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Consumer Complaint

Anthem Premium Increases

Companies Involved: 
Anthem BC/BS Ohio -- Ohio Deptartment of Insurance
Issue Area: 
Insurance

I've sent emails to Ms. Carmen Balber and Ms. Pressley on this matter. Both email messages contained the letter to Ms. Erin Hoeflinger, President Anthem BC/BS Ohio. Today I've sent emails to Ms. Sebelius and members of her staff. If you see any benefit in using this story, please contact me. Linda A. Scott "Ms. Sebelius, I know my story is not unique. In “fighting” a 40% increase in 2009 and a subsequent 29% increase this year, I’ve run out of options and will be forced to drop my Health Insurance Coverage. Not good for Anthem, me or Health Care Reform. NET: 1. I have been an Anthem policy holder for 37 years. Currently self-employed with an individual policy (Cincinnati, OH) premiums have been paid to Anthem directly by me since 1996; prior to that time premiums were paid by my former employers. 2. Zero claims for 34 years. 3. 2007 Stage 1 Breast Cancer. NO lymph node involvement NO chemotherapy. Currently totally clear; excellent prognosis. 4. October 1, 2009 – 40% premium increase. ($368.88 to $509.38 -- $5,000.00 deductible) 5. Filed complaints with Anthem and the Ohio Department of Insurance in October 2009. Anthem responds that increase is “actuarially sound.” 6. In spite of an ODI Consent Order signed in June 2010 where 45,000 Ohio policy holders received a premium rebate, ODI agrees with Anthem and informs me that I am in the “highest risk category.” 7. A year completely wasted with ODI and appeals to elected officials. 8. I vigorously reject this "high risk" classification and have requested a written detailed explanation / justification of this classification from both Anthem and ODI. 9. October 1, 2010 – 29% premium increase, in spite of NO CLAIMS in 2010 and a March 1 plan change to a Luminous Policy which also carries a $5,000.00 deductible, and NO prescription coverage. 10. I’ve repeatedly requested specific details from Anthem and ODI on the methodology used to arrive at my premium charge. I want it justified. In spite of repeated requests, no response! 11. Attorneys at a well-known class action firm in Ohio, Waite, Schneider, Bayless & Cheslely, (http://www.wsbclaw.com/) while sympathetic to my case, e.g. questionable justification/methodology of being placed in a “high risk” category resulting in outrageous premium increases, do not see class action potential. Who do I turn to in order to enforce the law???? Insurance discrimination will be banned, so people who have been sick can’t be excluded from coverage or charged higher premiums. Women will no longer have to pay higher premiums because of their gender. New funding will be available to collect information on how women and racial and ethnic minorities experience the health care system, leading to improvements that will benefit these groups. The attached letter sent to Ms. Erin Hoefilinger, President of Anthem BC/BS Ohio over a month ago provides a bit more detail on my situation. (No response from Ms. Hoefilinger!) Is there anything you can suggest to do to halt or at least reduce Anthem’s premium increases? It’s obviously of great concern, not only because I can’t afford it, but because it’s WRONG! Thank you so very much for anything you are able to offer. Linda A. Scott