Health Secretary Kathleen Sebelius today sent the letter to five different companies, UnitedHealth Group Inc., WellPoint Inc., Aetna Inc., Health Care Service Corporation and CIGNA HealthCare Inc.

Here are the ten questions from the letter and the final summary, as the Obama Administration turns up the heat on insurance companies in a final drive for health care reform legislation in the Congress.
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At a minimum, I ask that you include the following in your justification:

1. Your estimates on medical cost and utilization increases, the assumptions driving these estimates, and the basis for those assumptions.

2. If your premiums increase more than estimated medical costs, a description of what accounts for those differences.

3. The number of people who will be receiving premium increases, as well as the number of people who will be receiving different levels of premium increases, further broken down by characteristics including plan type, age, and sex.

4. Enrollment changes in your different plans since the past year.

5. The number of people on whose experience the rate increase is calculated.

6. Any premium rating variation including rating variation by age and health status.

7. An affordability plan explaining what the company is doing to improve the affordability of health care, and the estimated financial impact of the company's affordability initiatives.

8. An explanation of any cost containment or quality improvement efforts you have made that affect the increase.

9. The expected medical loss ratio resulting from any premium increase.

10. Information on the percentage of premium revenues you spend on medical claims, disease management, quality initiatives, administrative costs, profits, and executive salaries broken down at least by market type.

The President is committed to passing health insurance reform that fixes our health insurance system and helps bring down costs for all Americans. These reforms will give American families the peace of mind they need and deserve, and will make our system more transparent. I hope your company will join our effort to make health care in America more transparent, and post this critical information without delay.

Sincerely,
Kathleen Sebelius