Professional Documents
Culture Documents
MEMORANDUM
1. General Information
Company Identifying Information
CompanyLegalName:
State:
HIOSIssuerID:
Market:
EffectiveDate:
HealthyAllianceLifeInsuranceCompany
Missouri
32753
SmallGroup
January1,2015
AndyDare
(314)9238947
Andy.Dare@wellpoint.com
PolicyFormNumber(s):
ABCBSMOSGPPOONv01
ABCBSMOSGPPOOFFv01
ABCBSMOSGBPOOFFv01
3. Introduction
Thisfilingincludesanaveragerateincreaseof7.7%,withrangebyplanbetween10.8%and28.2%.More
detailsareprovidedbelowinSection5:ProposedRateIncrease,andinExhibitI:NonGrandfathered
BenefitPlanFactorsandRateIncreases.
Areafactorshavebeenadjustedtoreflectmostcurrentexperience.RefertoExhibitK:AreaFactors.
ThisfilingincludesnewexhibitsshowingtheMarketAdjustedIndexRate,PlanAdjustedIndexRate,and
ConsumerAdjustedPremiumRates,asdefinedinthenewmemoinstructionsfor2015filings.SeeExhibit
O:QuarterlyIndex,Base,andMarketAdjustedIndexRateDevelopmentandExhibitP:PlanAdjusted
IndexRateandConsumerAdjustedPremiumRates.
Adjustmentsforriskadjustmentandreinsuranceareappliedtotheprojectedclaimscost.
Nonbenefitexpenses,profit,andriskareappliedtotheprojectedclaimscosttodeterminethe
requiredprojectionperiodpremium.
Theprojectionperiodpremiumisadjustedbytheaverageratingfactorsintheprojectionperiod
todeterminethebaserate.
Thebaseraterepresentsanaveragebenefitplanandareaforanage21nontobaccouserin
Missouri.
Premiumsatthememberlevelaredeterminedbymultiplyingthebaseratebytheapplicablefactorfor
eachoftheallowableratingcriteria:age,tobacco,areaandbenefitplan.Anexampleofthiscalculationis
showninExhibitL:SampleRateCalculation.
Changesinbenefitdesignthatvarybyplan
ChangesintheadjustmentfactorforCatastrophiceligibility
ChangesinNonBenefitExpensesthatareappliedonaPMPMbasis
Changesintheunderlyingarearatingfactors,whichareincludedintheplanlevelincreasefor
plansnotofferedinallareas
Anticipatedchangesduetonetworkcontractingbypricingarea.
In2014,theareafactorsvariedbyplanbasedonactuariallyjustifiednetworkcostdifferencesforeach
geographicratingarea.EffectiveJanuary1,2015,asingleareafactorwillapplytoallplansineach
geographicratingarea.Toretaintheactuariallyjustifiednetworkcostdifferencesforeachgeographic
areaandcomplywith45CFRpart147.102,severalnewplanshavebeenadded,eachofwhichis
availableinasinglegeographicratingarea.Newplanshavebeenmappedtocomparable2014plansfor
purposesofdeterminingtherateincrease.RefertoExhibitI:NonGrandfatheredBenefitPlanFactorsand
RateIncreasesandExhibitK:AreaFactorsfordetails.
TheserateincreasesbyplanareshowninExhibitI:NonGrandfatheredBenefitPlanFactorsandRate
Increases.
ExperienceshowninWorksheet1,SectionIoftheUnifiedRateReviewTemplateisfortheMissouriSmall
GroupSingleRiskPoolNonGrandfatheredBusiness.Consistentwithlastyear,Anthemisassigning0%
credibilitytothesingleriskpoolexperience,thusitisnotusedfordevelopingmanualrates.Themanual
ratedevelopmentisfullydetailedinSection9:CredibilityManualRateDevelopment.
ClaimsexperienceinWorksheet1,SectionIoftheUnifiedRateReviewTemplatereflectsdatesofservice
fromJanuary1,2013throughDecember31,2013.
ThepreliminaryMLRRebateestimateis$2,549,077,whichisconsistentwiththeDecember31,2013
AnthemgeneralledgerestimateallocatedtotheNonGrandfatheredportionofSmallGroup.Note
thatthisisanestimateandwillnotbefinaluntilJune1,2014.
7. Benefit Categories
ThemethodologyusedtodeterminebenefitcategoriesinWorksheet1,SectionIIoftheUnifiedRate
ReviewTemplateisasfollows:
InpatientHospital:Includesnoncapitatedfacilityservicesformedical,surgical,maternity,
mentalhealthandsubstanceabuse,skillednursing,andotherservicesprovidedinaninpatient
facilitysettingandbilledbythefacility.
OutpatientHospital:Includesnoncapitatedfacilityservicesforsurgery,emergencyroom,lab,
radiology,therapy,observationandotherservicesprovidedinanoutpatientfacilitysettingand
billedbythefacility.
Professional:Includesnoncapitatedprimarycare,specialist,therapy,theprofessional
componentoflaboratoryandradiology,andotherprofessionalservices,otherthanhospital
basedprofessionalswhosepaymentsareincludedinfacilityfees.
OtherMedical:Includesnoncapitatedambulance,homehealthcare,DME,prosthetics,supplies,
visionexams,dentalservicesandotherservices.
PrescriptionDrug:Includesdrugsdispensedbyapharmacyandrebatesreceivedfromdrug
manufacturers.
8. Projection Factors
Aspreviouslyindicated,thecredibilitylevelassignedtotheexperienceinWorksheet1,SectionIIIofthe
UnifiedRateReviewTemplateis0%.Consequently,factorstoprojectexperienceclaimsarenotprovided
astheyarenotapplicable.However,thefactorsusedtodevelopthemanualratesarefullydetailedin
Section9:CredibilityManualRateDevelopment.
Changes in Benefits
n/aseeCredibilityManualRateDevelopment
Changes in Demographics
n/aseeCredibilityManualRateDevelopment
Other Adjustments
n/aseeCredibilityManualRateDevelopment
Thesourcedataunderlyingthedevelopmentofthemanualrateconsistsofclaimsforall
GrandfatheredandNonGrandfatheredSmallGroupbusiness,incurredduringtheperiodJanuary1,
2013December31,2013andpaidthroughMarch31,2014.Completionfactorsarethencalculated
toreflectadditionalmonthsofrunoutafterMarch31,2014.Anthemexpectsalargeportionofthe
GrandfatheredpolicyholderstomigratetoACAcompliantpoliciespriortoandduringtheprojection
period.
IndevelopingrateseffectiveJanuary1,2015,onlylimited2014experienceisavailable.This
experienceisnotdeemedcredibleforpurposesofratedevelopment.
Otherthancompletingtheincurredclaims,nofurtherexplicitadjustmentsaremadetothe
experiencedata.
Formoredetail,seeExhibitB:ClaimsExperienceforManualRateDevelopment.
ChangesinDemographics(Normalization)
Thesourcedatawasnormalizedtoreflectanticipatedchangesinage/gender,area,network,and
benefitplanfromtheexperienceperiodtotheprojectionperiod.Thepurposeofthesefactorsisto
adjustcurrentexperiencetobereflectiveofexpectedclaimexperienceintheprojectionperiod.See
Section23:MembershipProjectionsforadditionalinformationonmembershipmovement.The
normalizationfactorsandtheiraggregateimpactontheunderlyingexperiencedataaredetailedin
ExhibitC:NormalizationFactors.
Age/Gender:Theassumedclaimscostisappliedbyageandgendertotheexperienceperiod
distributionandtheprojectionperioddistribution.
Area/Network:TheareaclaimsfactorsaredevelopedbasedonananalysisofSmallGroupand
Individualallowedclaimsbynetwork,mappedtotheprescribed2015ratingareasusing5digit
zipcode.
BenefitPlan:Theexperienceperiodclaimsarenormalizedtoanaverage2015planusingbenefit
relativities.Thebenefitrelativitiesincludethevalueofcostsharesandanticipatedchangesin
utilizationduetothedifferenceinaveragecostsharerequirements.
ChangesinBenefits
Benefitchangesincludethefollowing:
PreventiveRx(overthecounter):Theclaimsareadjustedfor100%coverageofbenefitsfor
specificoverthecounterdrugsobtainedwithaprescriptionfromaphysician.
RxAdjustments:TheclaimsareadjustedfordifferencesintheRxformularyaswellasforthe
impactofmovingdrugsintodifferenttiersintheprojectionperiodrelativetowhatisreflectedin
thebaseexperiencedata.
