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Ruling that OK'd Highmark surpluses faces court challenge
Thursday, March 17, 2005

A group of individuals, unions, consumer activists and advocates for the poor and elderly have asked Commonwealth Court to overturn state Insurance Commissioner M. Diane Koken's decision that financial surpluses held by Pennsylvania's four Blue Cross carriers were not excessive.

The group's court petition asserts that Koken's determination last month contradicted a "standard" the state Insurance Department issued more than a year ago when it notified Highmark Inc. and three other Blue Cross carriers that they had to quantify their surpluses and make plans for distributing any "excess" amounts.

Highmark's $2.2 billion surplus is the largest among the Pennsylvania Blues, whose combined surpluses amount to $4 billion. Pittsburgh-based Highmark is the region's largest health insurer.

The appellants, which included Pittsburgh's Consumer Health Coalition, the Mon Valley Unemployed Committee, the Pennsylvania Alliance for Retired Americans and the Service Employees International Union, also charged that Koken's decision was "arrived at in secret and without any semblance of due process."

Koken's press secretary was not available for comment yesterday.

The insurance commissioner's determination that the Blues surpluses were in line with amounts needed to ensure their solvency came just two days after Gov. Ed Rendell unveiled an initiative in which the Blues agreed to fund $1 billion worth of charitable activity over the next six years, mostly to expand coverage for the uninsured.

A spokeswoman in the governor's office of health care reform said yesterday that the $1 billion agreement would not be affected if Commonwealth Court reversed Koken's decision.

Highmark spokesman Michael Weinstein said he could not comment on whether the $1 billion commitment might be withdrawn if Koken's decision was overturned. He said Highmark was "monitoring" the legal challenge.

Koken insisted last month that the $1 billion arrangement worked out between the governor and the Blues was unrelated to her determination. Some critics suggested they were linked.

First published on March 17, 2005 at 12:00 am
Pamela Gaynor can be reached at pgaynor@post-gazette.com or 412-263-1613.