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PA Bulletin, Doc. No. 06-800

NOTICES

Highmark Blue Shield; Medically Underwritten Direct Pay PPO Plan; Rate Filing

[36 Pa.B. 2256]

   On April 19, 2006, Highmark, Inc. d/b/a Highmark Blue Shield submitted Filing No. 1A-BSMUPPO-06-HBS for its medically underwritten Direct Pay PPO Plan in Central Pennsylvania Region requesting an average rate increase of 6.5%. This filing will affect about 4,400 contract holders and will produce an annual premium income of about $768,000. An effective date of October 1, 2006, is requested.

   In addition to the increase in premium rates, the following changes are being made to the Medically Underwritten PPO Plan:

   *  A contract year benefit maximum of $1 million per individual combined for In-Network and Out-of-Network medical benefits is being added.

   *  Enforcing exclusion for prescription drugs used to treat mental health and substance abuse.

   *  Increasing coverage for routine physical examinations to match Highmark's preventive schedule.

   *  Adding two new Deductible Options.

   *  Effective January 1, 2007, the Plan is requesting to change the prescription drug benefit design:

   *  The deductible of $50 is moving to $100 per calendar year per individual.

   *  A $50,000 annual maximum per calendar year per individual is being added.

   *  The $3,000 out-of-pocket maximum is being removed.

   A copy of the filing is available on the Insurance Department's (Department) website at 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 Rashmi Mathur, Actuary, Bureau of Accident and Health Insurance, Insurance Department, 1311 Strawberry Square, Harrisburg, PA 17120 within 30 days after publication of this notice in the Pennsylvania Bulletin.

M. DIANE KOKEN,   
Insurance Commissioner

[Pa.B. Doc. No. 06-800. Filed for public inspection May 5, 2006, 9:00 a.m.]


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