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PA Bulletin, Doc. No. 05-2239

Geisinger Health Plan; Employer Group; Rate Filing

   On November 14, 2005, Geisinger Health Plan submitted a filing for the Employer Group rates, requesting a rate increase of 13.3%. The filing will affect approximately 147,165 members and generate additional revenue of $49.4 million annually. An effective date of April 1, 2006, is requested.

   In this filing, Geisinger Health Plan has requested the following benefit changes:

   *  Coverage excluded for podiatry services, acupuncture and services provided by a member's relative.

   *  Coverage excluded for care related autistic disease of childhood, hyperkinetic syndrome, learning disabilities, behavioral problems and mental retardation which extend beyond traditional medical management.

   *  Surgery for correction of obesity--a copay of $2,000 is added for facility charges.

   *  PT/OT/ST--20 visits per year for each therapy. Currently there are 45 combined dates per year.

   *  Inpatient detox--A limit of 7 days per admission on four admissions per lifetime.

   *  Add colonoscopies (professional services) for age 50 and older and hematocrit and hemoglobin for under 24 months of age.

   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 available for public inspection during normal working hours, by appointment, 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. 05-2239. Filed for public inspection December 2, 2005, 9:00 a.m.]


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