NOTICES
Rate Filing Information for Pennsylvania Issuers Requesting Affordable Care Act-Compliant Premium Rates Effective January 1, 2017, through December 31, 2017
[46 Pa.B. 2922]
[Saturday, June 4, 2016]The Insurance Department (Department) made the following rate request summaries public on May 25, 2016. The Department will make a copy of each filing public the week of June 13, 2016. In addition, correspondence and filing revisions will be made public as they occur during review.
The filing will be available on the Department's web site at www.insurance.pa.gov. To view this filing, hover the cursor over ''Consumers'' in the blue bar at the top of the webpage then select ''ACA Health Rate Filings.'' Portions of the filing can also be viewed at the Centers for Medicare and Medicaid Services' web site at https://ratereview.healthcare.gov/.
Portions of the filing are also available for public inspection, by appointment, during normal working hours at the Department's regional office in Harrisburg.
For the following filings, all interested parties are invited to submit written or e-mail comments, suggestions or objections to Cherri Sanders-Jones, Insurance Department, Insurance Product Regulation, 1311 Strawberry Square, Harrisburg, PA 17120, csandersjo@pa.gov by July 22, 2016.
Company name: Federated Mutual Insurance Company
Market: Small Group
Product: PPO
Average rate change: 33.3% and $147.58 per member per
month (pmpm)
Range of rate change: 19.6% to 34.9%
Current number of covered lives: 4,542
Current number of policyholders: 253
Experience period revenue: $11,960,895
Additional revenue from rate increase: $3,987,212Company name: First Priority Life Insurance Company
Market: Individual
Product: PPO
Average rate change: 38.8% and $132 pmpm
Range of rate change: 38.8% to 38.8%
Current number of covered lives: 833
Current number of policyholders: 608
Experience period revenue: $170 million
Additional revenue from rate increase: $1.3 millionCompany name: Highmark Health Insurance Company
Market: Individual
Product: PPO
Average rate change: 48.1% and $238 pmpm
Range of rate change: 32.2% to 114.1%
Current number of covered lives: 20,327
Current number of policyholders: 13,253
Experience period revenue: $144 million
Additional revenue from rate increase: $58.1 millionCompany name: Highmark Health Insurance Company
Market: Small Group
Products: PPO, HDHP-PPO, EPO and Flex Blue PPO
Average rate change: 1.85% and $11.14 pmpm
Range of rate change: -3.5% to 5.8%
Current number of covered lives: 1,027
Current number of policyholders: 584
Experience period revenue: $459 million
Additional revenue from rate increase: $300,000Company name: Highmark, Inc. d/b/a Highmark Blue
Cross Blue Shield (Western PA)
Market: Individual
Product: PPO, EPO
Average rate change: 38.4% and $110 pmpm
Range of rate change: 26.0% to 55.6%
Current number of covered lives: 38,559
Current number of policyholders: 27,497
Experience period revenue: $760 million
Additional revenue from rate increase: $50.8 millionCompany name: Highmark, Inc. (Western PA)
Market: Small Group
Product: PPO, HDHP-PPO, EPO
Average rate change: 5.73% and $25.74 pmpm
Range of rate change: -1.1% to 8.5%
Current number of covered lives: 15,580
Current number of policyholders: 8,754
Experience period revenue: $93.7 million
Additional revenue from rate increase: $4.4 millionCompany name: Highmark Benefits Group
Market: Small Group
Product: PPO, EPO, HDHP-PPO
Average rate change: 6.08% and $35.27 pmpm
Range of rate change: -0.30% to 10.10%
Current number of covered lives: 8,574
Current number of policyholders: 4,848
Experience period revenue: $36.6 million
Additional revenue from rate increase: $5.1 millionCompany name: Highmark Choice Company (formerly
Keystone Health Plan West)
Market: Individual
Product: HMO
Average rate change: 44.8% and $185.71 pmpm
Range of rate change: 44.8% to 44.8%
Current number of covered lives: 302
Current number of policyholders: 206
Experience period revenue: $1 million
Additional revenue from rate increase: $672,000Company name: Highmark Choice Company (formerly
Keystone Health Plan West)
Market: Small Group
Product: HMO
Average rate change: 1.92% and $13.70 pmpm
Range of rate change: 1.92% to 1.92%
Current number of covered lives: 5
Current number of policyholders: 4
Experience period revenue: $781,821
Additional revenue from rate increase: $23,000Company name: Highmark Coverage Advantage
Market: Small Group
Product: PPO and HDHP-PPO
Average rate change: -3.83% and -$25.00 pmpm
Range of rate change: -12.60% to -1.60%
Current number of covered lives: 1,927
Current number of policyholders: 1,020
Experience period revenue: $10.9 million
Additional revenue from rate increase: -$200,000Company name: Highmark Select Resources
Market: Individual
Product: PPO
Average rate change: 25.4% and $111 pmpm
Range of rate change: 13.9% to 35.0%
Current number of covered lives: 1,298
Current number of policyholders: 763
Experience period revenue: $0
Additional revenue from rate increase: $1.7 millionCompany name: First Priority Health HMO (Northeast-
ern PA)
Market: Individual
Product: HMO
Average rate change: N/A
Range of rate change: N/A
Current number of covered lives: N/A
Current number of policyholders: N/A
Experience period revenue: $ N/A
Additional revenue from rate increase: $ N/ACompany name: UPMC Health Coverage, Inc.