ChangesintheMorbidityofthePopulationInsured
Theclaimsareadjustedtoreflectshiftsinhealthinsurancecoverageasaresultoftheprovisionsof
theACA.Themarketshifts,orpopulationmovements,affectingthemorbidityoftheSmallGroup
marketintheprojectionperiodinclude:
SmallGroupselectingtodropcoverage
SmallGroupmemberselectingtobeuninsured
SmallGroupsmovingtoselffundedcoverage
SmallGroupmembersmovingtoMedicaid
SmallGroupselectingtoremainontheircurrent(nonACA)productsin2015.
SmallGroupmemberselectingtoforegoCOBRAcoverageupontermination
Themovementassumptionsabovearebasedonmarketresearchandassumptionsontheemployer
optoutandconsumeruptakerates.Themorbidityimpactsofpopulationmovementarebasedon
healthstatusdeterminedfrominternalriskscoredata.
TrendFactors
Theannualpricingtrendusedinthedevelopmentoftheratesis9.4%.Thetrendisdevelopedby
normalizinghistoricalbenefitexpenseforchangesintheunderlyingpopulationandknowncost
drivers,andtheresultisprojectedforward.Thetrendincludesavolatilityprovisionin
accordancewithActuarialStandardsofPractice.Theclaimsaretrended25monthsfromthe
midpointoftheexperienceperiod,whichisJuly1,2013,tothemidpointoftheprojection
period,whichisAugust1,2015.
Projectedtrendsincludetheestimatedcostduring2014and2015ofthepharmaceuticalSovaldi
andotherhighcostdrugsfortreatingHepatitisC.Thesecostestimateswerebasedonclaims
experienceforMissouriSmallGroupbusiness,togetherwithCDCrecommendationsandIndustry
andEnterprisedata.
OtherCostofCareImpacts
Utilizationorcostperservicechange:anticipatedchangesarereflectedinthemorbiditychanges
andtrend.
ChangeinMedicalManagement:medicalmanagementsavingsnotalreadyincludedintheclaims
experienceandtrend.
ChangeinProviderContracts:anticipatedchangesinprovidercontractsarereflectedinthe
benefitplanfactorsandtheregionratingfactors.
OtherClaimAdjustments
TheadjustmentsdescribedbelowarepresentedinExhibitE:OtherClaimAdjustments.
RxRebates:TheprojectedclaimscostisadjustedtoreflectanticipatedRxrebates.These
projectionstakeintoaccountthemostuptodateinformationregardinganticipatedrebate
contracts,drugprices,anticipatedpriceinflation,andupcomingpatentexpirations.
Thecostofaddingbenefitsforpediatricdentalandvisionareincluded.
Capitation Payments
Capitationarrangementsdonotexistforthisbusiness.
ThePaidtoAllowedAverageFactorinProjectionPeriodshowninWorksheet1,SectionIIIoftheUnified
RateReviewTemplateisdevelopedbymembershipweightedessentialhealthbenefitpaidclaimsdivided
bymembershipweightedessentialhealthbenefitallowedclaimsofeachplan.Theprojectedmembership
byplanisshowninWorksheet2,SectionII.
Administrative Expense
AdministrativeExpensesareexpectedtobeconsistentwithhistoricallevelsandaredeveloped
utilizingthesamemethodologyaspreviousfilings,theyarenotvariedbyproductor
plan.Maintenancecostsareassumedtobeflatonapermemberbasiswithsavingsfrom
administrativeefficienciesandtheeliminationofunderwritingoffsetbynewexpensesforrisk
managementandregulatorycompliance.
TheQIExpenseassumptionsarebasedonhistoricalamountsrelatedtothefollowinginitiatives:
ImproveHealthOutcomes,ActivitiestoPreventHospitalReadmissions,ImprovePatientSafetyand
ReduceMedicalErrors,WellnessandHealthPromotionActivities,HITExpensesforHealthCare
QualityImprovements,OtherCostContainmentandICD10.
Selling Expense
SellingExpenserepresentsbrokercommissionsandbonusesassociatedwiththebrokerdistribution
channelusinghistoricalandprojectedcommissionlevels.CommissionswillbepaidbothOnExchange
andOffExchange.
Profit
Profitisreflectedonaposttaxbasisasapercentthatdoesnotvarybyproductorplan.Theprofit
percentagedoesnotincludeanyassumedriskcorridorpaymentsorreceipts.
TheprojectedFederalMLRfortheproductsinthisfilingisestimatedinExhibitM:FederalMLR
EstimatedCalculation.Pleasenotethatthiscalculationispurelyanestimateandnotmeanttobea
truemeasureforFederalorStateMLRrebatepurposes.Theproductsinthisfilingrepresentonlya
subsetofAnthem'sSmallGroupbusiness.TheMLRforAnthem'sentirebookofSmallGroupbusiness
willbecomparedtotheminimumFederalbenchmarkforpurposesofdeterminingregulationrelated
premiumrefunds.AlsonotethattheprojectedFederalMLRpresentedheredoesnotcaptureall
adjustments,includingbutnotlimitedto:threeyearaveraging,credibility,dualoption,and
deductible.Anthem'sprojectedMLRisexpectedtomeetorexceedtheminimumMLRstandardsat
themarketlevelafterincludingalladjustments.
TheindexraterepresentstheaverageallowedclaimsPMPMofessentialhealthbenefitsforAnthem's
SmallGroupNonGrandfatheredBusiness.Theprojectionperiodindexratewasdevelopedasshown
inExhibitN:IndexRateDevelopmentbyadjustingtheprojectedincurredclaimsPMPMdescribedin
Section9:CredibilityManualRateDevelopmentofthismemorandum.Coveredbenefitsinexcessof
essentialhealthbenefitsthatareincludedintheprojectionperiodallowedclaims(cellT30of
Worksheet1,SectionIIoftheUnifiedRateReviewTemplate)butexcludedfromExhibitN:IndexRate
Development'sprojectionperiodindexrate(alsoshownincellV44ofWorksheet1,SectionIIIofthe
UnifiedRateReviewTemplate)arewellnessbenefitsincludingonlinefitnesstrainers,tobaccofree
certification,andfitnessreimbursement.
19. Calibration
Therequiredpremiumintheprojectionperiodiscalibratedbytheaverageratingcalibrationfactors(Age,
Area,andPlanFactor),whichareusedtodeveloptheConsumerAdjustedPremiumRates.Theaverage
ratingfactorsareshowninExhibitH:Calibration,ExhibitP:PlanAdjustedIndexRateandConsumer
AdjustedPremiumRates,andappliedinlineitem14ofExhibitA:BaseRateDevelopment.
RefertoExhibitI:NonGrandfatheredBenefitPlanFactorsandRateIncreases.
Age Factors
Area Factors
In2014,theareafactorsvariedbyplanbasedonactuariallyjustifiednetworkcostdifferencesfor
eachgeographicratingarea.EffectiveJanuary1,2015,asingleareafactorwillapplytoallplansin
eachgeographicratingarea.
Areafactorshavebeenadjustedtoreflectthemostcurrentexperience.RefertoExhibitK:Area
Factors.
TheActuarialValue(AV)MetalValuesincludedinWorksheet2oftheUnifiedRateReviewTemplateare
basedontheAVCalculator.Totheextentacomponentofthebenefitdesignwasnotaccommodatedby
anavailableinputwithintheAVCalculator,thebenefitcharacteristicwasadjustedtobeactuarially
equivalenttoanavailableinputwithintheAVCalculatorforpurposesofutilizingtheAVCalculatorasthe
basisfortheAVMetalValues.BenefitsforPlansthatarenotcompatiblewiththeparametersoftheAV
CalculatorhavebeenseparatelyidentifiedanddocumentedintheUniquePlanDesignSupporting
DocumentationandJustificationthatsupportsthePlan&BenefitsTemplate.
TheprojectedmorbiditychangesshowninExhibitD:ProjectionPeriodAdjustmentsincludeexpected
morbiditychangesduetopopulationmovement.
ThelistofterminatedproductsisshowninExhibitQ:TerminatedProducts.
27. Reliance
Insupportofthisratedevelopment,variousdataandanalyseswereprovidedbyothermembersof
Anthem'sinternalactuarialstaff,includingdataandanalysisrelatedtocostofcare,valuation,andpricing.
Ihavereviewedthesedataandanalysesforreasonablenessandconsistency.IhavealsoreliedonBrian
Renshaw,FSA,MAAAtoprovidetheactuarialcertificationfortheUniquePlanDesignSupporting
DocumentationandJustificationforplansincludedinthisfiling.
(1)TheprojectedIndexRateis:
IncompliancewithallapplicableStateandFederalStatutesandRegulations(45CFR
156.80(d)(1)),
DevelopedincompliancewiththeapplicableActuarialStandardsofPractice
Reasonableinrelationtothebenefitsprovidedandthepopulationanticipatedtobecovered
Neitherexcessivenordeficient.
