2015 Anthem Small Group 1-1-2015 Rate Filing PDF

ACTUARIAL
MEMORANDUM
1. General Information
Company Identifying Information
CompanyLegalName:
State:
HIOSIssuerID:
Market:
EffectiveDate:
HealthyAllianceLifeInsuranceCompany
Missouri
32753
SmallGroup
January1,2015
Company Contact Information

PrimaryContactName:
PrimaryContactTelephoneNumber:
PrimaryContactEmailAddress:
AndyDare
(314)9238947
Andy.Dare@wellpoint.com
2. Scope and Purpose of the Filing

TothebestofAnthem'sknowledgeandcurrentunderstanding,thisfilingcomplieswiththemostrecent
regulationsandrelatedguidance.Totheextentrelevantrulesorguidanceontherulesareupdatedor
changed,amendmentstothisfilingmayberequired.
Thepurposeofthisratefilingistoestablishratesthatarereasonablerelativetothebenefitsprovidedand
todemonstratecompliancewithstatelawsandprovisionsoftheAffordableCareAct(ACA).Therateswill
beinforceforeffectivedatesonorafterJanuary1,2015.Subsequentratechangeswillbeimplemented
quarterlyasdiscussedinmoredetailinSection16:IndexRate.Theserateswillapplytoplansofferedboth
OnExchangeandOffExchange.Thisratefilingisnotintendedtobeusedforotherpurposes.
PolicyFormNumber(s):
ABCBSMOSGPPOONv01
ABCBSMOSGPPOOFFv01
ABCBSMOSGBPOOFFv01
3. Introduction
Thisfilingincludesanaveragerateincreaseof7.7%,withrangebyplanbetween10.8%and28.2%.More
detailsareprovidedbelowinSection5:ProposedRateIncrease,andinExhibitI:NonGrandfathered
BenefitPlanFactorsandRateIncreases.
Changes from 2014 Filings

TobaccoratingfactorsnowvarybyageseeExhibitJ:AgeandTobaccoFactors.
Areafactorshavebeenadjustedtoreflectmostcurrentexperience.RefertoExhibitK:AreaFactors.
ThisfilingincludesnewexhibitsshowingtheMarketAdjustedIndexRate,PlanAdjustedIndexRate,and
ConsumerAdjustedPremiumRates,asdefinedinthenewmemoinstructionsfor2015filings.SeeExhibit
O:QuarterlyIndex,Base,andMarketAdjustedIndexRateDevelopmentandExhibitP:PlanAdjusted
IndexRateandConsumerAdjustedPremiumRates.
4. Description of How the Base Rate Is Determined

Themethodologyusedtodeveloptheratesthisyearisconsistentwiththemethodologythatwasused
lastyear.ThedevelopmentoftheBaseRateisdetailedinExhibitA:BaseRateDevelopment.Further
detailsonhowthebaserateisdevelopedcanbefoundinSection9:CredibilityManualRate
Development,Section12:RiskAdjustmentandReinsurance,Section13:NonBenefitExpenses,Profitand
Risk,andSection19:Calibration.Adescriptionofthemethodologyusedtodeterminethebaserateisas
follows:
SmallGroupmanualratesaredevelopedbasedonhistoricalexperienceofGrandfatheredand
NonGrandfatheredbusiness.
Theexperiencedataisnormalizedtoreflectanticipatedchangesinage/gender,area/network
andbenefitplanfromtheexperienceperiodtotheprojectionperiodbasedonexpected
distributionofmembership.
Theprojectedclaimscostiscalculatedbyadjustingthenormalizedclaimsfortheimpactof
benefitchanges,populationmorbidity,trendfactors,etc.Adjustmentisnotbasedonthehealth
statusofthemember.
TheprojectionperiodisFebruary1,2015January31,2016.SmallGroupBusinessrenewsona
quarterlybasis;thereforethemiddlemonthofthefirstquarterisFebruary2015.
Adjustmentsforriskadjustmentandreinsuranceareappliedtotheprojectedclaimscost.
Nonbenefitexpenses,profit,andriskareappliedtotheprojectedclaimscosttodeterminethe
requiredprojectionperiodpremium.
Theprojectionperiodpremiumisadjustedbytheaverageratingfactorsintheprojectionperiod
todeterminethebaserate.
Thebaseraterepresentsanaveragebenefitplanandareaforanage21nontobaccouserin
Missouri.
Premiumsatthememberlevelaredeterminedbymultiplyingthebaseratebytheapplicablefactorfor
eachoftheallowableratingcriteria:age,tobacco,areaandbenefitplan.Anexampleofthiscalculationis
showninExhibitL:SampleRateCalculation.
5. Proposed Rate Increase

Theaverageproposedrateincreaseis7.7%.Factorsthataffecttheproposedrateincreaseforallplans
include:
Changesinbenefitdesign
Anticipatedchangesinthemarketwidemorbidityofthecoveredpopulationintheprojection
period
Changingtrendsinmedicalcostsandutilizationandothercostofcareimpacts
AnticipatedchangesinpaymentstotheFederalTransitionalReinsuranceProgram
Changesintaxes,fees,andothernonbenefitexpenses
TherateincreaseisshowninExhibitI:NonGrandfatheredBenefitPlanFactorsandRateIncreases.
Althoughratesarebasedonthesamesingleriskpoolofexperience,proposedrateincreasesvarybyplan
from10.8%to28.2%.Factorsthataffectthevariationintheproposedrateincreasebyplaninclude:
Changesinbenefitdesignthatvarybyplan
ChangesintheadjustmentfactorforCatastrophiceligibility
ChangesinNonBenefitExpensesthatareappliedonaPMPMbasis
Changesintheunderlyingarearatingfactors,whichareincludedintheplanlevelincreasefor
plansnotofferedinallareas
Anticipatedchangesduetonetworkcontractingbypricingarea.
In2014,theareafactorsvariedbyplanbasedonactuariallyjustifiednetworkcostdifferencesforeach
geographicratingarea.EffectiveJanuary1,2015,asingleareafactorwillapplytoallplansineach
geographicratingarea.Toretaintheactuariallyjustifiednetworkcostdifferencesforeachgeographic
areaandcomplywith45CFRpart147.102,severalnewplanshavebeenadded,eachofwhichis
availableinasinglegeographicratingarea.Newplanshavebeenmappedtocomparable2014plansfor
purposesofdeterminingtherateincrease.RefertoExhibitI:NonGrandfatheredBenefitPlanFactorsand
RateIncreasesandExhibitK:AreaFactorsfordetails.
TheserateincreasesbyplanareshowninExhibitI:NonGrandfatheredBenefitPlanFactorsandRate
Increases.
6. Experience Period Premium and Claims
ExperienceshowninWorksheet1,SectionIoftheUnifiedRateReviewTemplateisfortheMissouriSmall
GroupSingleRiskPoolNonGrandfatheredBusiness.Consistentwithlastyear,Anthemisassigning0%
credibilitytothesingleriskpoolexperience,thusitisnotusedfordevelopingmanualrates.Themanual
ratedevelopmentisfullydetailedinSection9:CredibilityManualRateDevelopment.
ClaimsexperienceinWorksheet1,SectionIoftheUnifiedRateReviewTemplatereflectsdatesofservice
fromJanuary1,2013throughDecember31,2013.
Paid Through Date

