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PA Bulletin, Doc. No. 04-454

NOTICES

Highmark, Inc. d/b/a Highmark Blue Cross Blue Shield; Rate Increase and Benefit Changes for CompleteCare Program (Western Region); Rate Filing

[34 Pa.B. 1529]

   By filing no. 2-CCP-04-HBCBS, Highmark, Inc. d/b/a Highmark Blue Cross Blue Shield requests approval to increase the premium rates for its CompleteCare Program. The filing requests an increase of about 6.4% of current premium, or an average of $13.92 per contract per month. This will affect about 33,000 contract holders and will produce additional annual premium income of about $5.5 million. The requested effective date of the change is July 1, 2004.

   In addition to the increase in premium rates, the following benefit changes are being made to the CompleteCare Program:

   A contract year maximum of $1 million per member is being added.

   Effective January 1, 2005, the plan is requesting to change the prescription drug benefit design:

   A deductible of $100 per member per calendar year is being added. The prescription drug benefit will no longer be integrated with the medical deductible.

   A $50,000 calendar year prescription drug maximum is being added.

   A $10 minimum/$100 maximum copayment for retail generic scripts and a $20 minimum/$100 maximum copayment for retail brand scripts are being added. For mail order drugs, a $20 minimum/$200 maximum copayment for generic scripts and a $40 minimum/$200 maximum copayment for brand scripts will apply. The 20% coinsurance will continue to apply otherwise.

   The formulary is moving from open to closed.

   The design is moving from a soft to a hard mandatory generic provision.

   A copy of the filing is available on the Insurance Department's (Department) website:  www.ins.state.pa.us. To access the filing, select ''Consumer Information'' on the left side. Under the ''General Information'' heading, click on ''Notices.'' The PDF copy is at the ''Filing.pdf'' link following the name of the filing.

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

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

M. DIANE KOKEN,   
Insurance Commissioner

[Pa.B. Doc. No. 04-454. Filed for public inspection March 12, 2004, 9:00 a.m.]


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