(2)TheIndexRateandonlytheallowablemodifiersasdescribedin45CFR156.80(d)(1)and45CFR
156.80(d)(2)wereusedtogenerateplanlevelrates.
(3)ThepercentoftotalpremiumthatrepresentsessentialhealthbenefitsincludedinWorksheet2,
SectionsIIIandIViscalculatedinaccordancewithactuarialstandardsofpractice.
(4)TheAVCalculatorwasusedtodeterminetheAVMetalValuesshowninWorksheet2ofthePartI
UnifiedRateReviewTemplateforallplans.
ThePartIUnifiedRateReviewTemplatedoesnotdemonstratetheprocessusedbytheissuertodevelop
therates.RatheritrepresentsinformationrequiredbyFederalregulationtobeprovidedinsupportofthe
reviewofrateincreases,forcertificationofQualifiedHealthPlansforFederallyFacilitatedExchanges,and
forcertificationthattheIndexRateisdevelopedinaccordancewithFederalregulation,usedconsistently,
andonlyadjustedbytheallowablemodifiers.However,thisActuarialMemodoesaccuratelydescribethe
processusedbytheissuertodeveloptherates.
NicoleStyka,FSA,MAAA
RegionalVicePresidentandActuaryIII
August20,2014
Date
1) ExperiencePeriodCostPMPM
2) xNormalizationFactor
3) =NormalizedClaims
PaidClaims
$ 253.96
0.8777
$ 222.90
ExhibitB
ExhibitC
=(1)x(2)
4)
5)
6)
7)
8)
0.9918
1.1022
1.2057
1.0000
$ 293.79
ExhibitD
ExhibitD
ExhibitD
ExhibitD
=(3)x(4)x(5)x(6)x(7)
9) +OtherClaimAdjustments
$ (4.22)
ExhibitE
10) =ClaimsProjectedtoProjectionPeriod
$ 289.57
=(8)+(9)
11) +RiskAdjustmentandReinsuranceContributionsandPayments
12) +NonBenefitExpensesandProfit&Risk{1}
13) =RequiredPremiuminProjectionPeriod
$ 3.63
$ 83.25
$ 376.45
ExhibitF
ExhibitG
=(10)+(11)+(12)
14) CalibrationFactor
15) TobaccoAverageRatingFactor
16) =RequiredBaseRate(AveragePlanLevelAge21NonTobacco)
1.4006
1.0032
$ 267.92
ExhibitH
ExhibitH
=(13)(14)(15)
xBenefitChanges
xMorbidityChanges
xTrendFactor
xOtherCostofCareImpacts
=ProjectedClaimCost
17) ProjectedLossRatio(ConventionalBasis)
77.9%
=[(10)+(11)](13)
NOTES:
{1}EquivalenttoPMPMexpensesonExhibitG+%ofpremiumexpensesonExhibitGappliedtoRequiredPremium(Row13above).
IncurredandPaidClaims:
Medical
Drug
$314,414,330 $112,466,759
IBNR:
Medical
$33,311,813
FullyIncurredClaims:
Drug
Medical
Drug
$ 4,155,407 $347,726,143 $116,622,166
Capitation
$
Total
BenefitExpense
$ 464,348,309
Member
Months
1,828,457
Total
PMPM
$253.96
Capitation
$
Total
BenefitExpense
$ 610,877,636
Member
Months
1,828,457
Total
PMPM
$334.09
ALLOWED CLAIMS:
IncurredandPaidClaims:
Medical
Drug
$422,452,256 $138,035,690
IBNR:
Medical
$45,310,539
FullyIncurredClaims:
Drug
Medical
Drug
$ 5,079,151 $467,762,795 $143,114,841
Age/Gender
Area/Network
BenefitPlan
Total
AverageClaimFactors
ExperiencePeriod
Future
Population
Population
0.9696
1.0223
1.0108
0.9932
0.8098
0.6860
Normalization
Factor
1.0544
0.9826
0.8472
0.8777
ImpactofChangesBetweenExperiencePeriodandProjectionPeriod:
AdjustmentFactor
Benefitchanges
PreventiveRx(overthecounter)
RxAdjustments{1}
TotalBenefitChanges
1.0001
0.9917
0.9918
Morbiditychanges
TotalMorbidityChanges
1.1022
Costofcareimpacts
AnnualMedical/RxTrendRate
1MonthsofProjection
TrendFactor
9.39%
25
1.2057
TotalotherImpacts
NOTES:
{1}IncludesRxformularyandimpactsformovingdrugsintodifferenttiers
1.0000
Adjustmentstoprojectionperiodclaimstoreflectcoveredbenefitsnotincludedinexperienceperioddata:
PMPM
RxRebates
($6.50)
PediatricDental
$0.80
PediatricVision
$0.99
CCPPackages
$0.49
Total
($4.22)
NOTES:
AdjustmentsabovereflectONLYadditionalcostsbeyondthosealreadycapturedinlineItem8ofExhibitA.
RiskAdjustment:
PMPM
FederalProgram
UserFee
$0.08
NetTransfer
$0.00
Note:
Itisassumedtheriskfortheplansincludedinthisratefilingisnobetter/worsethananyotherplanswithinthismarket.
Reinsurance:
PMPM
ContributionsMade
FederalProgram
$3.55
ExpectedReceipts
$0.00
SmallGroupPlanscontributefundsbutonlyIndividualPlansare
eligibletoreceivepayments
Source:
HHSestimatesanationalpercapitacontributionrateof$13.67permonth($44peryear)inbenefityear2015(perPayment
ParameterRule).
GrandTotalofAllRiskMitigationPrograms
NOTES:
$3.55 =$13.67*(11months/12months)+$12.30*(1month/12months)
$3.67 =2015contribution
$2.30 =2016contribution
$3.63
$17.42
$3.27
$14.52
$0.31
$35.52
0.00%
$35.52
3.55%
0.35%
0.34%
2.94%
7.18%
5.45%
12.63%
$27.21
$20.52
$83.25
$0.18
$0.18
$35.70
NOTES:
{1}Thesumoftheroundedpercentagesshownmaynotequalthetotalatthebottomofthetableduetorounding.
{2}IncludesonlythoseincometaxeswhicharedeductiblefromtheMLRdenominator;inparticular,Federalincometaxesoninvestmentincomeare
excluded.
{3}Profitshownhereisposttaxprofit,netofthosefederalandstateincometaxeswhicharedeductiblefromtheMLRdenominator.
Exhibit H - Calibration
Healthy Alliance Life Insurance Company
Small Group
Rates Effective January 1, 2015
Average2015ratingfactorsfor2015population:
Tobacco
Age
Area
BenefitPlan
TotalCalibrationFactor
TotalAverageRatingFactor
AverageRatingFactor
1.0032
CalibrationFactors
1.4008
0.9999
1.0000
1.4006
1.4051
NOTES:
SeeLineItem14onExhibitA.
Thebaserateisdevelopedbydividingtherequiredpremiumintheprojectionperiodbythetotalaveragerating
factorshownabove.