ClaimsshowninWorksheet1,SectionIoftheUnifiedRateReviewTemplatearepaidthroughMarch
31,2014.
Allowed and Incurred Claims Incurred During the Experience Period

Theallowedclaimsaredeterminedbysubtractingnoncoveredbenefits,providerdiscounts,and
coordinationofbenefitsamountsfromthebilledamount.
Allowedandincurredclaimsarecompletedusingthechainladdermethod,anindustrystandard,by
usinghistoricpaidvs.incurredclaimspatterns.Themethodcalculateshistoriccompletion
percentages,representingthepercentofclaimspaidforaparticularmonthafteronemonthofrun
out,twomonths,etc.,forafortyeightmonthviewofhistory.Claimbacklogfilesarereviewedona
monthlybasisandareaccountedforinthehistoricalcompletionfactorestimates.
Premiums (net of MLR Rebate) in Experience Period

TheestimatedNonGrandfatheredgrossearnedpremiumforMissouriSmallGroupis$467,171,983,
whereearnedpremiumistheproratashareofpremiumowedtoAnthemduetosubscribersactively
purchasinginsurancecoverageduringtheexperienceperiod.
ThepreliminaryMLRRebateestimateis$2,549,077,whichisconsistentwiththeDecember31,2013
AnthemgeneralledgerestimateallocatedtotheNonGrandfatheredportionofSmallGroup.Note
thatthisisanestimateandwillnotbefinaluntilJune1,2014.
7. Benefit Categories
ThemethodologyusedtodeterminebenefitcategoriesinWorksheet1,SectionIIoftheUnifiedRate
ReviewTemplateisasfollows:
InpatientHospital:Includesnoncapitatedfacilityservicesformedical,surgical,maternity,
mentalhealthandsubstanceabuse,skillednursing,andotherservicesprovidedinaninpatient
facilitysettingandbilledbythefacility.
OutpatientHospital:Includesnoncapitatedfacilityservicesforsurgery,emergencyroom,lab,
radiology,therapy,observationandotherservicesprovidedinanoutpatientfacilitysettingand
billedbythefacility.
Professional:Includesnoncapitatedprimarycare,specialist,therapy,theprofessional
componentoflaboratoryandradiology,andotherprofessionalservices,otherthanhospital
basedprofessionalswhosepaymentsareincludedinfacilityfees.
OtherMedical:Includesnoncapitatedambulance,homehealthcare,DME,prosthetics,supplies,
visionexams,dentalservicesandotherservices.
PrescriptionDrug:Includesdrugsdispensedbyapharmacyandrebatesreceivedfromdrug
manufacturers.
8. Projection Factors
Aspreviouslyindicated,thecredibilitylevelassignedtotheexperienceinWorksheet1,SectionIIIofthe
UnifiedRateReviewTemplateis0%.Consequently,factorstoprojectexperienceclaimsarenotprovided
astheyarenotapplicable.However,thefactorsusedtodevelopthemanualratesarefullydetailedin
Section9:CredibilityManualRateDevelopment.
Changes in the Morbidity of the Population Insured

n/aseeCredibilityManualRateDevelopment
Changes in Benefits
Changes in Demographics
Other Adjustments
Trend Factors (cost/utilization)

9. Credibility Manual Rate Development

Consistentwithlastyear'smethodology,experiencedevelopedandprojectedhereinisAnthem'sSmall
GroupBusinessbasedonplanliabilityamounts.TheratedevelopmentisshowninExhibitA:BaseRate
Development.
Source and Appropriateness of Experience Data Used
Thesourcedataunderlyingthedevelopmentofthemanualrateconsistsofclaimsforall
GrandfatheredandNonGrandfatheredSmallGroupbusiness,incurredduringtheperiodJanuary1,
2013December31,2013andpaidthroughMarch31,2014.Completionfactorsarethencalculated
toreflectadditionalmonthsofrunoutafterMarch31,2014.Anthemexpectsalargeportionofthe
GrandfatheredpolicyholderstomigratetoACAcompliantpoliciespriortoandduringtheprojection
period.
IndevelopingrateseffectiveJanuary1,2015,onlylimited2014experienceisavailable.This
experienceisnotdeemedcredibleforpurposesofratedevelopment.
Otherthancompletingtheincurredclaims,nofurtherexplicitadjustmentsaremadetothe
experiencedata.
Formoredetail,seeExhibitB:ClaimsExperienceforManualRateDevelopment.
Adjustments Made to the Data

