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COMMONWEALTH OF PENNSYLVANIA

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PA Bulletin, Doc. No. 05-1653

NOTICES

Keystone Health Plan West; Conversion Rates; Rate Filing

[35 Pa.B. 4983]

   By Filing No. 1-Conv-05-KHPW, Keystone Health Plan West requests approval to increase the premium rates for its conversion product. The filing requests an average increase of about 2%. This filing will affect about 700 contract holders and will produce additional premium income of about $4,400 annually. The filing requests the following changes to the current benefit:

Benefit Current Coverage New Coverage
Deductible
(Individual/Family)
$100/$200 $250/$500
Routine GYN $15 copay per visit $25 copay per visit
Diagnostic Services 100% after deductible --Advanced Imaging $100 copay per date of service not subject to deductible
--All other diagnostic services 100% after deductible
*  Standard Imaging
*  Pathology/Laboratory
*  Allergy Testing
*  Other Diagnostic Medical

   The requested effective date of the change is January 1, 2006.

   Unless formal administrative action is taken before November 16, 2005, the subject filing may be deemed approved by operation of law.

   A copy of the filing is available on the Insurance Department's (Department) website: www.ins.state.pa.us. Under the Quick Links section, click on the link ''Rate Filings Published in the PA Bulletin.''

   Copies of the filing are also available for public inspection, by appointment, during normal working hours at the Department's regional office in Harrisburg.

   Interested parties are invited to submit written comments, suggestions or objections to Cherri Sanders-Jones, Insurance Department, Insurance Product Regulation and Market Enforcement, Room 1311, Strawberry Square, Harrisburg, PA 17120, csandersjo@state.pa.us within 30 days after publication of this notice in the Pennsylvania Bulletin.

M. DIANE KOKEN,   
Insurance Commissioner

[Pa.B. Doc. No. 05-1653. Filed for public inspection September 2, 2005, 9:00 a.m.]



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