Increased “cost pressures” facing health insurers could mean that an effort to free insurance agent and broker commissions from the grip of the federal health reform law might not lead to restored payments.

On the heels of releasing the first of four reports on Pennsylvania’s four Blue Cross Blue Shield plans and possible anti-competitive practices, state regulators face a suit by Highmark for what it calls an “unlawful and unauthorized” examination.

Highmark Inc., the state’s largest health insurer, is shifting its small-group business to a for-profit entity, which will allow it to consider medical underwriting.

Only a few months old, Pennsylvania insurers are saying it is too soon to gauge the impact of raising the adult dependent age to 30 for coverage on employer-based health plans.

Pittsburgh, Pa.-based health insurer Highmark says it remains “financially strong,” in light of A.M. Best shifting its outlook to “negative” for the parent company and two of its health subsidiaries.

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