October 11, 2008-Fargo Forum

The employee groups represent nearly a quarter of the members of Blue Cross Blue Shield, which is North Dakota’s largest insurer.

“We found out about this decision at the same time the public did, so we’re still analyzing this decision,” Blues spokeswoman Denise Kolpack said Friday. “We have a responsibility to our members and our providers to thoroughly weigh this decision and how it affects them.”

It is the second Blues rate request rejected by the insurance commissioner in recent months. In July, Hamm turned down the Blues’ request for a 14.8 percent increase in premiums for the bank depositor group, which represents individuals.

Hamm said more than 110,000 North Dakotans are covered under group policies through Blue Cross Blue Shield of North Dakota.

Hamm said one factor in his decision was that Blue Cross Blue Shield had indicated for the first time that it would cut medical payments to its providers, saying its contracts allowed that.

In July, the insurer said it was dropping plans for a 2.5 percent reduction in payments to the medical providers, though it said that would hurt its financial condition.

Hamm said the decision to drop plans for a cut came “part way” in addressing the issue, but it was not reflected in the Blues’ contract language.

“They need to amend their contract and remove the language that gives them the ability to unilaterally change payments to providers,” he said.

After Blue Cross Blue shield changes its provider contracts, it can refile its rate request, he said.

He said the insurer remains in good financial shape.