Health insurers post losses, blame state rate caps

By Robert Weisman, Globe Staff

The state's four biggest health insurers today posted first-quarter losses totaling more than $150 million, with three of the carriers blaming the bulk of their deficit on the Patrick administration's decision to cap rate increases for individuals and small businesses.

Blue Cross Blue Shield of Massachusetts, the state's largest health insurer, reported a $65.2 million net loss for the three months ending March 31. Its operating loss was even steeper, $95.5 million. The company drew $55 million from its reserve to cover the anticipated losses from the state-imposed premium cap in the second quarter, accounting for the majority of its operating loss.

The net loss for Boston-based Blue Cross was partly offset by $26.7 million in investment income in the first quarter. During the same January-to-March period last year, the insurer had a net loss of $36.6 million and investment income of $13.7 million.

Harvard Pilgrim Health Care of Wellesley posted a quarterly net loss of $27 million and an operating loss of $28.6 million, drawing $21 million from its reserve against losses because of the state's limits on rate hikes. In last year's first quarter, traditionally a weak period for insurers, Harvard Pilgrim had a $3 million net loss and a $6.9 million operating loss.

Tufts Health Plan of Watertown, reported a first quarter net loss of $51.9 million and an operating loss of $59 million. That included $40 million drawn from its loss reserve. During the same period in 2009, Tufts had a $13.1 million net loss and a $16.5 million operating loss.

The only large carrier that didn't tap into its reserve in the first quarter was Fallon Community Health Plan, which posted a net loss of $8.5 million and an operating loss of $10.8 million compared with net income of $976,163 and an operating loss of $1.3 million for the same period last year. A spokeswoman for Fallon said the Worcester insurer decided not to draw from reserves in the first quarter to cover losses it anticipates in the second quarter.

On April 1, the Massachusetts Division of Insurance rejected the insurers' proposed double-digit premium increases for small businesses and individuals in the so-called small group market, instead ordering the carriers to continue using premiums that took effect a year earlier.

The companies, which contend they will lose millions of dollars because of the rate caps, are challenging the decision in administrative hearings and through a lawsuit in Suffolk Superior Court.