United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1994-04-13 monographic deposited born digital GA 1.13:HEHS-94-71 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-94-71 P0b002ee18038d99e f:he94071 DGPO 2010-08-12 2011-03-28 GAOREPORTS-HEHS-94-71 machine generated eng fdlp REPORT GAOREPORTS-HEHS-94-71 HEHS-94-71 Health insurance Insurance regulation Insurance companies Financial management Internal controls Consumer protection Health services administration Health care planning Financial disclosure reporting State programs West Virginia World War II Maine Maryland Massachusetts New Hampshire New Jersey Vermont New York New York (NY) Rochester (NY) District of Columbia California Blue Cross-Blue Shield Benefits Insurance Plan National Health Care Reform Initiative Clinton Health Care Plan Health Security Act Letter Report HEHS The 1990 failure of Blue Cross and Blue Shield of West Virginia left thousands of people and many health care providers with millions of dollars in unpaid claims. More recently, congressional investigators uncovered serious financial problems as well as mismanagement at three other "Blues" plans and raised questions about the oversight of these plans by their boards of directors and state regulators. GAO found that 53 of 64 Blues plans are rated in fair to excellent condition by Weiss Research, Inc.--the only insurance rating agency doing such evaluations of Blues plans. The remaining 11 plans, which insure about one-quarter of all Blues subscribers, are rated as weak to very weak financially. Some plans were slow to respond to changing market conditions or made poor investment decisions, while others were put at a competitive disadvantage by rate-setting constraints and coverage requirements applicable only to Blues plans. In addition, weaknesses in oversight by plan boards of directors and state regulators allowed plans' financial problems to persist. The Blue Cross and Blue Shield Association, individual plans, and states have tried to remedy the problems of financially troubled plans, but it is too soon to tell how successful these efforts will be. Under health care reform, the role of state insurance regulators in monitoring the financial solvency of Blues plans and protecting subscribers' and providers' interest will become increasingly important and challenged. It is essential that state insurance regulators have the tools necessary to enforce new requirements on Blues plans and other health insurers. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-94-71/html/GAOREPORTS-HEHS-94-71.htm GAO/HEHS-94-71 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-94-71 Letter Report GAO/HEHS-94-71; Blue Cross and Blue Shield: Experiences of Weak Plans Underscore The Role of Effective State Oversight; Health insurance Insurance regulation Insurance companies Financial management Internal controls Consumer protection Health services administration Health care planning Financial disclosure reporting State programs West Virginia World War II Maine Maryland Massachusetts New Hampshire New Jersey Vermont New York New York (NY) Rochester (NY) District of Columbia California Blue Cross-Blue Shield Benefits Insurance Plan National Health Care Reform Initiative Clinton Health Care Plan Health Security Act