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Louisiana Health Insurance Premiums & Privacy Information

Questions and Answers About Premiums

Why do companies raise premiums?

• Insurance companies often raise premiums when the cost of paying medical claims increases.
• Medical cost inflation is a major factor that contributes to premium increases.
• Medical utilization or an increase in the number medical procedures performed each year also causes premium increases.
• Cost shifting occurs when one group of patients pays less than the true cost of their medical care. When this happens, providers may overcharge others to make up the difference.

What do your premiums pay for?

Premiums help pay policyholders' claims and other expenses, such as agent commissions, premium taxes and administrative expenses.

How do insurance companies determine premiums?

An insurance company considers many factors when setting premiums, such as:

• Cost of medical care
• Covered benefits
• Age of the policyholder (both current age and the age when the policy was issued)
• Gender
• Lifestyle habits (such as smoking)
• Geographic area
• Additional coverage added to the policy

Medical Privacy

The Federal HIPAA privacy rule provides that an individual has a right to adequate notice of how an insurance company or medical provider may use and disclose protected health information about the individual, as well as his or her rights and the covered entity's obligations with respect to that information. More information regarding the Federal HIPAA Privacy Rules can be accessed at the United States Department of Health & Human Services Web page at www.os.dhhs.gov.