ThedevelopmentoftheprojectedclaimsissummarizedinExhibitA:BaseRateDevelopment,items
(1)(10),anddescribedindetailbelow.
Theprojectedclaimscostiscalculatedbymultiplyingthenormalizedclaimscostbytheimpactof
benefitchanges,anticipatedchangesinpopulationmorbidity,andcostofcareimpacts.The
adjustmentsaredescribedbelow,andthefactorsarepresentedinExhibitD:ProjectionPeriod
Adjustments.Inaddition,thesourcedataisnormalizedforchangesintheprovidercontracts.
ChangesinDemographics(Normalization)
Thesourcedatawasnormalizedtoreflectanticipatedchangesinage/gender,area,network,and
benefitplanfromtheexperienceperiodtotheprojectionperiod.Thepurposeofthesefactorsisto
adjustcurrentexperiencetobereflectiveofexpectedclaimexperienceintheprojectionperiod.See
Section23:MembershipProjectionsforadditionalinformationonmembershipmovement.The
normalizationfactorsandtheiraggregateimpactontheunderlyingexperiencedataaredetailedin
ExhibitC:NormalizationFactors.
Age/Gender:Theassumedclaimscostisappliedbyageandgendertotheexperienceperiod
distributionandtheprojectionperioddistribution.
Area/Network:TheareaclaimsfactorsaredevelopedbasedonananalysisofSmallGroupand
Individualallowedclaimsbynetwork,mappedtotheprescribed2015ratingareasusing5digit
zipcode.
BenefitPlan:Theexperienceperiodclaimsarenormalizedtoanaverage2015planusingbenefit
relativities.Thebenefitrelativitiesincludethevalueofcostsharesandanticipatedchangesin
utilizationduetothedifferenceinaveragecostsharerequirements.
ChangesinBenefits
Benefitchangesincludethefollowing:
PreventiveRx(overthecounter):Theclaimsareadjustedfor100%coverageofbenefitsfor
specificoverthecounterdrugsobtainedwithaprescriptionfromaphysician.
RxAdjustments:TheclaimsareadjustedfordifferencesintheRxformularyaswellasforthe
impactofmovingdrugsintodifferenttiersintheprojectionperiodrelativetowhatisreflectedin
thebaseexperiencedata.
ChangesintheMorbidityofthePopulationInsured
Theclaimsareadjustedtoreflectshiftsinhealthinsurancecoverageasaresultoftheprovisionsof
theACA.Themarketshifts,orpopulationmovements,affectingthemorbidityoftheSmallGroup
marketintheprojectionperiodinclude:
SmallGroupselectingtodropcoverage
SmallGroupmemberselectingtobeuninsured
SmallGroupsmovingtoselffundedcoverage
SmallGroupmembersmovingtoMedicaid
SmallGroupselectingtoremainontheircurrent(nonACA)productsin2015.
SmallGroupmemberselectingtoforegoCOBRAcoverageupontermination
Themovementassumptionsabovearebasedonmarketresearchandassumptionsontheemployer
optoutandconsumeruptakerates.Themorbidityimpactsofpopulationmovementarebasedon
healthstatusdeterminedfrominternalriskscoredata.
TrendFactors
Theannualpricingtrendusedinthedevelopmentoftheratesis9.4%.Thetrendisdevelopedby
normalizinghistoricalbenefitexpenseforchangesintheunderlyingpopulationandknowncost
drivers,andtheresultisprojectedforward.Thetrendincludesavolatilityprovisionin
accordancewithActuarialStandardsofPractice.Theclaimsaretrended25monthsfromthe
midpointoftheexperienceperiod,whichisJuly1,2013,tothemidpointoftheprojection
period,whichisAugust1,2015.
Projectedtrendsincludetheestimatedcostduring2014and2015ofthepharmaceuticalSovaldi
andotherhighcostdrugsfortreatingHepatitisC.Thesecostestimateswerebasedonclaims
experienceforMissouriSmallGroupbusiness,togetherwithCDCrecommendationsandIndustry
andEnterprisedata.
OtherCostofCareImpacts
Utilizationorcostperservicechange:anticipatedchangesarereflectedinthemorbiditychanges
andtrend.
ChangeinMedicalManagement:medicalmanagementsavingsnotalreadyincludedintheclaims
experienceandtrend.
ChangeinProviderContracts:anticipatedchangesinprovidercontractsarereflectedinthe
benefitplanfactorsandtheregionratingfactors.
OtherClaimAdjustments
TheadjustmentsdescribedbelowarepresentedinExhibitE:OtherClaimAdjustments.
RxRebates:TheprojectedclaimscostisadjustedtoreflectanticipatedRxrebates.These
projectionstakeintoaccountthemostuptodateinformationregardinganticipatedrebate
contracts,drugprices,anticipatedpriceinflation,andupcomingpatentexpirations.
Thecostofaddingbenefitsforpediatricdentalandvisionareincluded.
Capitation Payments
Capitationarrangementsdonotexistforthisbusiness.
10. Credibility of Experience

ThecombinationofbothGrandfatheredandNonGrandfatheredexperiencedatamostreasonablyreflects
SmallGroupclaimsexperienceunderthefutureprojectionperiod.Actuarialjudgmenthasbeenexercised
todeterminethatrateswillbedevelopedgivingfullcredibilitytothedataunderlyingthemanualratein
Section9:CredibilityManualRateDevelopment.
Resulting Credibility Level Assigned to Base Period Experience

ThecredibilitylevelassignedtotheexperienceinWorksheet1,SectionIIIoftheUnifiedRateReview
Templateis0%.
11. Paid to Allowed Ratio
ThePaidtoAllowedAverageFactorinProjectionPeriodshowninWorksheet1,SectionIIIoftheUnified
RateReviewTemplateisdevelopedbymembershipweightedessentialhealthbenefitpaidclaimsdivided
bymembershipweightedessentialhealthbenefitallowedclaimsofeachplan.Theprojectedmembership
byplanisshowninWorksheet2,SectionII.
12. Risk Adjustment and Reinsurance

Projected Risk Adjustment
TheRiskAdjustmentprogramtransfersfundsfromlowerriskplanstohigherriskplansintheNon
GrandfatheredIndividualandSmallGroupmarket.TheHHSoperatedRiskAdjustmentprogramis
supportedbyauserfee,asshowninExhibitF:RiskAdjustmentandReinsuranceContributionsand
Payments.
Anthemisassumingtheriskfortheplansinthisfilingarenobetterorworsethanotherplansinthe
market,resultinginnoestimatedrisktransfervalueasshowninExhibitF:RiskAdjustmentand
ReinsuranceContributionsandPayments.
Projected ACA Reinsurance Recoveries Net of Reinsurance Premium

ThetransitionalreinsuranceriskmitigationprogramcollectsfundsfromallinsuranceissuersandTPAs
andredistributesthemtohighcostclaimantsintheNonGrandfatheredIndividualmarket.The
reinsurancecontributionisequaltothenationalpercapitareinsurancecontributionrateasshownin
ExhibitF:RiskAdjustmentandReinsuranceContributionsandPayments.
13. NonBenefit Expenses, Profit and Risk

NonBenefitexpensesaredetailedinExhibitG:NonBenefitExpensesandProfit&Risk.
Administrative Expense
AdministrativeExpensesareexpectedtobeconsistentwithhistoricallevelsandaredeveloped
utilizingthesamemethodologyaspreviousfilings,theyarenotvariedbyproductor
plan.Maintenancecostsareassumedtobeflatonapermemberbasiswithsavingsfrom
administrativeefficienciesandtheeliminationofunderwritingoffsetbynewexpensesforrisk
managementandregulatorycompliance.
Quality Improvement Expense

ThequalityimprovementexpenserepresentsAnthem'sdedicationtoprovidingthehigheststandard
ofcustomercareandconsistentlyseekingtoimprovehealthcarequality,outcomesandvalueina
costefficientmanner.
TheQIExpenseassumptionsarebasedonhistoricalamountsrelatedtothefollowinginitiatives:
ImproveHealthOutcomes,ActivitiestoPreventHospitalReadmissions,ImprovePatientSafetyand
ReduceMedicalErrors,WellnessandHealthPromotionActivities,HITExpensesforHealthCare
QualityImprovements,OtherCostContainmentandICD10.
Selling Expense
SellingExpenserepresentsbrokercommissionsandbonusesassociatedwiththebrokerdistribution
channelusinghistoricalandprojectedcommissionlevels.CommissionswillbepaidbothOnExchange
andOffExchange.
Taxes and Fees

PatientCenteredOutcomesResearchInstitute(PCORI)Fee:ThePCORIfeeisafederally
mandatedfeedesignedtohelpfundthePatientCenteredOutcomesResearchTrustFund.For
planyearsendingbeforeOctober1,2014,thefeeis$2permemberperyear.Thereafter,for
everyplanyearendingbeforeOctober1,2019,thefeewillincreasebythepercentageincrease
inNationalHealthcareExpenditures.
ACAInsurerFee:Thehealthinsuranceindustrywillbeassessedapermanentfee,basedon
marketshareofnetpremium,whichisnottaxdeductible.Thetaximpactofnondeductibilityis
capturedinthisfee.
ExchangeFee:TheExchangeUserFeeappliestoExchangebusinessonly,butthecostisspread
acrossallSmallGroupplans.Ablendedfee/percentageisdeterminedbasedonanassumed
10.0%ofmembersthatwillpurchaseproductsOnExchange.Theresultingfee/percentageis
appliedevenlytoallplansintheriskpool,bothOnandOffExchange.
Premiumtaxes,federalincometaxesandstateincometaxesarealsoincludedintheretention
items.
Profit
Profitisreflectedonaposttaxbasisasapercentthatdoesnotvarybyproductorplan.Theprofit
percentagedoesnotincludeanyassumedriskcorridorpaymentsorreceipts.
14. Projected Loss Ratio

