Ohio Orders Health Insurer to Refund $6M to Policyholders

June 30, 2010

More than 45,000 Ohioans will receive a refund or credit from Community Insurance Co., also known as Anthem, according to Insurance Director Mary Jo Hudson.

The Ohio Department of Insurance alleges that Anthem has been charging consumers rates for health insurance that were not consistent with the rates it filed with the department.

The department began an investigation after receiving “multiple consumer complaints earlier this year,” Hudson said. “We are pleased that Anthem has cooperated with our investigation, stepped up to the plate to provide refunds or credits to policyholders, and agreed that no rates will be increased in this action.”

“Even though some members would have seen an increase in their premiums with this adjustment, Anthem has chosen not to issue those increases,” said Erin Hoeflinger, president, Anthem Blue Cross and Blue Shield in Ohio. “We take our duty very seriously and we used the rates that we believed were in accordance with the new regulations.

“Since first contacted by the department, we have worked to ensure that this issue is resolved and appreciate their willingness to work with us in a constructive manner.”

The Ohio DOI and Anthem entered into a Consent Order on June 28 outlining the terms of the refund arrangement, along with requirements on Anthem to assure that such an event does not occur again in Ohio.

Anthem has also agreed to reimburse the department for all of its expenses associated with the investigation and enforcement of the Consent Order.

The department’s investigation found that the rates Anthem filed on Nov. 6, 2009, for use as of October 2009 with the department were not consistent with the rates they were charging policyholders.

These filings were made as a result of HB 1, which was effective October 2009.

The types of Anthem policies affected include:

  • Blue Access Plans 1 to 4
  • Blue Traditional Plans 1 to 3
  • Blue Economy
  • Blue Access Saver
  • Lumenos HIA
  • Lumenos HIA+
  • TAA
  • Blue Access Saver Plans (collectively the “Subject Policies”)

A copy of the Consent Order is available on the Department’s Web site at https://secured.insurance.ohio.gov/Agents/JournalSearch/journalsearch.aspx.

Source: Ohio Department of Insurance

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