Rate Justification

2017 Rate Increase Justification for Affordable Care Act (ACA) Products

 

Considerations for 2017 rate increases for Blue Cross Blue Shield of Louisiana and HMO Louisiana, Inc., individual and small group products include: 

  • Expected medical trend in both utilization and cost of services
  • Expected changes in the average morbidity (Individual products only)
  • Applicable taxes and fees, including those that are applicable for 2017 under the ACA 
  • Discontinuation of the Federal Transitional Reinsurance Program (for Individual products only)
  • Expected payments and charges under the Federal Risk Adjustment Program
  • Changes in cost-sharing levels and cost-sharing structures
  • Expected utilization and cost of services for provider networks (Individual HMO Louisiana products only)
  • Movement of members to 2017 plans from 2016 plans that are terminating in 2017

A subscriber’s actual rate increase could vary depending on the benefit plan.

2016 Rate Increase Justification for Affordable Care Act (ACA) Products

 

Considerations for 2016 rate increases for Blue Cross Blue Shield of Louisiana and HMO Louisiana, Inc., individual and small group products include: 

  • Expected medical trend in both utilization and cost of services
  • Expected changes in the average morbidity (Individual products only)
  • Applicable taxes and fees, including those that are applicable for 2016 under the ACA 
  • Expected payments and charges under the Federal Transitional Reinsurance and Risk Adjustment Programs (Individual products only)
  • Changes in cost sharing levels and cost sharing structure to make sure plans comply with the actuarial value metal level requirements and federal mandates, and to offset the increase in cost or use of medical care, and,
  • Movement of members to 2016 plans from 2015 plans that are being terminated in 2016.

A subscriber’s actual rate increase could vary depending on the benefit plan.