Projected Federal MLR
TheprojectedFederalMLRfortheproductsinthisfilingisestimatedinExhibitM:FederalMLR
EstimatedCalculation.Pleasenotethatthiscalculationispurelyanestimateandnotmeanttobea
truemeasureforFederalorStateMLRrebatepurposes.Theproductsinthisfilingrepresentonlya
subsetofAnthem'sSmallGroupbusiness.TheMLRforAnthem'sentirebookofSmallGroupbusiness
willbecomparedtotheminimumFederalbenchmarkforpurposesofdeterminingregulationrelated
premiumrefunds.AlsonotethattheprojectedFederalMLRpresentedheredoesnotcaptureall
adjustments,includingbutnotlimitedto:threeyearaveraging,credibility,dualoption,and
deductible.Anthem'sprojectedMLRisexpectedtomeetorexceedtheminimumMLRstandardsat
themarketlevelafterincludingalladjustments.
15. Single Risk Pool

AsdescribedaboveinSection4:DescriptionofHowtheBaseRateIsDetermined,theAnthemIndexRate
forSmallGroupbusinessinMissouriisbasedontotalcombinedclaimscostsforprovidingessentialhealth
benefitswithinthesingleriskpoolofnongrandfatheredSmallGroupplansinMissouri.TheIndexRateis
adjustedonamarketwidebasisforthestatebasedonthetotalexpectedmarketwidepaymentsand
chargesundertheriskadjustmentandreinsuranceprogramsandExchangeuserfees.Thepremiumrates
forallAnthemnongrandfatheredplansintheSmallGroupmarketusetheapplicablemarketwide
adjustedindexrate,subjectonlytothepermittedplanleveladjustments.Thisdemonstratesthatthe
SingleRiskPoolforAnthemSmallGroupbusinessisestablishedaccordingtotherequirementsin45CFR
part156,156.80(d).
16. Index Rate

Experience Period Index Rate
TheindexraterepresentstheaverageallowedclaimsPMPMofessentialhealthbenefitsforAnthem's
SmallGroupNonGrandfatheredBusiness.TheexperienceperiodindexrateshowninWorksheet1,
SectionI(cellG17)oftheUnifiedRateReviewTemplateis$316.00andisthesameastheexperience
periodallowedclaims(cellG16inthesamelocation).Acomparisontothebenchmarkwas
performed,andonlyessentialhealthbenefitswerecoveredduringtheexperienceperiod.
Projection Period Index Rate
TheindexraterepresentstheaverageallowedclaimsPMPMofessentialhealthbenefitsforAnthem's
SmallGroupNonGrandfatheredBusiness.Theprojectionperiodindexratewasdevelopedasshown
inExhibitN:IndexRateDevelopmentbyadjustingtheprojectedincurredclaimsPMPMdescribedin
Section9:CredibilityManualRateDevelopmentofthismemorandum.Coveredbenefitsinexcessof
essentialhealthbenefitsthatareincludedintheprojectionperiodallowedclaims(cellT30of
Worksheet1,SectionIIoftheUnifiedRateReviewTemplate)butexcludedfromExhibitN:IndexRate
Development'sprojectionperiodindexrate(alsoshownincellV44ofWorksheet1,SectionIIIofthe
UnifiedRateReviewTemplate)arewellnessbenefitsincludingonlinefitnesstrainers,tobaccofree
certification,andfitnessreimbursement.
Quarterly Index and Base Rate

QuarterlyindexandbaseratechangeswillbeimplementedOnExchangeandOffExchange.See
ExhibitO:QuarterlyIndex,Base,andMarketAdjustedIndexRateDevelopment.
17. Market Adjusted Index Rate

TheMarketAdjustedIndexrateiscalculatedastheIndexRateadjustedforallallowablemarketwide
modifiersdefinedinthemarketratingrules.ThisdevelopmentispresentedinExhibitN:IndexRate
DevelopmentandExhibitO:QuarterlyIndex,Base,andMarketAdjustedIndexRateDevelopment.
18. Plan Adjusted Index Rate

ThePlanAdjustedIndexRateiscalculatedastheMarketAdjustedIndexRateadjustedforallallowable
planlevelmodifiersdefinedinthemarketratingrules.ThisdevelopmentispresentedinExhibitP:Plan
AdjustedIndexRateandConsumerAdjustedPremiumRates.
PlanLevelModifiers
CostSharingAdjustments:Thisisamultiplicativefactorthatadjustsfortheprojected
paid/allowedratioofeachplan,basedontheAVmetalvaluewithanadjustmentforutilization
differencesduetodifferencesincostsharing.Thisalsoincludesanadjustmentfortheaverage
tobaccofactorshowninExhibitH:Calibration.
ProviderNetworkAdjustments:Thisisamultiplicativefactorthatadjustsfordifferencesin
projectedclaimscostduetodifferentnetworkdiscounts.
AdjustmentsforBenefitsinAdditiontoEHBs:Thismultiplicativefactoradjustsforadditional
benefitsthatarenotEHBs.
Adjustmentsforadministrativecost:ThisisanadditiveadjustmentthatincludesalltheSelling
Expense,AdministrationandOtherRetentionItemsshowninExhibitG:NonBenefitExpenses
andProfit&Risk,withtheexceptionoftheExchangeUserFee.
19. Calibration
Therequiredpremiumintheprojectionperiodiscalibratedbytheaverageratingcalibrationfactors(Age,
Area,andPlanFactor),whichareusedtodeveloptheConsumerAdjustedPremiumRates.Theaverage
ratingfactorsareshowninExhibitH:Calibration,ExhibitP:PlanAdjustedIndexRateandConsumer
AdjustedPremiumRates,andappliedinlineitem14ofExhibitA:BaseRateDevelopment.
Benefit Plan Factors

Thebenefitplanratingfactorsareappliedtotheprojectionperioddistribution.
Benefitplanfactorsalsoconsiderthefollowingadjustments,asapplicable.
BenefitRichnessFactorAdjustment:Thisadjustmentaccountsformemberbehaviorvariations
dependingontherichnessofthebenefitdesign.
PediatricDentalandVisionBenefits:Forplansexcludingthepediatricdentalbenefitand
pediatricvisionbenefit,thebenefitplanfactorreflectsreducedbenefits.
NonEHBs:ForplansincludingbenefitsinadditiontoEHBs,thebenefitplanfactorreflects
enhancedbenefits.
ProviderNetwork:Thisfactoraccountsfordifferencesincontractedratesandnetworkstructure.
RefertoExhibitI:NonGrandfatheredBenefitPlanFactorsandRateIncreases.
Age Factors
Area Factors
In2014,theareafactorsvariedbyplanbasedonactuariallyjustifiednetworkcostdifferencesfor
eachgeographicratingarea.EffectiveJanuary1,2015,asingleareafactorwillapplytoallplansin
eachgeographicratingarea.
Areafactorshavebeenadjustedtoreflectthemostcurrentexperience.RefertoExhibitK:Area
Factors.
20. Consumer Adjusted Premium Rate

