Blue Cross & Blue Shield of Rhode Island Submits Direct Pay Rate Filing to the Office of the Health Insurance Commissioner

(Providence, RI, 11.25.2009)

Due largely to rising healthcare costs, Blue Cross & Blue Shield of Rhode Island (BCBSRI) Friday filed a request with the Office of the Health Insurance Commissioner (OHIC) for an average rate increase of 10.2 percent for its direct pay plans.

BCBSRI sought a rate increase of 5.9 percent last year for direct pay plans, but was denied any increase. Meanwhile, the claims costs continued to escalate and topped $1.4 billion in 2008. This made it necessary to increase premiums by approximately 10 percent to cover the rising cost of medical services provided. 

In the filing, BCBSRI also included the company’s plans for a new direct pay pricing structure, which may help reduce rates for younger subscribers, as well as a new direct pay plan to be offered in May 2010. The new plan will provide the most comprehensive coverage that the company offers for individual members, including health management programs and incentives for living a healthier lifestyle, which will also better control costs.

James E. Purcell, BCBSRI president and CEO, said the company is aggressively undergoing a business transformation designed to help improve the health of Rhode Islanders and moderate long-term healthcare costs.

“We believe that every Rhode Islander should have access to affordable, high-quality health insurance, regardless of pre-existing conditions,” said Purcell. “Innovative new product offerings, such as the new direct pay plan that we’ll be rolling out in the spring, are just one of the many ways we’re working to improve the healthcare delivery system here in Rhode Island.”

BCBSRI also offers several programs to eligible members that make health insurance more affordable:

  • AccessBlue helps qualifying individuals and families by paying a portion of their BCBSRI premium.
  • Preferred Rate offers lower rates based on age, gender, and health status, if individuals pass a health questionnaire.  
  • Wellness Reward Program allows individuals to earn a reward equal to 10 percent of their annual paid premiums if they complete a series of wellness requirements. The Wellness Reward Program is voluntary and available to only HealthMate Coast-to-Coast Direct Plan 2000/4000 members.

“Particularly during these difficult economic times, we strongly encourage members to take advantage of the many financial aid programs that we currently offer. These programs provide premium relief to those who need it most,” said Purcell.

With more than 14,000 direct pay members, BCBSRI is the only Rhode Island insurer that offers guaranteed coverage to Rhode Island residents who are not eligible for health insurance through an employer, Medicare, or Medicaid. The company currently offers four direct pay plans that can be purchased directly from BCBSRI, regardless of an individual’s health status. Additionally, BCBSRI is the only insurer in the Rhode Island market to offer guaranteed coverage, regardless of pre-existing conditions during its annual open enrollment. Currently, AccessBlue provides assistance with premiums to more than 25 percent of BCBSRI’s direct pay members.

If approved, the new direct pay rates will go into effect on April 1, 2010. The company’s new direct pay plan will be available during open enrollment, May 15 to June 15, 2010, with an effective date of July 1, 2010. The filing does not affect the rates for Plan 65 or Medicare Advantage subscribers.

Blue Cross & Blue Shield of Rhode Island is the state's leading health insurer and covers more than 600,000 members. Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association.

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