HIOSPlanName
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemBronzeBlueAccess4500E/0%/6350w/HSA
AnthemBronzeBlueAccessChoice4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBlueAccessChoice6000/0%/6600Plus
AnthemBronzeBlueAccess6000/0%/6600Plus
2015HIOSPlanID
32753MO0780011
32753MO0780012
32753MO0780013
32753MO0780014
32753MO0780015
32753MO0780016
32753MO0780017
32753MO0780018
32753MO0780019
32753MO0780020
32753MO0780021
32753MO0780022
32753MO0780023
32753MO0780024
32753MO0780004
32753MO0780005
32753MO0780006
32753MO0780007
32753MO0780008
32753MO0780009
32753MO0780010
32753MO0790260
32753MO0790261
32753MO0790262
32753MO0790263
32753MO0790264
32753MO0790265
32753MO0790266
32753MO0790267
32753MO0790268
32753MO0790287
32753MO0790288
32753MO0790289
32753MO0790290
32753MO0790291
32753MO0790292
32753MO0790293
32753MO0790294
32753MO0790295
On/Off
Exchange
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
MetalLevel
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
BenefitPlan
Factor
NetworkName
0.8076
MOSG::BluePreferred
0.7847
MOSG::BluePreferred
0.7760
MOSG::BluePreferred
0.7468
MOSG::BluePreferred
0.7349
MOSG::BluePreferred
0.7701
MOSG::BluePreferred
0.7751
MOSG::BluePreferred
1.0485
MOSG::BluePreferred
1.0187
MOSG::BluePreferred
1.0075
MOSG::BluePreferred
0.9696
MOSG::BluePreferred
0.9541
MOSG::BluePreferred
0.9999
MOSG::BluePreferred
1.0064
MOSG::BluePreferred
1.1668
MOSG::BluePreferred
1.1337
MOSG::BluePreferred
1.1212
MOSG::BluePreferred
1.0790
MOSG::BluePreferred
1.0618
MOSG::BluePreferred
1.1127
MOSG::BluePreferred
1.1199
MOSG::BluePreferred
0.9067
MOSG::BlueAccess
0.9067
MOSG::BlueAccessChoice
0.8796
MOSG::BluePreferred
0.8546
MOSG::BluePreferred
0.8452
MOSG::BluePreferred
0.8134
MOSG::BluePreferred
0.8004
MOSG::BluePreferred
0.8388
MOSG::BluePreferred
0.8442
MOSG::BluePreferred
0.8881
MOSG::BluePreferred
0.8629
MOSG::BluePreferred
0.8535
MOSG::BluePreferred
0.8213
MOSG::BluePreferred
0.8082
MOSG::BluePreferred
0.8470
MOSG::BluePreferred
0.8525
MOSG::BluePreferred
0.9156
MOSG::BlueAccessChoice
0.9156
MOSG::BlueAccess
Area(s)Offered
02
05
06
07
08
09
10
02
05
06
07
08
09
10
02
05
06
07
08
09
10
02,05,07,08,09,10
06
02
05
06
07
08
09
10
02
05
06
07
08
09
10
06
02,05,07,08,09,10
2014HIOSPlanID
Mapping
32753MO0780003
32753MO0780003
32753MO0780003
32753MO0780003
32753MO0780003
32753MO0780003
32753MO0780003
32753MO0780002
32753MO0780002
32753MO0780002
32753MO0780002
32753MO0780002
32753MO0780002
32753MO0780002
32753MO0780001
32753MO0780001
32753MO0780001
32753MO0780001
32753MO0780001
32753MO0780001
32753MO0780001
32753MO0790023
32753MO0790114
32753MO0790115
32753MO0790115
32753MO0790115
32753MO0790115
32753MO0790115
32753MO0790115
32753MO0790115
32753MO0790185
32753MO0790185
32753MO0790185
32753MO0790185
32753MO0790185
32753MO0790185
32753MO0790185
32753MO0790184
32753MO0790071
PlanSpecificRate
Increase*
(excludingaging)
10.45%
6.40%
3.45%
4.86%
9.17%
5.95%
4.10%
26.06%
21.44%
18.07%
8.59%
3.67%
20.92%
18.81%
12.88%
8.74%
5.73%
2.77%
7.17%
8.28%
6.39%
8.76%
10.21%
17.68%
13.36%
10.22%
1.36%
3.23%
12.88%
10.91%
28.24%
23.54%
20.11%
10.46%
5.46%
23.01%
20.86%
20.10%
18.53%
25
HIOSPlanName
2015HIOSPlanID
AnthemSilverBlueAccessChoice3000/20%/4500Plus
AnthemSilverBlueAccess3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferredOptions2750/40%/6600
AnthemSilverBlueAccess4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBlueAccessChoice4000E/0%/5000w/HSA
AnthemSilverBlueAccessChoice2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBlueAccess2000/30%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBlueAccessChoice5000/20%/6600
AnthemSilverBlueAccess5000/20%/6600
AnthemSilverBlueAccess2600E/20%/5500w/HSA
AnthemSilverBlueAccessChoice2600E/20%/5500w/HSA
32753MO0790195
32753MO0790196
32753MO0790197
32753MO0790198
32753MO0790199
32753MO0790200
32753MO0790201
32753MO0790202
32753MO0790203
32753MO0790259
32753MO0790278
32753MO0790279
32753MO0790280
32753MO0790281
32753MO0790282
32753MO0790283
32753MO0790284
32753MO0790285
32753MO0790286
32753MO0790296
32753MO0790297
32753MO0790298
32753MO0790299
32753MO0790300
32753MO0790301
32753MO0790302
32753MO0790303
32753MO0790304
32753MO0790305
32753MO0790306
32753MO0790307
32753MO0790308
32753MO0790309
32753MO0790310
32753MO0790311
32753MO0790312
32753MO0790313
32753MO0790314
32753MO0790315
On/Off
Exchange MetalLevel
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
BenefitPlan
Factor
NetworkName
Area(s)Offered
1.0241
1.0241
0.9934
0.9652
0.9546
0.9186
0.9039
0.9473
0.9535
0.8966
0.9713
0.9422
0.9154
0.9054
0.8713
0.8573
0.8985
0.9043
0.9713
1.0079
0.9777
0.9500
0.9396
0.9042
0.8897
0.9324
0.9385
1.0079
0.9244
0.8982
0.8883
0.8548
0.8412
0.8815
0.8873
0.9530
0.9530
0.9649
0.9649
MOSG::BlueAccessChoice
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferredOptions
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccessChoice
MOSG::BlueAccessChoice
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccessChoice
MOSG::BlueAccess
MOSG::BlueAccess
MOSG::BlueAccessChoice
06
02,05,07,08,09,10
02
05
06
07
08
09
10
10
02,05,07,08,09,10
02
05
06
07
08
09
10
06
06
02
05
06
07
08
09
10
02,05,07,08,09,10
02
05
06
07
08
09
10
06
02,05,07,08,09,10
02,05,07,08,09,10
06
2014HIOSPlanID
Mapping
32753MO0790174
32753MO0790057
32753MO0790175
32753MO0790175
32753MO0790175
32753MO0790175
32753MO0790175
32753MO0790175
32753MO0790175
None
32753MO0790033
32753MO0790129
32753MO0790129
32753MO0790129
32753MO0790129
32753MO0790129
32753MO0790129
32753MO0790129
32753MO0790128
None
32753MO0790149
32753MO0790149
32753MO0790149
32753MO0790149
32753MO0790149
32753MO0790149
32753MO0790149
None
32753MO0790163
32753MO0790163
32753MO0790163
32753MO0790163
32753MO0790163
32753MO0790163
32753MO0790163
32753MO0790162
32753MO0790051
32753MO0790016
32753MO0790100
PlanSpecificRate
Increase*
(excludingaging)
15.92%
14.40%
23.78%
19.24%
15.93%
6.61%
1.78%
18.72%
16.66%
n/a
8.12%
16.98%
12.69%
9.56%
0.76%
3.81%
12.20%
10.25%
9.55%
n/a
15.10%
10.88%
7.81%
0.85%
5.35%
10.41%
8.48%
n/a
14.73%
10.52%
7.46%
1.18%
5.65%
10.05%
8.13%
7.45%
6.04%
0.23%
1.56%
26
HIOSPlanName
2015HIOSPlanID
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemGoldBlueAccessChoice1000/20%/2500Plus
AnthemGoldBlueAccess1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferredOptions500/20%/4000
AnthemGoldBlueAccessChoice1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBlueAccess1500/30%/5000
AnthemGoldBlueAccessChoice5000/0%/5000
AnthemGoldBlueAccess5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBluePreferred3500/0%/4000
32753MO0790316
32753MO0790317
32753MO0790318
32753MO0790319
32753MO0790320
32753MO0790321
32753MO0790322
32753MO0790186
32753MO0790187
32753MO0790188
32753MO0790189
32753MO0790190
32753MO0790191
32753MO0790192
32753MO0790193
32753MO0790194
32753MO0790204
32753MO0790205
32753MO0790206
32753MO0790207
32753MO0790208
32753MO0790209
32753MO0790210
32753MO0790211
32753MO0790212
32753MO0790213
32753MO0790214
32753MO0790215
32753MO0790216
32753MO0790217
32753MO0790218
32753MO0790219
32753MO0790220
32753MO0790221