TheConsumerAdjustedPremiumRateiscalculatedasthePlanAdjustedIndexRatecalibratedas
describedintheprevioussection.ThisdevelopmentispresentedinExhibitP:PlanAdjustedIndexRate
andConsumerAdjustedPremiumRates.ThecalibrationisshowninExhibitH:Calibration.
21. Actuarial Value Metal Values
TheActuarialValue(AV)MetalValuesincludedinWorksheet2oftheUnifiedRateReviewTemplateare
basedontheAVCalculator.Totheextentacomponentofthebenefitdesignwasnotaccommodatedby
anavailableinputwithintheAVCalculator,thebenefitcharacteristicwasadjustedtobeactuarially
equivalenttoanavailableinputwithintheAVCalculatorforpurposesofutilizingtheAVCalculatorasthe
basisfortheAVMetalValues.BenefitsforPlansthatarenotcompatiblewiththeparametersoftheAV
CalculatorhavebeenseparatelyidentifiedanddocumentedintheUniquePlanDesignSupporting
DocumentationandJustificationthatsupportsthePlan&BenefitsTemplate.
22. Actuarial Value Pricing Values

TheAVPricingValuesforeachProductIDareinWorksheet2,SectionIoftheUnifiedRateReview
Template.TheAVPricingValuerepresentsthecumulativeeffectofadjustmentsmadebytheissuerto
movefromtheMarketAdjustedIndexRatetothePlanAdjustedIndexRate.ConsistentwithfinalMarket
rules,utilizationadjustmentsaremadetoaccountformemberbehaviorvariationsbaseduponcostshare
variationsofthebenefitdesignandnotthehealthstatusofthemember.Theaverageallowablemodifiers
totheIndexRatecanbefoundinExhibitP:PlanAdjustedIndexRateandConsumerAdjustedPremium
Rates.
23. Membership Projections

MembershipprojectionsinWorksheet2oftheUnifiedRateReviewTemplatearedevelopedusinga
populationmovementmodelplusadjustmentsforsalesexpectations.Thismodelprojectsthe
membershipintheprojectionperiodbytakingintoaccount:
SmallGroupsdroppingcoverage
SmallGroupmembersoptingoutofcoverage
SmallGroupmemberselectingtoforegoCOBRAcoverageupontermination
Theplandistributionisbasedonassumedmetaltierandnetworkdistributions.Some2014
preliminaryenrollmentinformationhasbeenconsideredinprojectingmembershipdistributions.
TheprojectedmorbiditychangesshowninExhibitD:ProjectionPeriodAdjustmentsincludeexpected
morbiditychangesduetopopulationmovement.
24. Warning Alerts

TherearewarningalertsincellsA80andA82onWorksheet2,SectionIVoftheUnifiedRateReview
Template.ThisisbecausetheSmallGroupPlanAdjustedIndexRatesreflectthememberweighted
averageoftheratesforalleffectivedatesinthefiling,whereastheWorksheet1SingleRiskPoolGross
PremiumAvg.RatereflectstheeffectivedateofthechangeintheIndexRate.
25. Terminated Products
ThelistofterminatedproductsisshowninExhibitQ:TerminatedProducts.
26. Plan Type

PlantypesinWorksheet2,SectionIoftheURRTadequatelydescribeAnthem'splans.
27. Reliance
Insupportofthisratedevelopment,variousdataandanalyseswereprovidedbyothermembersof
Anthem'sinternalactuarialstaff,includingdataandanalysisrelatedtocostofcare,valuation,andpricing.
Ihavereviewedthesedataandanalysesforreasonablenessandconsistency.IhavealsoreliedonBrian
Renshaw,FSA,MAAAtoprovidetheactuarialcertificationfortheUniquePlanDesignSupporting
DocumentationandJustificationforplansincludedinthisfiling.
28. Actuarial Certification

I,NicoleStyka,FSA,MAAA,amanactuaryforAnthem.IamamemberoftheAmericanAcademyof
ActuariesandaFellowoftheSocietyofActuaries.ImeettheQualificationStandardsoftheAmerican
AcademyofActuariestorendertheactuarialopinioncontainedherein.Iherebycertifythatthefollowing
statementsaretruetothebestofmyknowledgewithregardstothisfiling:
(1)TheprojectedIndexRateis:
IncompliancewithallapplicableStateandFederalStatutesandRegulations(45CFR
156.80(d)(1)),
DevelopedincompliancewiththeapplicableActuarialStandardsofPractice
Reasonableinrelationtothebenefitsprovidedandthepopulationanticipatedtobecovered
Neitherexcessivenordeficient.
(2)TheIndexRateandonlytheallowablemodifiersasdescribedin45CFR156.80(d)(1)and45CFR
156.80(d)(2)wereusedtogenerateplanlevelrates.
(3)ThepercentoftotalpremiumthatrepresentsessentialhealthbenefitsincludedinWorksheet2,
SectionsIIIandIViscalculatedinaccordancewithactuarialstandardsofpractice.
(4)TheAVCalculatorwasusedtodeterminetheAVMetalValuesshowninWorksheet2ofthePartI
UnifiedRateReviewTemplateforallplans.
ThePartIUnifiedRateReviewTemplatedoesnotdemonstratetheprocessusedbytheissuertodevelop
therates.RatheritrepresentsinformationrequiredbyFederalregulationtobeprovidedinsupportofthe
reviewofrateincreases,forcertificationofQualifiedHealthPlansforFederallyFacilitatedExchanges,and
forcertificationthattheIndexRateisdevelopedinaccordancewithFederalregulation,usedconsistently,
andonlyadjustedbytheallowablemodifiers.However,thisActuarialMemodoesaccuratelydescribethe
processusedbytheissuertodeveloptherates.
NicoleStyka,FSA,MAAA
RegionalVicePresidentandActuaryIII
August20,2014
Date
Exhibit A - Base Rate Development

Healthy Alliance Life Insurance Company
Small Group
Rates Effective January 1, 2015
1) ExperiencePeriodCostPMPM
2) xNormalizationFactor
3) =NormalizedClaims
PaidClaims
$ 253.96
0.8777
$ 222.90
ExhibitB
ExhibitC
=(1)x(2)
4)
5)
6)
7)
8)
0.9918
1.1022
1.2057
1.0000
$ 293.79
ExhibitD
ExhibitD
ExhibitD
ExhibitD
=(3)x(4)x(5)x(6)x(7)
9) +OtherClaimAdjustments
$ (4.22)
ExhibitE
10) =ClaimsProjectedtoProjectionPeriod
$ 289.57
=(8)+(9)
11) +RiskAdjustmentandReinsuranceContributionsandPayments
12) +NonBenefitExpensesandProfit&Risk{1}
13) =RequiredPremiuminProjectionPeriod
$ 3.63
$ 83.25
$ 376.45
ExhibitF
ExhibitG
=(10)+(11)+(12)
14) CalibrationFactor
15) TobaccoAverageRatingFactor
16) =RequiredBaseRate(AveragePlanLevelAge21NonTobacco)
1.4006
1.0032
$ 267.92
ExhibitH
ExhibitH
=(13)(14)(15)
xBenefitChanges
xMorbidityChanges
xTrendFactor
xOtherCostofCareImpacts
=ProjectedClaimCost
17) ProjectedLossRatio(ConventionalBasis)
77.9%
=[(10)+(11)](13)
NOTES:
{1}EquivalenttoPMPMexpensesonExhibitG+%ofpremiumexpensesonExhibitGappliedtoRequiredPremium(Row13above).
Exhibit B - Claims Experience for Manual Rate Development

