Jones described the 9.8 percent boost in rates for roughly 120,000 small-group enrollees as the fourth consecutive rate increase by the Thousand Oaks-based health insurer that the California Department of Insurance found to be "excessive and unreasonable."
Jones said the increase is yet another "unreasonable rate increase on its small group employer members, while (Anthem) is continuing to make excessive profits of over 20 percent."
As the Los Angeles Times reported earlier today, the new Anthem rates took effect Oct. 1 for about 15,000 small businesses with approximately 120,000 employees and dependents.
But Anthem, a unit of giant WellPoint Inc., said the average increase for employers renewing policies in the fourth quarter will be 7.8 percent, reflecting new data — a change it unilaterally implemented this week, according to spokesman Darrel Ng.
If it had complied with Jones' demand for a 2.1 percent increase, Anthem said, that "would have led to widening losses in this part of the Small Group market" regulated by the CDI.
Of the 2.1 percent increase proposed by the commissioner, 1.6 percent — or more than three-quarters of the total increase — would cover new Affordable Care Act fees and taxes, leaving next to nothing going to Anthem.
The insurer, one of the state's largest, has already lost $8.5 million on this segment of its business, said Ng.But Jones argues that Anthem has used accounting tricks to "mask" the true size of its profits.
The latest rate increase confrontation between Jones and Anthem comes less than two weeks before the Nov. 4 election, in which Jones is seeking reelection and Proposition 45, a ballot initiative he supports that would give the commissioner more authority to regulate health insurance rates is also on the ballot. It's opposed by major insurers, including Kaiser Foundation Health Plan, Anthem and Blue Shield of California.
The commissioner's approach "pretty much makes the point for the No on 45 folks," said Micah Weinberg, senior policy adviser at the Bay Area Council, which receives funding from businesses and insurers and opposes the measure. It's "not worth submarining health reform to have a politician take personal control of a process when businesses are actually asking him not to do this."
Anthem says it filed for the new rates on July 17, and that Jones and his agency took roughly 100 days to review the filing. It says it met the federal guidelines requiring insurers to spend at least 80 percent of premium dollars on medical care in its filing.
Jones can't stop Anthem or other health insurers from raising rates more steeply than he thinks appropriate, but is backing Prop. 45, which would give his office more power to do so for health plans that cover individual and small-group policyholders.
In fact, Jones is the "one politician" that anti-Proposition 45 TV and radio ads rail against, arguing that the ballot measure would give the insurance commissioner too much authority, without naming the job or its current occupant.
Opponents also claim the initiative would complicate matters for Covered California, the Obamacare health exchange, which already negotiates separately with insurers on the rates they charge policyholders who buy their coverage on the exchange.
Chris Rauber's beats include health care, insurance, nonprofits and the wine industry for the San Francisco Business Times.