CID: Health Insurance Rate Filing - Anthem Health Plans. Inc. (Small Group)

Health Insurance Rate Filing - Anthem Health Plans. Inc. (Small Group)



Rate request: Average increase of 11.6 percent

Decision: Disapproved, approved lower increase of 11.5 percent.

On March 7, 2017, Anthem Health Plans, Inc. filed a revised rate request for an average increase of 11.6 percent on small group health plans that have been marketed on and off the state’s health insurance exchange for employers with 50 or fewer workers.

These plans provide coverage for approximately 42,200 employees and their dependents.

Anthem initially asked the Department on March 1 for permission to revise the rates with a 24.1 percent increase. However, the Department rejected the request because criteria used in the filing was not in compliance with Department guidelines set forth in Bulletin HC-106.

This new revised increase request of 11.6 percent is an adjustment for the 3rd and 4th quarter of 2017 and would replace a previously approved increase of 10.5 percent that is scheduled to take effect July 1, 2017.

Anthem said the increase is needed to address increases in medical service costs, prescription drug prices and demand for those services, a factor known as “trend.” The company projects that “trend” will have an impact of about 13 percent on its pricing. Additionally, the company cites changes in provider contracting and benefit modification to comply with the federally mandated actuarial values of the plans it markets under the Affordable Care Act (ACA).

The company also noted the effects of taxes, fees and the discontinuance of the Federal Transitional Reinsurance Program, which had provided funds to insurers to stabilize premiums and help offset costs from the expected high-costs claims of the newly insured under the ACA.

After conducting an actuarial review, the Department determined that the company overestimated the impact of medical inflation or “trend” on pricing, requiring a re-calculation which lowered trend impact from almost 13 percent to 12.6 percent. As a result, the Department disapproved the initial increase request and instead approved an average increase of 11.5 percent on April 11, 2017.

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Find the filing, brief summary and public comment section here at Health Insurance Rate Filing


Content Last Modified on 4/11/2017 11:09:54 AM