Small Group
Incurred January 1, 2013 through December 31, 2013
Paid through March 31, 2014
PAID CLAIMS:
IncurredandPaidClaims:
Medical
Drug
$314,414,330 $112,466,759
IBNR:
Medical
$33,311,813
FullyIncurredClaims:
Drug
Medical
Drug
$ 4,155,407 $347,726,143 $116,622,166
Capitation
$
Total
BenefitExpense
$ 464,348,309
Member
Months
1,828,457
Total
PMPM
$253.96
Capitation
$
Total
BenefitExpense
$ 610,877,636
Member
Months
1,828,457
Total
PMPM
$334.09
ALLOWED CLAIMS:
IncurredandPaidClaims:
Medical
Drug
$422,452,256 $138,035,690
IBNR:
Medical
$45,310,539
FullyIncurredClaims:
Drug
Medical
Drug
$ 5,079,151 $467,762,795 $143,114,841
Exhibit C - Normalization Factors

Small Group
Age/Gender
Area/Network
BenefitPlan
Total
AverageClaimFactors
ExperiencePeriod
Future
Population
Population
0.9696
1.0223
1.0108
0.9932
0.8098
0.6860
Normalization
Factor
1.0544
0.9826
0.8472
0.8777
Exhibit D - Projection Period Adjustments

Small Group
ImpactofChangesBetweenExperiencePeriodandProjectionPeriod:
AdjustmentFactor
Benefitchanges
PreventiveRx(overthecounter)
RxAdjustments{1}
TotalBenefitChanges
1.0001
0.9917
0.9918
Morbiditychanges
TotalMorbidityChanges
1.1022
Costofcareimpacts
AnnualMedical/RxTrendRate
1MonthsofProjection
TrendFactor
9.39%
25
1.2057
TotalotherImpacts
NOTES:
{1}IncludesRxformularyandimpactsformovingdrugsintodifferenttiers
1.0000
Exhibit E - Other Claim Adjustments

Small Group
Adjustmentstoprojectionperiodclaimstoreflectcoveredbenefitsnotincludedinexperienceperioddata:
PMPM
RxRebates
($6.50)
PediatricDental
$0.80
PediatricVision
$0.99
CCPPackages
$0.49
Total
($4.22)
NOTES:
AdjustmentsabovereflectONLYadditionalcostsbeyondthosealreadycapturedinlineItem8ofExhibitA.
Exhibit F - Risk Adjustment and Reinsurance - Contributions and Payments

Small Group
RiskAdjustment:
PMPM
FederalProgram
UserFee
$0.08
NetTransfer
$0.00
Note:
Itisassumedtheriskfortheplansincludedinthisratefilingisnobetter/worsethananyotherplanswithinthismarket.
Reinsurance:
PMPM
ContributionsMade
FederalProgram
$3.55
ExpectedReceipts
$0.00
SmallGroupPlanscontributefundsbutonlyIndividualPlansare
eligibletoreceivepayments
Source:
HHSestimatesanationalpercapitacontributionrateof$13.67permonth($44peryear)inbenefityear2015(perPayment
ParameterRule).
GrandTotalofAllRiskMitigationPrograms
NOTES:
$3.55 =$13.67*(11months/12months)+$12.30*(1month/12months)
$3.67 =2015contribution
$2.30 =2016contribution
$3.63
Exhibit G - Non-Benefit Expenses and Profit & Risk

Small Group
ExpensesAppliedAsa ExpensesAppliedasa Expressedasa

PMPMCost
%ofPremium
PMPM{1}
AdministrativeExpenses
AdministrativeCosts
QualityImprovementExpense
SellingExpense
SpecialtyExpenses
TotalAdministrativeExpenses
TaxesandFees
PCORIFee
ACAInsurerFee
ExchangeFee
PremiumTax
MLRDeductibleFederal/StateIncomeTaxes {2}
TotalTaxesandFees
ProfitandRisk{3}
TotalNonBenefitExpenses,Profit,andRisk
$17.42
$3.27
$14.52
$0.31
$35.52
0.00%
$35.52
3.55%
0.35%
0.34%
2.94%
7.18%
5.45%
12.63%
$27.21
$20.52
$83.25
$0.18
$0.18
$35.70
NOTES:
{1}Thesumoftheroundedpercentagesshownmaynotequalthetotalatthebottomofthetableduetorounding.
{2}IncludesonlythoseincometaxeswhicharedeductiblefromtheMLRdenominator;inparticular,Federalincometaxesoninvestmentincomeare
excluded.
{3}Profitshownhereisposttaxprofit,netofthosefederalandstateincometaxeswhicharedeductiblefromtheMLRdenominator.
Exhibit H - Calibration
Small Group
Average2015ratingfactorsfor2015population:
Tobacco
Age
Area
BenefitPlan
TotalCalibrationFactor
TotalAverageRatingFactor
AverageRatingFactor
1.0032
CalibrationFactors
1.4008
0.9999
1.0000
1.4006
1.4051
NOTES:
SeeLineItem14onExhibitA.
Thebaserateisdevelopedbydividingtherequiredpremiumintheprojectionperiodbythetotalaveragerating
factorshownabove.
Exhibit I - Non-Grandfathered Benefit Plan Factors and Rate Increases

