PROVIDNECE – Citing rising health care costs, Blue Cross & Blue Shield of Rhode Island has asked R.I. Health Insurance Commissioner Christopher F. Koller to approve a 10.2 percent hike in premiums for its direct-pay plans, which are available to individuals who cannot get group or government coverage.

Blue Cross has more than 14,000 direct-pay members and is the only local insurer serving that population, with guaranteed coverage for anyone who is ineligible for health insurance through an employer, Medicare or Medicaid.

Blue Cross had sought to raise rates by 5.9 percent as of April 1, but in February, Koller denied any increase, noting that almost half the hike was for reserves, which he had already deemed inappropriate in the previous direct-pay rate filing.

Koller also said Blue Cross would likely benefit from a trend of healthier people enrolling in its individual plans, which have tended to attract older and sicker subscribers.

But Koller’s prediction was wrong, according to Blue Cross – instead, costs continued to escalate, topping $1.4 billion in 2008, the insurer said in a news release. That has made it necessary to hike premiums by 10.2 percent, Blue Cross said.

The hike would go into effect next April 1, with open enrollment set to start May 15. At the same time, however, Blue Cross is proposing to restructure its direct-pay pricing in a way that it predicts may help reduce rates for younger subscribers.

For people who want more comprehensive coverage, meanwhile, Blue Cross wants to introduce a new kind of plan beginning next July 1 that would include health-management programs and incentives for living a healthier lifestyle.

“We believe that every Rhode Islander should have access to affordable, high-quality health insurance, regardless of pre-existing conditions,” said BCBSRI President and CEO James E. Purcell. “Innovative new product offerings, such as the new direct-pay plan that we’ll be rolling out in the spring, are just one of the many ways we’re working to improve the health-care delivery system here in Rhode Island.”

In the news release, Blue Cross cited several programs it offers to make individual plans more affordable, including the AccessBlue subsidy plan, which pays a portion of premiums for roughly 25 percent of members; the Wellness Reward Program, which reimburses 10 percent of the premium for members who complete a series of wellness requirements; and the Preferred Rate system, which offers lower rates based on age, gender and health status to people who can pass a questionnaire-based medical screening.

“Particularly during these difficult economic times, we strongly encourage members to take advantage of the many financial aid programs that we currently offer,” Purcell said. “These programs provide premium relief to those who need it most.”

To learn more about direct-pay plans, go to bcbsri.com. To read Koller’s explanation of his decision earlier this year, go to ohic.ri.gov.