32753MO0790222
32753MO0790223
32753MO0790224
32753MO0790225
32753MO0790226
On/Off
Exchange MetalLevel
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
BenefitPlan
Factor
NetworkName
Area(s)Offered
0.9360
0.9095
0.8995
0.8656
0.8518
0.8926
0.8984
1.2315
1.2315
1.1946
1.1607
1.1480
1.1048
1.0871
1.1393
1.1466
1.1425
1.1854
1.1499
1.1173
1.1050
1.0634
1.0464
1.0966
1.1037
1.1854
1.1306
1.1306
1.0967
1.0656
1.0539
1.0142
0.9980
1.0459
1.0527
1.1643
1.1312
1.1188
1.0766
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccessChoice
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferredOptions
MOSG::BlueAccessChoice
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccess
MOSG::BlueAccessChoice
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
02
05
06
07
08
09
10
06
02,05,07,08,09,10
02
05
06
07
08
09
10
10
06
02
05
06
07
08
09
10
02,05,07,08,09,10
06
02,05,07,08,09,10
02
05
06
07
08
09
10
02
05
06
07
2014HIOSPlanID
Mapping
32753MO0790101
32753MO0790101
32753MO0790101
32753MO0790101
32753MO0790101
32753MO0790101
32753MO0790101
32753MO0790166
32753MO0790053
32753MO0790167
32753MO0790167
32753MO0790167
32753MO0790167
32753MO0790167
32753MO0790167
32753MO0790167
None
32753MO0790140
32753MO0790141
32753MO0790141
32753MO0790141
32753MO0790141
32753MO0790141
32753MO0790141
32753MO0790141
32753MO0790039
32753MO0790158
32753MO0790049
32753MO0790159
32753MO0790159
32753MO0790159
32753MO0790159
32753MO0790159
32753MO0790159
32753MO0790159
32753MO0790157
32753MO0790157
32753MO0790157
32753MO0790157
PlanSpecificRate
Increase*
(excludingaging)
8.44%
4.47%
1.57%
6.59%
10.82%
4.02%
2.21%
9.26%
7.82%
16.66%
12.38%
9.27%
0.49%
4.06%
11.90%
9.95%
n/a
5.98%
13.16%
9.01%
5.99%
2.53%
6.94%
8.54%
6.65%
4.59%
6.28%
4.88%
13.48%
9.32%
6.28%
2.26%
6.68%
8.85%
6.95%
10.89%
6.82%
3.86%
4.49%
27
HIOSPlanName
2015HIOSPlanID
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBlueAccess3500/0%/4000
AnthemGoldBlueAccessChoice3500/0%/4000
AnthemGoldBlueAccessChoice1000/20%/3500
AnthemGoldBlueAccess1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBlueAccess2500/20%/4500
AnthemGoldBlueAccessChoice2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBlueAccessChoice1500/20%/4000
AnthemGoldBlueAccess1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBluePreferred500/20%/3500
32753MO0790227
32753MO0790228
32753MO0790229
32753MO0790230
32753MO0790231
32753MO0790232
32753MO0790233
32753MO0790234
32753MO0790235
32753MO0790236
32753MO0790237
32753MO0790238
32753MO0790239
32753MO0790240
32753MO0790241
32753MO0790242
32753MO0790243
32753MO0790244
32753MO0790245
32753MO0790246
32753MO0790247
32753MO0790248
32753MO0790249
32753MO0790250
32753MO0790251
32753MO0790252
32753MO0790253
32753MO0790254
32753MO0790255
32753MO0790256
32753MO0790257
32753MO0790258
32753MO0790269
32753MO0790270
32753MO0790271
32753MO0790272
32753MO0790273
32753MO0790274
32753MO0790275
On/Off
Exchange MetalLevel
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
BenefitPlan
Factor
1.0594
1.1103
1.1175
1.2002
1.2002
1.2524
1.2524
1.2148
1.1804
1.1674
1.1234
1.1055
1.1585
1.1660
1.1673
1.1673
1.1323
1.1001
1.0881
1.0471
1.0303
1.0798
1.0868
1.2267
1.2267
1.1899
1.1561
1.1435
1.1004
1.0828
1.1348
1.1421
1.2414
1.2062
1.1929
1.1480
1.1297
1.1839
1.1915
NetworkName
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccess
MOSG::BlueAccessChoice
MOSG::BlueAccessChoice
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccess
MOSG::BlueAccessChoice
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccessChoice
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
Area(s)Offered
08
09
10
02,05,07,08,09,10
06
06
02,05,07,08,09,10
02
05
06
07
08
09
10
02,05,07,08,09,10
06
02
05
06
07
08
09
10
06
02,05,07,08,09,10
02
05
06
07
08
09
10
02
05
06
07
08
09
10
2014HIOSPlanID
Mapping
32753MO0790157
32753MO0790157
32753MO0790157
32753MO0790048
32753MO0790156
None
None
32753MO0790042
32753MO0790042
32753MO0790042
32753MO0790042
32753MO0790042
32753MO0790042
32753MO0790042
32753MO0790041
32753MO0790144
32753MO0790145
32753MO0790145
32753MO0790145
32753MO0790145
32753MO0790145
32753MO0790145
32753MO0790145
32753MO0790154
32753MO0790047
32753MO0790155
32753MO0790155
32753MO0790155
32753MO0790155
32753MO0790155
32753MO0790155
32753MO0790155
32753MO0790077
32753MO0790077
32753MO0790077
32753MO0790077
32753MO0790077
32753MO0790077
32753MO0790077
PlanSpecificRate
Increase*
(excludingaging)
8.81%
6.36%
4.51%
2.49%
3.85%
n/a
n/a
11.13%
7.05%
4.08%
4.28%
8.61%
6.59%
4.74%
4.36%
5.75%
12.91%
8.77%
5.75%
2.74%
7.15%
8.31%
6.42%
5.80%
4.41%
12.96%
8.82%
5.80%
2.70%
7.11%
8.35%
6.47%
11.53%
7.44%
4.46%
3.93%
8.28%
6.98%
5.12%
28
HIOSPlanName
2015HIOSPlanID
AnthemGoldBlueAccessChoice500/20%/3500
AnthemGoldBlueAccess500/20%/3500
AnthemGoldBlueAccess2000/0%/4000
AnthemGoldBlueAccessChoice2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
32753MO0790276
32753MO0790277
32753MO0790323
32753MO0790324
32753MO0790325
32753MO0790326
32753MO0790327
32753MO0790328
32753MO0790329
32753MO0790330
32753MO0790331
On/Off
Exchange MetalLevel
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
BenefitPlan
Factor
1.2797
1.2797
1.2607
1.2607
1.2229
1.1882
1.1751
1.1309
1.1128
1.1662
1.1737
NetworkName
MOSG::BlueAccessChoice
MOSG::BlueAccess
MOSG::BlueAccess
MOSG::BlueAccessChoice
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
Area(s)Offered
06
02,05,07,08,09,10
02,05,07,08,09,10
06
02
05
06
07
08
09
10
2014HIOSPlanID
Mapping
32753MO0790076
32753MO0790004
None
None
None
None
None
None
None
None
None
PlanSpecificRate
Increase*
(excludingaging)
4.45%
3.08%
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
NOTES:
BenefitPlanFactorsabovereflectplanbyplandifferencesfromtheindexrateforallowableadjustmentsasdescribedindetailintheMarketReformandPaymentParametersRegulationsandillustratedinExhibitP.Theweightedaverageoftheseadjustmentsfor
theentireriskpoolincludedinthisratefilingisdetailedinExhibitH.
Planlevelincreasesinratesdonotincludedemographicchangesinthepopulation.
29
Age
017
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64+
AgeRatingFactor
0.635
0.635
0.635
0.635
1.000
1.000
1.000
1.000
1.004
1.024
1.048
1.087
1.119
1.135
1.159
1.183
1.198
1.214
1.222
1.230
1.238
1.246
1.262
1.278
1.302
1.325
1.357
1.397
1.444
1.500
1.563
1.635
1.706
1.786
1.865
1.952
2.040
2.135
2.230
2.333
2.437
2.548
2.603
2.714
2.810
2.873
2.952
3.000
TobaccoRatingFactor
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.050
1.050
1.050
1.050
1.050
1.100
1.100
1.100
1.100
1.100
1.200
1.200
1.200
1.200
1.200
1.300
1.300
1.300
1.300
1.300
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
NOTES:
{1}TheweightedaveragesofthesefactorsfortheentireriskpoolincludedinthisratefilingisdetailedinExhibitH.
RatingAreaDescription
RatingArea2Northeast
RatingArea5Central
RatingArea6St.LouisMetro
RatingArea7Joplin
RatingArea8Springfield
RatingArea9SouthCentral
RatingArea10Southeast
AreaRatingFactor
1.1246
1.0305
0.9570
0.9439
1.0124
1.0789
1.2519
NOTES:
{1}Theweightedaverageofthesefactorsfortheentireriskpoolincluded
inthisratefilingisdetailedinExhibitH.
