Anthem will pay about 90,000 policyholders in Colorado a total of $20 million under the terms of a settlement with the Colorado Division of Insurance.
The money will go to people who were insured by Anthem’s individual health insurance policies from Jan. 1 to Sept. 30 of this year.
The settlement came as a result of the division’s market conduct examination of three individual health insurance rate filings. Those rate increases were originally approved by the Division of Insurance. Earlier this year, Commissioner Marcy Morrison took the unusual step of reviewing the rate increases after a number of consumer complaints.
The premium credit will be issued either as a premium reduction to policyholders or as a disbursement check for those who no longer hold the insurance.
“Getting $20 million back into the pockets of Colorado consumers is a positive and beneficial outcome,” Morrison said. “We will continue our active review of all rate filings.”
For its part, Anthem said it is confident that “its rates are appropriate, consistent with state law and in line with its competitors,” said spokeswoman Joyzelle Davis. “As part of the agreement, the DOI reaffirmed our 2010 individual premiums, and those rates will not change.”
Davis said Anthem was not fined as a reult of the market conduct examination.
“Anthem is not admitting any fault or wrongdoing with respect ot either the factual and legal issues, or the disputes that were the subject of the market examination,” she said. “Anthem agreed to the premium credit in order to terminate the examination…”
The credit does not apply to Colorado Major Med, Custom Plus Plans or group conversion policyholders.
The credit will be allocated on a pro rata basis based on the amount of the member’s premium paid for their effective dates of coverage.