Can Oklahoma Health Insurance Premiums Spike In Response To Fine?

Posted November 30, 2016

This month, Blue Cross Blue Shield announced that it intends to increase all individual Affordable Care Act compliant plans by 76 percent, after the company recently faced a hefty fine ($3 million)—the largest in state history, in fact–from the Oklahoma Insurance Commissioner for providing “poor customer service” (specifically, for issues arising out of billing and claim handling). For some, this rate increase could bring their health insurance costs as high as $1,875 per month (or $22,500 per year).

And yet, what the company likely is not disclosing is that its top executives recently received $20 million in raises and additional compensation, and the top executives working for the parent company (HCSC) received close to $57 million in salary and bonuses last year.

But is this legal? Can companies like Blue Cross Blue Shield just decide to increase their rates by that much, particularly given that having health insurance is now mandatory by law?

Litigation over Rising Rates

In fact, insurance companies have been sued recently for cost increases. For example, Transamerica Life Insurance Co. was sued earlier this year for raising the cost of insurance on some universal life insurance contracts. Similarly, lawsuits have also been filed over health insurance premium increases under the argument that the new rates would place a burden on public education employees who have limited salaries.

Another Strike for Blue Cross Blue Shield in Oklahoma

Unfortunately, this appears to be strike three, so to speak, for Blue Cross Blue Shield in Oklahoma: In addition to being fined by the state Commissioner—and now increasing health insurance premium costs significantly—the company was also involved in a recent legal controversy concerning refusing to cover cancer treatments for two Oklahoma citizens. The company reportedly covers approximately one-third of all Americans when it comes to health insurance, and is also being sued under antitrust claims alleging that it is conspiring to divvy up markets, avoid competing with one another, drive up customers’ prices, and decrease the amounts paid to doctors and other healthcare providers.

Your Rights

Under the Affordable Care Act, any large proposed increases are supposed to be evaluated by experts in order to ensure that they are based on reasonable cost assumptions—and valid, credible evidence—in a process known as effective rate review standards. Insurance companies are also supposed to provide justification to customers as to why they are putting forth any significant rate increases.

Attorneys Protecting the Insured in Oklahoma

The Bennett Law Firm has been helping victim policyholders who are wrongfully denied their benefits or have their policies raised to unaffordable, unfair levels by health insurance companies for years, serving our communities in Oklahoma City and surrounding areas. We know the actions of insurance companies can have devastating repercussions on your health and that of your family’s. Contact one of our experienced bad faith insurance attorneys today to schedule a free consultation.