In recent weeks, Aetna, ConnectiCare and Anthem all have requested rate hikes of 13 to 14 percent for small-business coverage.

That’s just below the 15 percent threshold that could trigger a public hearing on the proposed increases.

The requests have some health care advocates questioning whether increases are still too high. Insurance companies say the hikes reflect the cost of mandated federal benefits required by the Affordable Care Act.

In recent weeks, Aetna Health Inc. applied for a 14 percent increase in its small group health insurance, and was approved for 12.6 percent.

Meanwhile, Anthem last week filed a request for a 13.8 percent hike and ConnectiCare Inc. is seeking a 13.5 percent increase. The state Insurance Department has not yet ruled on those requests. Collectively, the three plans cover a total of 120,300 people — employees and their dependents.

Each of these requests comes in just under a 15 percent threshold set in July 2011 by state Healthcare Advocate  Victoria Veltri and state Insurance Commissioner Thomas B. Leonardi. The threshold allows Veltri to ask the commissioner to hold a public hearing for any rate increase request that comes in at 15 percent or higher. The agreement allows up to four public hearings a year.

The threshold was a compromise reached after Gov. Dannel P. Malloy vetoed a bill that would have required hearings on increases of 10 percent or more.

Veltri said she is concerned that some of the increases are still relatively high.

“It’s a grave concern when we have a 13.5 or 14 percent increase,” Veltri said. “That’s pretty substantial to a small employer and that can be a disincentive to provide health coverage.”

“The agreement has been working fairly well, but if rate increases keep coming in at just under 15 percent, that raises a concern for me that we still have significant increases,” Veltri said. “We do have to make sure we are doing everything to drive costs down and the premiums aren’t one penny higher than they have to be.

“If rates keep going up at this percent, I’m going to want to take a more detailed look at this again,” she added.

Kevin Galvin, a health care advocate for small businesses, said the trend shows a pattern of non-collaboration on the part of health insurers.

“To me, they keep raising the rates year after year,” said Galvin, chairman of Small Business for Healthy Connecticut.

Aetna spokeswoman Susan Millerick said Aetna’s rate request was aired in a public process and the increase was driven in part by additional services required by the Affordable Care Act. She said the company provided documents showing the actuarial impact of the act.

“We asked for what we thought was justified,” Millerick said.

Aetna and other health insurers cited new requirements mandated by the Affordable Care Act as one of the reasons for the proposed increases. The new requirements include women’s preventive health benefits, such as  well-woman visits, gestational diabetes screenings, domestic and interpersonal violence screening and counseling, FDA-approved contraceptive methods, and contraceptive education and counseling, breastfeeding support supplies and counseling.

Spokesmen for Anthem and ConnectiCare could not be reached for comment.

Connecticut Insurance Department spokeswoman Donna Tommelleo said all rate requests are reviewed by the department’s actuaries and sometimes rate requests are reduced, as in Aetna’s case.

She pointed out that Leonardi has made some changes to make the process much more open and public. Besides the hearing trigger, the department posts rate increase information on Twitter and Facebook and sends out e-alerts to anyone who signs up.

The department also has a public comment section on its website so that anyone can publicly comment on any rate proposals. In addition, the department added a new requirement in April that requires insurers to send a notice to policy holders to alert them to upcoming rate hike proposals.

“We’re trying to keep everybody in the loop,” Tommelleo said.

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