Rate Justification

2021 Rate Increase Justification for Affordable Care Act (ACA) products

Considerations for 2021 rate increases for Blue Cross and 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)
  • Taxes and fees, including those that are applicable for 2021 under the ACA
  • Expected payments and charges under the Federal Risk Adjustment Program
  • Continued absence of federal funding for the cost-sharing reductions, applicable to Individual Silver metal level plans
  • Changes in cost-sharing levels
  • Movement of members to 2021 plans from 2020 plans that are being terminated in 2021 (Small Group products only)
  • Expected utilization, cost of services, and changes in delivery system characteristics for provider networks (HMO Louisiana products only)

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