Market: Small Group
Product: HMO
Average rate change: 6.7% and $15.50 pmpm
Range of rate change: 5.9% to 8.3%
Current number of covered lives: 1,197
Current number of policyholders: 711
Experience period revenue: $8,381,647
Additional revenue from rate increase: $615,400Company name: UPMC Health Coverage, Inc.
Market: Individual
Product: HMO
Average rate change: 0.9% and $1.89 pmpm
Range of rate change: 0.9% to 0.9%
Current number of covered lives: 7
Current number of policyholders: 5
Experience period revenue: $41,884
Additional revenue from rate increase: $159Company name: United Healthcare Insurance Company
Market: Small Group
Product: Indemnity, EPO and PPO
Average rate change: 4.23% and $16.16 pmpm
Range of rate change: -3.1% to 15.3%
Current number of covered lives: 15,520
Current number of policyholders: 1,044
Experience period revenue: $71,450,594
Additional revenue from rate increase: $4,040,017Company name: First Priority Life Insurance Company
Market: Small Group
Product: PPO
Average rate change: 11.1% and $57.00 pmpm
Range of rate change: -7.6% to 17.5%
Current number of covered lives: 4,448
Current number of policyholders: 2,837
Experience period revenue: $18,351,831
Additional revenue from rate increase: $3.04 millionFor the following filings, all interested parties are invited to submit written or e-mail comments, suggestions or objections to Rashmi Mathur, Insurance Department, Insurance Product Regulation, 1311 Strawberry Square, Harrisburg, PA 17120, rmathur@pa.gov by July 22, 2016.
Company name: Geisinger Health Plan
Market: Individual
Product: HMO and POS
Average rate change: 41.2% and $194.26 pmpm
Range of rate change: 29.6% to 74.9%
Current number of covered lives: 25,021
Current number of policyholders: 17,872
Experience period revenue: $92,056,264
Additional revenue from rate increase: $58,325,726Company name: Geisinger Health Plan
Market: Small Group
Product: HMO and POS
Average rate change: 9.3% and $46.05 pmpm
Range of rate change: -8.9% to 13.9%
Current number of covered lives: 9,561
Current number of policyholders: 5,736
Experience period revenue: $74,001,235
Additional revenue from rate increase: $5,283,974Company name: Geisinger Quality Options
Market: Individual
Product: PPO
Average rate change: 40.7% and $192.65 pmpm
Range of rate change: 35.0% to 73.0%
Current number of covered lives: 6,314
Current number of policyholders: 4,380
Experience period revenue: $30,294,687
Additional revenue from rate increase: $14,597,052Company name: Geisinger Quality Options
Market: Small Group
Product: PPO
Average rate change: 5.2% and $26.32 pmpm
Range of rate change: -0.6% to 7.1%
Current number of covered lives: 3,974
Current number of policyholders: 2,302
Experience period revenue: $115,044,557
Additional revenue from rate increase: $1,255,206Company name: Keystone Health Plan East
Market: Individual
Product: HMO
Average rate change: 19.9% and $78.25 pmpm
Range of rate change: 3.4% to 39.8%
Current number of covered lives: 129,928
Current number of policyholders: 86,467
Experience period revenue: $467,044,692
Additional revenue from rate increase: $92,941,894Company name: Keystone Health Plan East
Market: Small Group
Product: HMO
Average rate change: 3.7% and $18.64 pmpm
Range of rate change: 1.2% to 5.8%
Current number of covered lives: 125,640
Current number of policyholders: 73,044
Experience period revenue: $616,774,973
Additional revenue from rate increase: $22,820,674Company name: QCC Insurance Company
Market: Individual
Product: PPO
Average rate change: 22.5% and $117.89 pmpm
Range of rate change: 10.4% to 40.1%
Current number of covered lives: 53,629
Current number of policyholders: 33,691
Experience period revenue: $308,952,050
Additional revenue from rate increase: $69,514,211Company name: QCC Insurance Company
Market: Small Group
Product: PPO
Average rate change: 4.35% and $24.22 pmpm
Range of rate change: 3.6% to 11.2%
Current number of covered lives: 74,616
Current number of policyholders: 35,577
Experience period revenue: $437,196,684
Additional revenue from rate increase: $19,018,056Company name: Freedom Life Insurance Company
Market: Individual
Product: PPO
Average rate change: 9.95% and $41.70 pmpm
Range of rate change: 9.95% to 9.95%
Current number of covered lives: 0
Current number of policyholders: 0
Experience period revenue: $0
Additional revenue from rate increase: $0Company name: National Foundation Life Insurance
Company
Market: Individual
Product: PPO
Average rate change: 9.95% and $42.93 pmpm
Range of rate change: 9.95% to 9.95%
Current number of covered lives: 0
Current number of policyholders: 0
Experience period revenue: $0
Additional revenue from rate increase: $0Company name: UPMC Health Options
Market: Individual
Product: PPO and EPO
Average rate change: 16.2% and $28.45 pmpm
Range of rate change: 13.6% to 18.5%
Current number of covered lives: 110,825
Current number of policyholders: 76,541
Experience period revenue: $192,348,466
Additional revenue from rate increase: $40,809,723Company name: UPMC Health Options
Market: Small Group
Product: PPO and EPO
Average rate change: 5.3% and $14.12 pmpm
Range of rate change: 0.1% to 23.1%
Current number of covered lives: 8,032
Current number of policyholders: 4,606
Experience period revenue: $522,524,157
Additional revenue from rate increase: $4,783,328For the following filings, all interested parties are invited to submit written or e-mail comments, suggestions or objections to Michael Gurgiolo, Insurance Department, Insurance Product Regulation, 1311 Strawberry Square, Harrisburg, PA 17120, mgurgiolo@pa.gov by July 22, 2016.