GroupName:
EffectiveDate:
On/OffExchange:
MetalLevel:
PlanID:
RatingArea:
SampleGroup
1/1/2015
Off
Silver
32753MO0790300
RatingArea7Joplin
GroupCensus:
Employee11
Employee12
Employee13
Employee14
Employee15
Employee16
Employee17
Employee18
Employee19
Employee110
Employee111
Employee112
Age
24
26
28
32
30
45
53
41
56
39
62
64
Employee
Tobacco
User
Yes
No
No
Yes
No
No
Yes
No
No
No
No
No
CalculationofMonthlyPremium:
BaseRate=
xBenefitPlanFactor
xAreaFactor
BaseRateAdjustedforPlan/Area=
Spouse
Age
23
Tobacco
User
No
33
No
45
55
No
Yes
64
Child11
Tobacco
User
Age
0
No
Child12
Tobacco
User
Age
Child13
Tobacco
User
Age
2
18
No
No
4
15
No
No
12
16
No
13
No
25
Yes
No
No
$267.92 ExhibitA
0.9042 ExhibitI
0.9439 ExhibitK
$228.66
Age/TobaccoFactors:
ExhibitJ
Employee11
Employee12
Employee13
Employee14
Employee15
Employee16
Employee17
Employee18
Employee19
Employee110
Employee111
Employee112
Employee
Age
Tobacco
Factor
Factor
1.000
1.0000
1.024
1.0000
1.087
1.0000
1.183
1.0500
1.135
1.0000
1.444
1.0000
2.040
1.4000
1.302
1.0000
2.333
1.0000
1.262
1.0000
2.873
1.0000
3.000
1.0000
Spouse
Age
Factor
1.000
Tobacco
Factor
1.0000
1.198
1.0000
1.444
2.230
1.0000
1.4000
3.000
Age
Factor
0.635
Child11
Tobacco
Factor
1.0000
Age
Factor
Child12
Tobacco
Factor
0.635
0.635
1.0000
1.0000
0.635
0.635
1.0000
1.0000
0.635
1.0000
0.635
1.0000
1.004
1.0000
Age
Factor
0.635
Child13
Tobacco
Factor
1.0000
1.0000
FinalMonthlyPremiumPMPM:
Employee11
Employee12
Employee13
Employee14
Employee15
Employee16
Employee17
Employee18
Employee19
Employee110
Employee111
Employee112
Employee
$228.66
$234.15
$248.55
$284.03
$259.53
$330.19
$653.05
$297.72
$533.46
$288.57
$656.94
$685.98
Spouse
Children
Total
$228.66
$145.20
$602.52
$234.15
$248.55
$273.93
$557.96
$290.40
$549.93
$330.19
$435.60
$1,095.98
$713.88
$1,366.93
$290.40
$588.12
$533.46
$229.57
$518.14
$656.94
$685.98
$1,371.96
NOTES:
{1}AspertheMarketReformRule,whencomputingfamilypremiumsnomorethanthethreeoldestcoveredchildrenundertheageof21aretakenintoaccountwhereasthepremiumsassociatedwitheachchildage21+a
{2}ThissamplecalculationignoresthetobaccooffsetunderaWellnessProgramasdescribedintheMarketReformRule.
{3}Minorratevariancesmayoccurduetodifferencesinroundingmethodology.
Numerator:
IncurredClaims
+QualityImprovementExpense
+RiskCorridorContributions
+RiskAdjustmentNetTransfer
+ReinsuranceReceipts
+RiskCorridorReceipts
+ReductiontoRxIncurredClaims(ACAMLR)
=Estimated FederalMLRNumerator
$ 289.57
$3.27
$
$
$
$
$ (6.84)
$ 286.00
ExhibitA
ExhibitG
Denominator:
Premiums
FederalandStateTaxes
PremiumTaxes
RiskAdjustmentUserFee
ReinsuranceContributions
LicensingandRegulatoryFees
=Estimated FederalMLRDenominator
$ 376.45
$ 11.07
$1.28
$0.08
$3.55
$ 14.86
$ 345.60
ExhibitA
ExhibitA(Line13)xExhibitG(IncomeTaxes)
ExhibitA(Line13)xExhibitG(PremiumTax)
ExhibitF
ExhibitF
ExhibitA(Line13)xExhibitG(Fees)
Estimated FederalMLR
ExhibitF
ExhibitF
{5}
82.76%
NOTES:
TheabovecalculationispurelyanestimateandnotmeanttobecomparedtotheminimumMLRbenchmarkforfederal/stateMLRrebatepurposes:
{1}Theabovecalculationrepresentsonlytheproductsinthisfiling.FederalMLRwillbecalculatedatthelegalentityandmarketlevel.
{2}Notallnumerator/denominatorcomponentsarecapturedabove(forexample,fraudandpreventionprogramcosts,payrolltaxes,assessmentsfor
statehighriskpoolsetc.).
{3}OtheradjustmentsmayalsobeappliedwithinthefederalMLRcalculationsuchas3yearaveraging,newbusiness,credibility,deductibleanddual
option.Theseareignoredintheabovecalculation.
{4}LicensingandRegulatoryFeesincludeACArelatedfeesasallowedundertheMLRFinalRule.
{5}Thisisthepercentageof2015pharmacyclaimsthatareattributabletoPBMAdministrativeExpenses(i.e.the"retailspread"or"pharmacyclaims
margin").Itiscalculatedbyapplyingthe3rdpartymarginpercentagetothe2015projectedPharmacyclaimsincludingprojectedrebates.
ExhibitNIndexRateDevelopment
Healthy Alliance Life Insurance Company
Small Group
Rates Effective January 1, 2015
1)
2)
3)
4)
5)
6)
7)
8)
ProjectedPaidClaimCost
NonEHBsEmbeddedinLineItem1)Above
=ProjectedPaidClaims,ExcludingALLNonEHBs
+RxRebates
+AdditionalEHBs{1}
=ProjectedPaidClaimsReflectingonlyEHBs
PaidtoAllowedRatio
=ProjectedAllowedClaimsReflectingonlyEHBs
NOTE:
{1} PediatricDentalandPediatricVision
$ 293.79
$
$ 293.79
$ (6.50)
$1.79
$ 289.08
0.7165
$ 403.46
ExhibitA,LineItem8
ExhibitE
ExhibitE
=IndexRate
Exhibit O - Quarterly Index, Base, and Market Adjusted Index Rate Development
Healthy Alliance Life Insurance Company
Small Group
RatesEffective:
RenewingMemberMonths
1Q15
316,513
2Q15
322,876
3Q15
386,061
4Q15
803,007
2.19%
2.19%
2.19%
QuarterlyAllowedTrend
IndexRate
ReinsuranceContribution
ExpectedReinsurancePayments
RiskAdjustmentFee
RiskAdjustmentNetTransfer
ExchangeFee
$ 3.55
$
$ 0.08
$
$ 1.32
$ 3.21
$
$ 0.08
$
$ 1.35
$ 2.87
$
$ 0.08
$
$ 1.38
$ 2.53
$
$ 0.08
$
$ 1.41
PaidtoallowedRatio
0.7165
0.7165
0.7165
0.7165
MarketAdjustedIndexRate
QuarterlyBaseRateTrend
BaseRate
MemberWeighted
Average
1,828,457
2.18%
2.20%
NOTES:
{1}The1Q15indexratewasderivedinExhibitN.
{2}The1Q15indexrateisassumedtoincreasewithquarterlyallowedtrendasillustratedabove.
{3}The1Q15reinsuranceandriskadjustmentfeesandpaymentsareshowninExhibitF.Thereinsurancecontributionforothereffectivedatesiscalculatedby
thesamemethodshowninExhibitF.
{4}MarketAdjustedIndexRate=IndexRate+((Reinsurance+RiskAdjustmentFee+ExchangeFee)PaidtoallowedRatio)
{5}The1Q15baseratewasderivedinExhibitA.
{6}The1Q15baserateisassumedtoincreasewithquarterlypaidtrendasillustratedabove.Thistrendratediffersfromtheindexratetrendinthatitincludes
anticipatedchangesfornonEHBs,deductibleleveraging,fees,andriskmitigationprograms.
{7}Minorratevariancesmayoccurduetodifferencesinroundingmethodology.
