Health Insurer Anthem Loses Appeal to Maine Supreme Court

The Maine supreme court has rejected health insurer Anthem’s claim that it has a right to a 3-percent profit and risk margin when setting individual health insurance premiums.

Maine’s insurance superintendent reduced the margin to 1 percent, and the state contended the superintendent acted within its discretion to keep insurance premiums affordable.

In its ruling, the Supreme Judicial Court said Monday that the superintendent “properly balanced the competing interests” in arriving at an approved rate increase of 5.2 percent for the second half of the 2011-2012 rate year. Anthem had sought a rate increase of 9.2 percent.

The premiums apply to about 11,000 Maine residents who buy coverage from Anthem because they don’t get insurance at work and don’t qualify for government-sponsored coverage.