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Highmark discusses factors affecting proposed rate hike

Delaware’s Insurance Commissioner hosted a public information session Monday night regarding Highmark’s proposed rate increase for Affordable Care Act healthcare plans.

Insurance Commissioner Trinidad Navarro says the sessions are designed to dispel misinformation and shed light on what goes into proposed rate increases.

“I can’t tell you how many phone calls, Facebook messages, contacts from people saying: ‘my employer’s already charging me x amount of dollars for my healthcare, I can’t afford another 32%.’ What folks don’t know – many folks don’t know – is that it does not affect those types of plans," Navarro said.

Highmark’s 33.6% proposed rate increase only applies to individual ACA plans; small group policies face only a potential 5.2% proposed hike. Highmark’s actuary Jeff Scheib said that's because, among their 20,000 small business policy holders, historical experience more closely aligns with future projections.


Sheib said the actual rate increase varies by plan design, and he detailed numerous factors that contribute to the hike: including but not limited to rising prescription drug and healthcare costs, higher utilization rates and uncertainty at the federal level. Sheib said the annual claim trend of 11 percent is consistent with trends in Delaware's individual ACA marketplace.

He added that Highmark has seen higher-than-anticipated medical costs for newly insured ACA individuals, driving up greater utilization rates. Additionally, he said they've seen significant adverse selection: when people buy coverage only when they plan to use the benefits.



"It's the actuary's job to determine the right balance of predicted claim costs, to ensure the future solvency of our company so that we can continue to be here for our policy holders when they need us," Sheib.


Highmark President Tim Constantine emphasized the rate increase isn’t designed to recoup past losses.

“I want to be clear that neither litigation nor the historical losses impact our rate filings," Constantine said. "Our rate filings are by their very nature forward-looking and applied to anticipated risk for 2018 for our ACA products.”

The rate hike is currently under review by independent actuary Art Lucker, who has reviewed over 200 individual and group ACA rate filings. After that, it will be submitted to CMS for review before Highmark must make a decision in late September about whether or not they'll continue to offer plans on Delaware’s exchange.

49-year-old Rich Mulhern was one of only a few residents who showed up for the session, but the Insurance Commissioner’s office says it’s received close to 100 online comments. Mulhern is concerned about how expensive his ACA plan has gotten. He says his monthly premium has gone up around $100 every year.


“Where am I supposed to get this extra money from? It’s very frustrating that they keep wanting to increase, increase and partially because I just get a year older," he said.


Public information sessions will be held in Kent County Wednesday evening, and in Sussex County Thursday evening. Here are the details of those meetings:


Kent County

Wednesday, August 2, 2017 -- 6 pm to 8 pm

Delaware Department of Insurance - 841 Silver Lake Blvd, Dover, DE 19904

Sussex County

Thursday, August 3, 2017 -- 6 pm to 8 pm

Delaware Tech - Owens Campus - 21179 College Dr, Georgetown, DE 19947

Those with questions should contact the Division of Consumer Services at (302) 674-7310 or by email at





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