ExhibitPPlanAdjustedIndexRateandConsumerAdjustedPremiumRates
Healthy Alliance Life Insurance Company
Small Group
Rates Effective January 1, 2015
HIOSPlanName
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemBronzeBlueAccess4500E/0%/6350w/HSA
AnthemBronzeBlueAccessChoice4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBlueAccessChoice6000/0%/6600Plus
AnthemBronzeBlueAccess6000/0%/6600Plus
AnthemSilverBlueAccessChoice3000/20%/4500Plus
AnthemSilverBlueAccess3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferredOptions2750/40%/6600
HIOSPlanID
32753MO0780011
32753MO0780012
32753MO0780013
32753MO0780014
32753MO0780015
32753MO0780016
32753MO0780017
32753MO0780018
32753MO0780019
32753MO0780020
32753MO0780021
32753MO0780022
32753MO0780023
32753MO0780024
32753MO0780004
32753MO0780005
32753MO0780006
32753MO0780007
32753MO0780008
32753MO0780009
32753MO0780010
32753MO0790260
32753MO0790261
32753MO0790262
32753MO0790263
32753MO0790264
32753MO0790265
32753MO0790266
32753MO0790267
32753MO0790268
32753MO0790287
32753MO0790288
32753MO0790289
32753MO0790290
32753MO0790291
32753MO0790292
32753MO0790293
32753MO0790294
32753MO0790295
32753MO0790195
32753MO0790196
32753MO0790197
32753MO0790198
32753MO0790199
32753MO0790200
32753MO0790201
32753MO0790202
32753MO0790203
32753MO0790259
MarketAdjusted
IndexRate
(ExhibitO)
CostSharing
Adjustment
Provider
Network
Adjustment
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
0.5746
0.5746
0.5746
0.5746
0.5746
0.5746
0.5746
0.7479
0.7479
0.7479
0.7479
0.7479
0.7479
0.7479
0.8330
0.8330
0.8330
0.8330
0.8330
0.8330
0.8330
0.6328
0.6328
0.6328
0.6328
0.6328
0.6328
0.6328
0.6328
0.6328
0.6327
0.6327
0.6327
0.6327
0.6327
0.6327
0.6327
0.6327
0.6327
0.7084
0.7084
0.7084
0.7084
0.7084
0.7084
0.7084
0.7084
0.7084
0.7074
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
0.9089
Adjustmentfor
CatastrophicPlan
Benefitsin
Adjustment
Additiontothe
{1}
AdministrativeCosts
EHBS
1.0110
1.0110
1.0110
1.0110
1.0110
1.0110
1.0110
1.0085
1.0085
1.0085
1.0085
1.0085
1.0085
1.0085
1.0076
1.0076
1.0076
1.0076
1.0076
1.0076
1.0076
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0100
1.0100
1.0100
1.0100
1.0100
1.0100
1.0100
1.0100
1.0100
1.0089
1.0089
1.0089
1.0089
1.0089
1.0089
1.0089
1.0089
1.0089
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
$68.82
$66.88
$66.15
$63.66
$62.65
$65.64
$66.07
$89.34
$86.82
$85.87
$82.65
$81.33
$85.22
$85.77
$99.44
$96.62
$95.57
$91.98
$90.52
$94.84
$95.46
$77.22
$77.22
$74.91
$72.79
$72.00
$69.29
$68.19
$71.45
$71.91
$75.63
$73.49
$72.69
$69.96
$68.84
$72.14
$72.60
$77.96
$77.96
$87.22
$87.22
$84.61
$82.22
$81.32
$78.26
$77.02
$80.70
$81.22
$76.39
PlanAdjusted
IndexRate
{2}
Calibration
Factor
{3}
Adjustto
1Q15eff
date
ConsumerAdjusted
PremiumRate
{4}
$315.96
$307.00
$303.63
$292.19
$287.52
$301.32
$303.27
$410.22
$398.58
$394.20
$379.36
$373.29
$391.21
$393.74
$456.51
$443.56
$438.69
$422.17
$415.42
$435.35
$438.18
$354.77
$354.77
$344.13
$334.37
$330.70
$318.24
$313.15
$328.18
$330.31
$347.49
$337.63
$333.92
$321.34
$316.21
$331.38
$333.53
$358.23
$358.23
$400.67
$400.67
$388.66
$377.63
$373.49
$359.42
$353.67
$370.65
$373.05
$350.79
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
$216.39
$210.25
$207.94
$200.11
$196.91
$206.36
$207.70
$280.94
$272.97
$269.97
$259.80
$255.65
$267.92
$269.65
$312.64
$303.77
$300.44
$289.12
$284.50
$298.15
$300.09
$242.96
$242.96
$235.68
$228.99
$226.48
$217.95
$214.46
$224.76
$226.21
$237.98
$231.23
$228.69
$220.07
$216.55
$226.95
$228.42
$245.33
$245.33
$274.40
$274.40
$266.18
$258.62
$255.78
$246.15
$242.21
$253.84
$255.48
$240.24
ExhibitPPlanAdjustedIndexRateandConsumerAdjustedPremiumRates
Healthy Alliance Life Insurance Company
Small Group
Rates Effective January 1, 2015
HIOSPlanName
AnthemSilverBlueAccess4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBlueAccessChoice4000E/0%/5000w/HSA
AnthemSilverBlueAccessChoice2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBlueAccess2000/30%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBluePreferred5000/20%/6600
AnthemSilverBlueAccessChoice5000/20%/6600
AnthemSilverBlueAccess5000/20%/6600
AnthemSilverBlueAccess2600E/20%/5500w/HSA
AnthemSilverBlueAccessChoice2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemSilverBluePreferred2600E/20%/5500w/HSA
AnthemGoldBlueAccessChoice1000/20%/2500Plus
AnthemGoldBlueAccess1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferredOptions500/20%/4000
AnthemGoldBlueAccessChoice1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
HIOSPlanID
32753MO0790278
32753MO0790279
32753MO0790280
32753MO0790281
32753MO0790282
32753MO0790283
32753MO0790284
32753MO0790285
32753MO0790286
32753MO0790296
32753MO0790297
32753MO0790298
32753MO0790299
32753MO0790300
32753MO0790301
32753MO0790302
32753MO0790303
32753MO0790304
32753MO0790305
32753MO0790306
32753MO0790307
32753MO0790308
32753MO0790309
32753MO0790310
32753MO0790311
32753MO0790312
32753MO0790313
32753MO0790314
32753MO0790315
32753MO0790316
32753MO0790317
32753MO0790318
32753MO0790319
32753MO0790320
32753MO0790321
32753MO0790322
32753MO0790186
32753MO0790187
32753MO0790188
32753MO0790189
32753MO0790190
32753MO0790191
32753MO0790192
32753MO0790193
32753MO0790194
32753MO0790204
32753MO0790205
32753MO0790206
32753MO0790207
MarketAdjusted
IndexRate
(ExhibitO)
CostSharing
Adjustment
Provider
Network
Adjustment
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
0.6779
0.6779
0.6779
0.6779
0.6779
0.6779
0.6779
0.6779
0.6779
0.7033
0.7033
0.7033
0.7033
0.7033
0.7033
0.7033
0.7033
0.7033
0.6651
0.6651
0.6651
0.6651
0.6651
0.6651
0.6651
0.6651
0.6651
0.6734
0.6734
0.6734
0.6734
0.6734
0.6734
0.6734
0.6734
0.6734
0.8530
0.8530
0.8530
0.8530
0.8530
0.8530
0.8530
0.8530
0.8530
0.9012
0.8273
0.8273
0.8273
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
0.9089
1.0276
0.9968
0.9685
Adjustmentfor
CatastrophicPlan
Benefitsin
Adjustment
Additiontothe
{1}
AdministrativeCosts
EHBS
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0074
1.0074
1.0074
1.0074
1.0074
1.0074
1.0074
1.0074
1.0074
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
$82.71
$80.24
$77.97
$77.12
$74.22
$73.04
$76.53
$77.03
$82.71
$85.89
$83.32
$80.97
$80.08
$77.08
$75.85
$79.47
$79.99
$85.89
$78.71
$76.49
$75.65
$72.81
$71.65
$75.08
$75.56
$81.14
$81.14
$82.21
$82.21
$79.75
$77.50
$76.65
$73.77
$72.60
$76.07
$76.56
$104.93
$104.93
$101.80
$98.92
$97.84
$94.17
$92.67
$97.10
$97.72
$97.45
$100.97
$97.96
$95.19
PlanAdjusted
IndexRate
{2}
Calibration
Factor
{3}
Adjustto
1Q15eff
date
ConsumerAdjusted
PremiumRate
{4}
$380.02
$368.62
$358.16
$354.23
$340.89
$335.44
$351.54
$353.82
$380.02
$394.36
$382.54
$371.69
$367.61
$353.76
$348.11
$364.82
$367.18
$394.36
$361.67
$351.41
$347.55
$334.46
$329.11
$344.91
$347.14
$372.85
$372.85
$377.54
$377.54
$366.22
$355.83
$351.93
$338.67
$333.26
$349.25
$351.51
$481.84
$481.84
$467.40
$454.14
$449.16
$432.24
$425.33
$445.74
$448.63
$447.03
$463.80
$449.90
$437.13
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
$260.26
$252.45
