Shield's rates will have increased 40 percent and Blue Cross' 25 percent over the last year.

Insurers have said the increases are necessary because health care costs are rising and will continue to rise.

They attribute the spiraling costs to increased physician fees, increased use of medical services, new and expensive technology, the practice of defensive medicine to avoid malpractice lawsuits, an aging population and unhealthy lifestyles.

Officials at Blue Shield, which reported a $6.5 million loss in 1989, have said the rate increase also would help bring reserves up to a level required by the state.

The state also may increase health insurance rates for Blue Cross by more than its request because the proposed rates would mean a $17.7 million for Blue Cross.

But a Blue Cross official said the insurer could cover the loss with its reserves and still end the year with a $30 million surplus.

There are no comments - be the first to comment