Company name: Aetna Health, Inc.
Market: Individual
Product: HMO
Average rate change: 17.2% and $39.48 pmpm
Range of rate change: 2.6% to 30.4%
Current number of covered lives: 47,305
Current number of policyholders: 32,892
Experience period revenue: $71.4 million
Additional revenue from rate increase: $25.5 millionCompany name: Aetna Health, Inc./Aetna Health Ins.
Co.
Market: Small Group
Product: HMO, POS
Average rate change: 31.8% and $105.77 pmpm
Range of rate change: -18.4% to 153.4%
Current number of covered lives: 10,431
Current number of policyholders: 6,065
Experience period revenue: $61.7 million
Additional revenue from rate increase: $19.6 millionCompany name: Aetna HealthAssurance of PA
Market: Small Group
Product: PPO, Indemnity
Average rate change: 32.3% and $111.64 pmpm
Range of rate change: 10.8% to 71.1%
Current number of covered lives: 26,468
Current number of policyholders: 15,043
Experience period revenue: $109.6 million
Additional revenue from rate increase: $35.5 millionCompany name: Aetna Life Insurance Company
Market: Small Group
Products: PPO, Indemnity
Average rate change: 31.7% and $51.82 pmpm
Range of rate change: 17.1% to 70.9%
Current number of covered lives: 6,123
Current number of policyholder: 3,201
Experience period revenue: $20.7 million
Additional revenue from rate increase: $6.7 millionFor the following filings, all interested parties are invited to submit written or e-mail comments, suggestions or objections to James Laverty, Actuary, Insurance Department, Insurance Product Regulation, 1311 Strawberry Square, Harrisburg, PA 17120, jlaverty@pa.gov by July 22, 2016.
Company name: Capital Advantage Assurance Company
Market: Small Group
Product: PPO
Average rate change: 4.3% and $252.88 pmpm
Range of rate change: -2.4% to 17.9%
Current number of covered lives: 56,439
Current number of policyholders: 31,866
Experience period revenue: $278.7 million
Additional revenue from rate increase: $14.3 millionCompany name: Capital Advantage Assurance Company
Market: Individual
Product: PPO
Average rate change: 27% and $121.00 pmpm
Range of rate change: 3.6% to 34.4%
Current number of covered lives: 38,043
Current number of policyholders: 22,830
Experience period revenue: $34.4 million
Additional revenue from rate increase: $55.3 millionCompany name: Capital Advantage Insurance Company
Market: Individual
Product: PPO
Average rate change: 21.1% and $101.97 pmpm
Range of rate change: 21.1% to 21.1%
Current number of covered lives: 14
Current number of policyholders: 9
Experience period revenue: $3.3 million
Additional revenue from rate increase: $17,131Company name: Capital Advantage Insurance Company
Market: Small Group
Product: PPO
Average rate change: 4.5% and $291.86 pmpm
Range of rate change: 4.4% to 5.8%
Current number of covered lives: 46
Current number of policyholders: 44
Experience period revenue: $1.7 million
Additional revenue from rate increase: $13,426Company name: Keystone Health Plan Central
Market: Individual
Product: HMO
Average rate change: 20.4% and $69.67 pmpm
Range of rate change: -13.6% to 28.7%
Current number of covered lives: 37,479
Current number of policyholders: 26,852
Experience period revenue: $8.2 million
Additional revenue from rate increase: $31.3 millionCompany name: Keystone Health Plan Central
Market: Small Group
Product: HMO
Average rate change: 8.0% and $33.65 pmpm
Range of rate change: -4.6% to 39.1%
Current number of covered lives: 901
Current number of policyholders: 600
Experience period revenue: $8.3 million
Additional revenue from rate increase: $363,790TERESA D. MILLER,
Insurance Commissioner
[Pa.B. Doc. No. 16-965. Filed for public inspection June 3, 2016, 9:00 a.m.]
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