Small Group
HIOSPlanName
AnthemBronzeBluePreferredX3500/20%/6350Plusw/HSA
AnthemSilverBluePreferredX1500/30%/6600Plus
AnthemGoldBluePreferredX1000/20%/5500Plus
AnthemBronzeBlueAccess4500E/0%/6350w/HSA
AnthemBronzeBlueAccessChoice4500E/0%/6350w/HSA
AnthemBronzeBluePreferred4500E/0%/6350w/HSA
AnthemBronzeBluePreferred6000/0%/6600Plus
AnthemBronzeBlueAccessChoice6000/0%/6600Plus
AnthemBronzeBlueAccess6000/0%/6600Plus
2015HIOSPlanID
32753MO0780011
32753MO0780012
32753MO0780013
32753MO0780014
32753MO0780015
32753MO0780016
32753MO0780017
32753MO0780018
32753MO0780019
32753MO0780020
32753MO0780021
32753MO0780022
32753MO0780023
32753MO0780024
32753MO0780004
32753MO0780005
32753MO0780006
32753MO0780007
32753MO0780008
32753MO0780009
32753MO0780010
32753MO0790260
32753MO0790261
32753MO0790262
32753MO0790263
32753MO0790264
32753MO0790265
32753MO0790266
32753MO0790267
32753MO0790268
32753MO0790287
32753MO0790288
32753MO0790289
32753MO0790290
32753MO0790291
32753MO0790292
32753MO0790293
32753MO0790294
32753MO0790295
On/Off
Exchange
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
On/Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
MetalLevel
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
Bronze
BenefitPlan
Factor
NetworkName
0.8076
MOSG::BluePreferred
0.7847
MOSG::BluePreferred
0.7760
MOSG::BluePreferred
0.7468
MOSG::BluePreferred
0.7349
MOSG::BluePreferred
0.7701
MOSG::BluePreferred
0.7751
MOSG::BluePreferred
1.0485
MOSG::BluePreferred
1.0187
MOSG::BluePreferred
1.0075
MOSG::BluePreferred
0.9696
MOSG::BluePreferred
0.9541
MOSG::BluePreferred
0.9999
MOSG::BluePreferred
1.0064
MOSG::BluePreferred
1.1668
MOSG::BluePreferred
1.1337
MOSG::BluePreferred
1.1212
MOSG::BluePreferred
1.0790
MOSG::BluePreferred
1.0618
MOSG::BluePreferred
1.1127
MOSG::BluePreferred
1.1199
MOSG::BluePreferred
0.9067
MOSG::BlueAccess
0.9067
MOSG::BlueAccessChoice
0.8796
MOSG::BluePreferred
0.8546
MOSG::BluePreferred
0.8452
MOSG::BluePreferred
0.8134
MOSG::BluePreferred
0.8004
MOSG::BluePreferred
0.8388
MOSG::BluePreferred
0.8442
MOSG::BluePreferred
0.8881
MOSG::BluePreferred
0.8629
MOSG::BluePreferred
0.8535
MOSG::BluePreferred
0.8213
MOSG::BluePreferred
0.8082
MOSG::BluePreferred
0.8470
MOSG::BluePreferred
0.8525
MOSG::BluePreferred
0.9156
0.9156
MOSG::BlueAccess
Area(s)Offered
02
05
06
07
08
09
10
02
05
06
07
08
09
10
02
05
06
07
08
09
10
02,05,07,08,09,10
06
02
05
06
07
08
09
10
02
05
06
07
08
09
10
06
02,05,07,08,09,10
2014HIOSPlanID
Mapping
32753MO0780003
32753MO0780003
32753MO0780003
32753MO0780003
32753MO0780003
32753MO0780003
32753MO0780003
32753MO0780002
32753MO0780002
32753MO0780002
32753MO0780002
32753MO0780002
32753MO0780002
32753MO0780002
32753MO0780001
32753MO0780001
32753MO0780001
32753MO0780001
32753MO0780001
32753MO0780001
32753MO0780001
32753MO0790023
32753MO0790114
32753MO0790115
32753MO0790115
32753MO0790115
32753MO0790115
32753MO0790115
32753MO0790115
32753MO0790115
32753MO0790185
32753MO0790185
32753MO0790185
32753MO0790185
32753MO0790185
32753MO0790185
32753MO0790185
32753MO0790184
32753MO0790071
PlanSpecificRate
Increase*
(excludingaging)
10.45%
6.40%
3.45%
4.86%
9.17%
5.95%
4.10%
26.06%
21.44%
18.07%
8.59%
3.67%
20.92%
18.81%
12.88%
8.74%
5.73%
2.77%
7.17%
8.28%
6.39%
8.76%
10.21%
17.68%
13.36%
10.22%
1.36%
3.23%
12.88%
10.91%
28.24%
23.54%
20.11%
10.46%
5.46%
23.01%
20.86%
20.10%
18.53%
25

Small Group
HIOSPlanName
2015HIOSPlanID
AnthemSilverBlueAccessChoice3000/20%/4500Plus
AnthemSilverBlueAccess3000/20%/4500Plus
AnthemSilverBluePreferred3000/20%/4500Plus
AnthemSilverBluePreferredOptions2750/40%/6600
AnthemSilverBlueAccess4000E/0%/5000w/HSA
AnthemSilverBluePreferred4000E/0%/5000w/HSA
AnthemSilverBlueAccessChoice4000E/0%/5000w/HSA
AnthemSilverBlueAccessChoice2000/30%/6600
AnthemSilverBluePreferred2000/30%/6600
AnthemSilverBlueAccess2000/30%/6600
32753MO0790195
32753MO0790196
32753MO0790197
32753MO0790198
32753MO0790199
32753MO0790200
32753MO0790201
32753MO0790202
32753MO0790203
32753MO0790259
32753MO0790278
32753MO0790279
32753MO0790280
32753MO0790281
32753MO0790282
32753MO0790283
32753MO0790284
32753MO0790285
32753MO0790286
32753MO0790296
32753MO0790297
32753MO0790298
32753MO0790299
32753MO0790300
32753MO0790301
32753MO0790302
32753MO0790303
32753MO0790304
32753MO0790305
32753MO0790306
32753MO0790307
32753MO0790308
32753MO0790309
32753MO0790310
32753MO0790311
32753MO0790312
32753MO0790313
32753MO0790314
32753MO0790315
On/Off
Exchange MetalLevel
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Silver
BenefitPlan
Factor
NetworkName
Area(s)Offered
1.0241
1.0241
0.9934
0.9652
0.9546
0.9186
0.9039
0.9473
0.9535
0.8966
0.9713
0.9422
0.9154
0.9054
0.8713
0.8573
0.8985
0.9043
0.9713
1.0079
0.9777
0.9500
0.9396
0.9042
0.8897
0.9324
0.9385
1.0079
0.9244
0.8982
0.8883
0.8548
0.8412
0.8815
0.8873
0.9530
0.9530
0.9649
0.9649
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferredOptions
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccess
MOSG::BlueAccess
06
02,05,07,08,09,10
02
05
06
07
08
09
10
10
02,05,07,08,09,10
02
05
06
07
08
09
10
06
06
02
05
06
07
08
09
10
02,05,07,08,09,10
02
05
06
07
08
09
10
06
02,05,07,08,09,10
02,05,07,08,09,10
06
2014HIOSPlanID
Mapping
32753MO0790174
32753MO0790057
32753MO0790175
32753MO0790175
32753MO0790175
32753MO0790175
32753MO0790175
32753MO0790175
32753MO0790175
None
32753MO0790033
32753MO0790129
32753MO0790129
32753MO0790129
32753MO0790129
32753MO0790129
32753MO0790129
32753MO0790129
32753MO0790128
None
32753MO0790149
32753MO0790149
32753MO0790149
32753MO0790149
32753MO0790149
32753MO0790149
32753MO0790149
None
32753MO0790163
32753MO0790163
32753MO0790163
32753MO0790163
32753MO0790163
32753MO0790163
32753MO0790163
32753MO0790162
32753MO0790051
32753MO0790016
32753MO0790100
PlanSpecificRate
Increase*
(excludingaging)
15.92%
14.40%
23.78%
19.24%
15.93%
6.61%
1.78%
18.72%
16.66%
n/a
8.12%
16.98%
12.69%
9.56%
0.76%
3.81%
12.20%
10.25%
9.55%
n/a
15.10%
10.88%
7.81%
0.85%
5.35%
10.41%
8.48%
n/a
14.73%
10.52%
7.46%
1.18%
5.65%
10.05%
8.13%
7.45%
6.04%
0.23%
1.56%
26

