Rate Request: 7.2 percent increase
Decision: Disapproved September 29, 2014, approved lower increase of 4%
On September 3, 2014, Anthem Health Plans filed a request to increase rates 7.2 percent on its large group health insurance policies for employers with 51 or more workers.
Anthem said the increase was needed to account for the impact of increasing medical and pharmacy costs and an increased demand for medical services, factors known as “trend.” The company projected the “trend” impact at 6.35 percent on medical and 16.45 percent on pharmacy benefits, with the largest impact attributed to the new Hepatitis C drug Sovaldi. In its filing to the Department the company expects that Sovaldi “will impact few members but at an extremely high cost.”
Anthem also calculated the impact of fees and taxes associated with the federal Affordable Care Act in its rate calculations.
After an actuarial review, the Department determined that Anthem over-calculated the impact of trend and found that the more appropriate projections are 5.5 percent impact on medical and 9.5 percent impact on pharmacy. As a result, the Department disapproved the request as submitted on September 29, 2014 and instead approved a 4 percent increase.
The new rates would take effect on January 1, 2015.