US Sen Rockefeller Chides Aetna For Financial-Report Miscue

By Patrick Yoest
Dow Jones Newswires
December 7, 2009

WASHINGTON (Dow Jones)--Senate Commerce Committee Chairman Jay Rockefeller (D., W.Va.) on Monday criticized health-insurance giant Aetna Inc. (AET) for a financial reporting mistake that led the company to overstate the proportion of premiums that it spent on medical care in the small-group market.

Rockefeller said that a Senate Commerce Committee investigation resulted in Aetna amending its 2008 health-insurance regulatory filings to reflect that its largest subsidiary had miscategorized $4.9 billion in premiums as coming from the large-group market rather than the small-group market.

The change means that Aetna's medical loss ratio for the small-group market--or the percentage of premiums that it spent on medical care--dropped from 82% to 79% for 2008.

"Failing to submit accurate medical loss ratio information to state insurance agencies not only violates the law, it also undermines the efforts of policymakers, consumer advocates, and regulators to determine whether consumers and businesses are getting a fair value for their health care premium dollars," Rockefeller said in a statement.

Aetna didn't immediately respond to a request for comment.

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