Decision – Approved July 13, 2012

 

 

On May 31, 2012, Anthem Health Plans filed a request to raise rates 9.1 percent on its individual policyholders in the direct pay active product options (Premier, SmartSense and Lumenos Plus).

 

The company sought the increase to adjust for rising medical and pharmacy costs and an increased use of medical services by members. The company calculated that the new rate would also generate the expected 80 percent small group medical loss ratio (MLR), for rebate purposes under the federal health care reform law.

 

The Department conducted an actuarial review of the request, received six public comments – which are summarized in the final disposition – and, on July 13, 2013, approved the new rate, determining that it is reasonable for the benefits provided.

 

The new rates will take effect October 1, 2013 and will affect 589 policyholders.