2012 Health Insurance Premium Rate Review Final Decision Detailed Tables
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1 2012 Health Insurance Premium Rate Review Final Decision Detailed Tables Introduction The following tables provide detailed information regarding the requested and approved health insurance premium rate factors for Blue Cross Blue Shield of Rhode Island (BCBSRI), Tufts Health Plan (Tufts), and United Healthcare (United) for both small and large employers. Detailed Tables Please note that the rate factors listed are not meant to sum to the expected overall average premium trend but do collectively result in the expected overall average premium trend. BCBSRI Small Group s: Requested and Approved * Hospital Inpatient 6.70% 6.70% Hospital Outpatient 8.90% 8.90% Primary Care 10.90% 10.90% Other Physician 6.20% 6.20% Pharmacy 7.50% 7.50% Prior Period Adjustment -2.60% -2.60% Pharmacy Benefit Manager Adjustment -2.70% -2.70% Total Weighted Medical Expense Trend 4.80% 4.80% Administrative Expense Per Member Per Month $62.60 $59.11 Contribution to Reserves as a Percent of Premium 3.34% 3.34% ACA Insurer Fee and Reinsurance Collection 1.80% 0.00% Expected Overall Average Premium Trend 4.15% 1.65% *Trend factors are weighted averages based on quarterly enrollment and weighting between 2013/2012 and 2014/2013 filed trends.
2 Page Health Insurance Premium Rate Review Final Decision Detailed Tables, September 2012 BCBSRI Large Group s: Requested and Approved * Hospital Inpatient 6.90% 6.90% Hospital Outpatient 7.50% 7.50% Primary Care 9.50% 9.50% Other Physician 5.00% 5.00% Pharmacy 6.10% 6.10% Prior Period Adjustment 0.00% 0.00% Pharmacy Benefit Manager Adjustment -2.70% -2.70% Total Weighted Medical Expense Trend 3.80% 3.80% Administrative Expense Per Member Per Month $55.04 $53.47 Contribution to Reserves as a Percent of Premium 3.34% 3.34% ACA Insurer Fee and Reinsurance Collection 1.60% 0.00% Expected Overall Average Premium Trend 5.88% 3.98% *Trend factors are weighted averages based on quarterly enrollment and weighting between 2013/2012 and 2014/2013 filed trends.
3 Page Health Insurance Premium Rate Review Final Decision Detailed Tables, September 2012 Tufts Small Group s: Requested and Approved Hospital Inpatient 5.20% 5.20% Hospital Outpatient 6.70% 6.70% Primary Care 5.40% 5.40% Other Physician 4.70% 4.70% Pharmacy 4.70% 4.70% Prior Period Adjustment 0.60% 0.60% Total Weighted Medical Expense Trend 5.40% 5.40% Administrative Expense Per Member Per Month $62.10 $59.11 Contribution to Reserves as a Percent of Premium 0.00% 0.00% Expected Overall Average Premium Trend 6.00% 5.30%
4 Page Health Insurance Premium Rate Review Final Decision Detailed Tables, September 2012 Tufts Large Group s: Requested and Approved Hospital Inpatient 5.20% 5.20% Hospital Outpatient 6.70% 6.70% Primary Care 5.40% 5.40% Other Physician 4.70% 4.70% Pharmacy 4.70% 4.70% Prior Period Adjustment 0.60% 0.60% Total Weighted Medical Expense Trend 5.40% 5.40% Administrative Expense Per Member Per Month $60.22 $53.47 Contribution to Reserves as a Percent of Premium 0.00% 0.00% Expected Overall Average Premium Trend 6.00% 4.50%
5 Page Health Insurance Premium Rate Review Final Decision Detailed Tables, September 2012 United Small Group s: Requested and Approved Hospital Inpatient 7.00% 7.00% Hospital Outpatient 14.00% 9.40% Primary Care 8.90% 8.90% Other Physician 8.30% 6.20% Pharmacy 12.30% 6.80% Prior Period Adjustment -3.20% -3.20% Total Weighted Medical Expense Trend 10.38% 7.54% Administrative Expense Per Member Per Month $48.36 $48.36 Contribution to Reserves as a Percent of Premium 2.00% 2.00% Expected Overall Average Premium Trend 6.20% 2.54%
6 Page Health Insurance Premium Rate Review Final Decision Detailed Tables, September 2012 United Large Group s: Requested and Approved Hospital Inpatient 7.20% 7.20% Hospital Outpatient 14.10% 11.10% Primary Care 9.00% 9.00% Other Physician 7.90% 7.00% Pharmacy 12.40% 8.00% Prior Period Adjustment -0.10% -0.10% Total Weighted Medical Expense Trend 10.50% 8.65% Administrative Expense Per Member Per Month $41.78 $41.78 Contribution to Reserves as a Percent of Premium 2.00% 2.00% Expected Overall Average Premium Trend 7.80% 5.53% For More Information For more information, please visit.
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