MISSOURI CONSOLIDATED SHOULD BE REQUIRED TO SHARE CLAIMS HISTORIES

Everyone knows how insurance works: You buy the protection hoping you'll never have to use it. You compare rates trying to get the best deal possible.

Such was the case with area school districts when administrators accepted insurance through a state-sponsored program several years ago. The aim was to secure lower rates for employees.

But the deal has turned sour, and districts are scrambling to cover substantially higher premiums or find other options. What started as a cost-saving plan went astray earlier this year when HMOs and other plans complained they were losing money by participating.

Those providers requested and received permission to lift the 3 percent cap on premium increases that had promised when the plan was sold. The increases that hit some area school districts were as high as 25 percent more than previous years.

What's more, area districts are having a hard time finding other coverage because Missouri Consolidated Health Care Plan refuses to release districts' claims history from the previous year.

Why is that? Could it be because their claims history would no way substantiate such an outlandish increase? Missouri Consolidated Health Plan should provide the claim histories for all the districts and point the finger where the numbers went wrong. Only then can districts understand why the costs increased so dramatically.

If the increases are legitimate, then why won't the company provide the data to public entities that would back up the increases?

Missouri Consolidated has told the Cape Girardeau School District it doesn't have access to those records. Then who does? Before districts pay higher premiums the state should demand that Missouri Consolidated provide such documentation to every school district or other public entity that requests it.

The state says Missouri Consolidated may not be required to provide such documentation unless it was part of the contract. But wait a minute. Wasn't a 3 percent cap part of the contract as well? Perhaps districts didn't feel such language was necessary with the cap. When the company negated that part of its contract, the rules changed. Missouri Consolidated owes these school districts and other public entities the facts so they can decide to stay or seek other options.

The bottom line is that this doesn't just affect school district employees. It affects taxpayers as well, since a portion of the costs are covered by school districts through benefit plans.

The Missouri Department of Insurance should take a much more aggressive look at this situation. Missouri Consolidated owes districts, teachers and taxpayers a better explanation of what happened with premiums and why.