$245.29
$242.60
$233.46
$229.73
$240.75
$242.31
$260.26
$270.08
$261.99
$254.55
$251.76
$242.28
$238.41
$249.85
$251.46
$270.08
$247.69
$240.66
$238.02
$229.06
$225.39
$236.21
$237.74
$255.35
$255.35
$258.56
$258.56
$250.81
$243.69
$241.02
$231.94
$228.23
$239.18
$240.73
$329.99
$329.99
$320.10
$311.02
$307.61
$296.02
$291.29
$305.27
$307.24
$306.15
$317.64
$308.12
$299.37
ExhibitPPlanAdjustedIndexRateandConsumerAdjustedPremiumRates
Healthy Alliance Life Insurance Company
Small Group
Rates Effective January 1, 2015
HIOSPlanName
HIOSPlanID
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBlueAccess1500/30%/5000
AnthemGoldBlueAccessChoice5000/0%/5000
AnthemGoldBlueAccess5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred5000/0%/5000
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBluePreferred3500/0%/4000
AnthemGoldBlueAccess3500/0%/4000
AnthemGoldBlueAccessChoice3500/0%/4000
AnthemGoldBlueAccessChoice1000/20%/3500
AnthemGoldBlueAccess1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBluePreferred1000/20%/3500
AnthemGoldBlueAccess2500/20%/4500
AnthemGoldBlueAccessChoice2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBluePreferred2500/20%/4500
AnthemGoldBlueAccessChoice1500/20%/4000
AnthemGoldBlueAccess1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
32753MO0790208
32753MO0790209
32753MO0790210
32753MO0790211
32753MO0790212
32753MO0790213
32753MO0790214
32753MO0790215
32753MO0790216
32753MO0790217
32753MO0790218
32753MO0790219
32753MO0790220
32753MO0790221
32753MO0790222
32753MO0790223
32753MO0790224
32753MO0790225
32753MO0790226
32753MO0790227
32753MO0790228
32753MO0790229
32753MO0790230
32753MO0790231
32753MO0790232
32753MO0790233
32753MO0790234
32753MO0790235
32753MO0790236
32753MO0790237
32753MO0790238
32753MO0790239
32753MO0790240
32753MO0790241
32753MO0790242
32753MO0790243
32753MO0790244
32753MO0790245
32753MO0790246
32753MO0790247
32753MO0790248
32753MO0790249
32753MO0790250
32753MO0790251
32753MO0790252
32753MO0790253
32753MO0790254
32753MO0790255
32753MO0790256
MarketAdjusted
IndexRate
(ExhibitO)
CostSharing
Adjustment
Provider
Network
Adjustment
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
0.8273
0.8273
0.8273
0.8273
0.8273
0.8273
0.7892
0.7892
0.7892
0.7892
0.7892
0.7892
0.7892
0.7892
0.7892
0.8378
0.8378
0.8378
0.8378
0.8378
0.8378
0.8378
0.8378
0.8378
0.8739
0.8739
0.8739
0.8739
0.8739
0.8739
0.8739
0.8739
0.8739
0.8147
0.8147
0.8147
0.8147
0.8147
0.8147
0.8147
0.8147
0.8147
0.8561
0.8561
0.8561
0.8561
0.8561
0.8561
0.8561
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
Adjustmentfor
CatastrophicPlan
Benefitsin
Adjustment
Additiontothe
{1}
AdministrativeCosts
EHBS
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
$94.15
$90.61
$89.17
$93.43
$94.04
$100.97
$96.23
$96.23
$93.35
$90.70
$89.71
$86.34
$84.96
$89.03
$89.61
$99.11
$96.30
$95.25
$91.67
$90.21
$94.53
$95.14
$102.16
$102.16
$106.70
$106.70
$103.52
$100.59
$99.49
$95.75
$94.23
$98.73
$99.37
$99.38
$99.38
$96.41
$93.68
$92.66
$89.18
$87.76
$91.95
$92.55
$104.48
$104.48
$101.35
$98.49
$97.41
$93.75
$92.26
PlanAdjusted
IndexRate
{2}
Calibration
Factor
{3}
Adjustto
1Q15eff
date
ConsumerAdjusted
PremiumRate
{4}
$432.34
$416.05
$409.40
$429.05
$431.83
$463.80
$442.37
$442.37
$429.11
$416.93
$412.35
$396.81
$390.47
$409.21
$411.86
$455.52
$442.59
$437.73
$421.24
$414.50
$434.40
$437.22
$469.60
$469.60
$490.00
$490.00
$475.31
$461.82
$456.76
$439.55
$432.53
$453.28
$456.22
$456.69
$456.69
$443.00
$430.43
$425.71
$409.67
$403.12
$422.47
$425.21
$479.94
$479.94
$465.55
$452.34
$447.38
$430.53
$423.64
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
$296.09
$284.93
$280.38
$293.84
$295.74
$317.64
$302.96
$302.96
$293.87
$285.53
$282.40
$271.76
$267.41
$280.25
$282.07
$311.96
$303.11
$299.78
$288.49
$283.88
$297.50
$299.43
$321.61
$321.61
$335.58
$335.58
$325.52
$316.28
$312.81
$301.03
$296.22
$310.43
$312.44
$312.77
$312.77
$303.39
$294.78
$291.55
$280.56
$276.08
$289.33
$291.20
$328.69
$328.69
$318.84
$309.79
$306.39
$294.85
$290.13
ExhibitPPlanAdjustedIndexRateandConsumerAdjustedPremiumRates
Healthy Alliance Life Insurance Company
Small Group
Rates Effective January 1, 2015
HIOSPlanName
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred1500/20%/4000
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBluePreferred500/20%/3500
AnthemGoldBlueAccessChoice500/20%/3500
AnthemGoldBlueAccess500/20%/3500
AnthemGoldBlueAccess2000/0%/4000
AnthemGoldBlueAccessChoice2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
AnthemGoldBluePreferred2000/0%/4000
HIOSPlanID
32753MO0790257
32753MO0790258
32753MO0790269
32753MO0790270
32753MO0790271
32753MO0790272
32753MO0790273
32753MO0790274
32753MO0790275
32753MO0790276
32753MO0790277
32753MO0790323
32753MO0790324
32753MO0790325
32753MO0790326
32753MO0790327
32753MO0790328
32753MO0790329
32753MO0790330
32753MO0790331
MarketAdjusted
IndexRate
(ExhibitO)
CostSharing
Adjustment
Provider
Network
Adjustment
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
0.8561
0.8561
0.8929
0.8929
0.8929
0.8929
0.8929
0.8929
0.8929
0.8929
0.8929
0.8799
0.8799
0.8799
0.8799
0.8799
0.8799
0.8799
0.8799
0.8799
0.9505
0.9567
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
Adjustmentfor
CatastrophicPlan
Benefitsin
Adjustment
Additiontothe
{1}
AdministrativeCosts
EHBS
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
$96.67
$97.30
$105.84
$102.85
$101.73
$97.91
$96.35
$100.96
$101.61
$109.10
$109.10
$107.34
$107.34
$104.14
$101.19
$100.08
$96.32
$94.79
$99.32
$99.96
PlanAdjusted
IndexRate
{2}
Calibration
Factor
{3}
Adjustto
1Q15eff
date
ConsumerAdjusted
PremiumRate
{4}
$443.98
$446.85
$485.70
$471.92
$466.74
$449.16
$441.98
$463.19
$466.19
$500.70
$500.70
$493.24
$493.24
$478.45
$464.87
$459.77
$442.45
$435.38
$456.27
$459.23
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
$304.06
$306.03
$332.63
$323.19
$319.65
$307.61
$302.69
$317.22
$319.27
$342.91
$342.91
$337.80
$337.80
$327.67
$318.37
$314.88
$303.01
$298.17
$312.48
$314.51
Notes:
{1}Thisadjustmentassumesahealthierthanaveragepopulationwillselectthecatastrophicplan.Thecatastrophicadjustmentfactorisnormalizedto1.0acrossallplansforrevenueneutralityacrosstheentireblock.
{2}ThePlanAdjustedIndexRateiscalculatedbymultiplyingtheMarketAdjustedIndexRatebytheAVandcostsharing,providernetwork,benefitsinadditiontotheEHBs,andcatastrophicplanadjustmentsandthenaddingtheadministrativecosts.ThePlanAdjustedIndexRatecanalsobe
describedasaPlanLevelRequiredPremium.
{3}SeeExhibitHCalibration.
{4}TheConsumerAdjustedPremiumRateiscalculatedbydividingbyCalibrationFactorandthenmultiplyingbyAdjustto1Q15effectivedatefactor.
Followingaretheproductsthatwillbeterminatedpriortotheeffectivedate:
ThisincludesproductsthathaveexperienceincludedintheURRTduringtheexperienceperiodand
anyproductsthatwerenotineffectduringtheexperienceperiodbutweremadeavailable
thereafter.
PreACATerminatedProducts
HIOSProductID
HIOSProductName
32753MO076
LumenosBluePreferredSelect
HIOSProductID
PostACATerminatedPlans
HIOSProductName