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New reviews of health insurance rate hikes in California due soon

July 15, 2010 |  6:16 pm

The results of new investigations into health insurer rate hikes are heading to the desk of California Insurance Commissioner Steve Poizner in the coming week.

A state consultant who found errors in Anthem Blue Cross’ rate filings is expected to deliver his findings on two of its competitors, Aetna Inc. and Blue Shield of California.

The consultant, actuary David Axene, is trying to determine whether the insurers spend at least 70 cents of every dollar they collect in premiums on medical claims, as required by state law.

Axene found numerous calculation mistakes in Anthem’s paperwork in April, prompting California’s largest for-profit health insurer to cancel rate hikes averaging 25% -- and reaching as high as 39% -- for many of its estimated 800,000 individual policyholders.

The Woodland Hills insurer has submitted a new plan calling for an average hike of 14% and a maximum of 20%. Axene is examining that filing and is expected to report to the state by mid-August, officials said.

Aetna withdrew its plan last month for an average 19% rate hike for its 65,000 individual policyholders after its own review uncovered math errors about the same time that Axene discovered the mistakes. The insurer filed a revised plan, which Axene is now studying.

Blue Shield is seeking rate hikes averaging 18% for its 240,000 individual policyholders. It is waiting for Axene’s report to move forward.

Axene also will review a filing submitted Thursday by Health Net Inc. and report back in six weeks, officials said. Health Net is seeking an average 16% rate hike for 38,000 individual policyholders, according to its filing.

For a look at the actuary behind the reviews, check out a profile of Axene in The Times on Friday.

-- Duke Helfand