Small Group
HIOSPlanName
2015HIOSPlanID
AnthemGoldBlueAccessChoice1000/20%/2500Plus
AnthemGoldBlueAccess1000/20%/2500Plus
AnthemGoldBluePreferred1000/20%/2500Plus
AnthemGoldBluePreferredOptions500/20%/4000
AnthemGoldBlueAccessChoice1500/30%/5000
AnthemGoldBluePreferred1500/30%/5000
AnthemGoldBlueAccess1500/30%/5000
32753MO0790316
32753MO0790317
32753MO0790318
32753MO0790319
32753MO0790320
32753MO0790321
32753MO0790322
32753MO0790186
32753MO0790187
32753MO0790188
32753MO0790189
32753MO0790190
32753MO0790191
32753MO0790192
32753MO0790193
32753MO0790194
32753MO0790204
32753MO0790205
32753MO0790206
32753MO0790207
32753MO0790208
32753MO0790209
32753MO0790210
32753MO0790211
32753MO0790212
32753MO0790213
32753MO0790214
32753MO0790215
32753MO0790216
32753MO0790217
32753MO0790218
32753MO0790219
32753MO0790220
32753MO0790221
32753MO0790222
32753MO0790223
32753MO0790224
32753MO0790225
32753MO0790226
On/Off
Exchange MetalLevel
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Silver
Silver
Silver
Silver
Silver
Silver
Silver
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
BenefitPlan
Factor
NetworkName
Area(s)Offered
0.9360
0.9095
0.8995
0.8656
0.8518
0.8926
0.8984
1.2315
1.2315
1.1946
1.1607
1.1480
1.1048
1.0871
1.1393
1.1466
1.1425
1.1854
1.1499
1.1173
1.1050
1.0634
1.0464
1.0966
1.1037
1.1854
1.1306
1.1306
1.0967
1.0656
1.0539
1.0142
0.9980
1.0459
1.0527
1.1643
1.1312
1.1188
1.0766
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferredOptions
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccess
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
02
05
06
07
08
09
10
06
02,05,07,08,09,10
02
05
06
07
08
09
10
10
06
02
05
06
07
08
09
10
02,05,07,08,09,10
06
02,05,07,08,09,10
02
05
06
07
08
09
10
02
05
06
07
2014HIOSPlanID
Mapping
32753MO0790101
32753MO0790101
32753MO0790101
32753MO0790101
32753MO0790101
32753MO0790101
32753MO0790101
32753MO0790166
32753MO0790053
32753MO0790167
32753MO0790167
32753MO0790167
32753MO0790167
32753MO0790167
32753MO0790167
32753MO0790167
None
32753MO0790140
32753MO0790141
32753MO0790141
32753MO0790141
32753MO0790141
32753MO0790141
32753MO0790141
32753MO0790141
32753MO0790039
32753MO0790158
32753MO0790049
32753MO0790159
32753MO0790159
32753MO0790159
32753MO0790159
32753MO0790159
32753MO0790159
32753MO0790159
32753MO0790157
32753MO0790157
32753MO0790157
32753MO0790157
PlanSpecificRate
Increase*
(excludingaging)
8.44%
4.47%
1.57%
6.59%
10.82%
4.02%
2.21%
9.26%
7.82%
16.66%
12.38%
9.27%
0.49%
4.06%
11.90%
9.95%
n/a
5.98%
13.16%
9.01%
5.99%
2.53%
6.94%
8.54%
6.65%
4.59%
6.28%
4.88%
13.48%
9.32%
6.28%
2.26%
6.68%
8.85%
6.95%
10.89%
6.82%
3.86%
4.49%
27

Small Group
HIOSPlanName
2015HIOSPlanID
32753MO0790227
32753MO0790228
32753MO0790229
32753MO0790230
32753MO0790231
32753MO0790232
32753MO0790233
32753MO0790234
32753MO0790235
32753MO0790236
32753MO0790237
32753MO0790238
32753MO0790239
32753MO0790240
32753MO0790241
32753MO0790242
32753MO0790243
32753MO0790244
32753MO0790245
32753MO0790246
32753MO0790247
32753MO0790248
32753MO0790249
32753MO0790250
32753MO0790251
32753MO0790252
32753MO0790253
32753MO0790254
32753MO0790255
32753MO0790256
32753MO0790257
32753MO0790258
32753MO0790269
32753MO0790270
32753MO0790271
32753MO0790272
32753MO0790273
32753MO0790274
32753MO0790275
On/Off
Exchange MetalLevel
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
BenefitPlan
Factor
1.0594
1.1103
1.1175
1.2002
1.2002
1.2524
1.2524
1.2148
1.1804
1.1674
1.1234
1.1055
1.1585
1.1660
1.1673
1.1673
1.1323
1.1001
1.0881
1.0471
1.0303
1.0798
1.0868
1.2267
1.2267
1.1899
1.1561
1.1435
1.1004
1.0828
1.1348
1.1421
1.2414
1.2062
1.1929
1.1480
1.1297
1.1839
1.1915
NetworkName
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccess
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
Area(s)Offered
08
09
10
02,05,07,08,09,10
06
06
02,05,07,08,09,10
02
05
06
07
08
09
10
02,05,07,08,09,10
06
02
05
06
07
08
09
10
06
02,05,07,08,09,10
02
05
06
07
08
09
10
02
05
06
07
08
09
10
2014HIOSPlanID
Mapping
32753MO0790157
32753MO0790157
32753MO0790157
32753MO0790048
32753MO0790156
None
None
32753MO0790042
32753MO0790042
32753MO0790042
32753MO0790042
32753MO0790042
32753MO0790042
32753MO0790042
32753MO0790041
32753MO0790144
32753MO0790145
32753MO0790145
32753MO0790145
32753MO0790145
32753MO0790145
32753MO0790145
32753MO0790145
32753MO0790154
32753MO0790047
32753MO0790155
32753MO0790155
32753MO0790155
32753MO0790155
32753MO0790155
32753MO0790155
32753MO0790155
32753MO0790077
32753MO0790077
32753MO0790077
32753MO0790077
32753MO0790077
32753MO0790077
32753MO0790077
PlanSpecificRate
Increase*
(excludingaging)
8.81%
6.36%
4.51%
2.49%
3.85%
n/a
n/a
11.13%
7.05%
4.08%
4.28%
8.61%
6.59%
4.74%
4.36%
5.75%
12.91%
8.77%
5.75%
2.74%
7.15%
8.31%
6.42%
5.80%
4.41%
12.96%
8.82%
5.80%
2.70%
7.11%
8.35%
6.47%
11.53%
7.44%
4.46%
3.93%
8.28%
6.98%
5.12%
28

Small Group
HIOSPlanName
2015HIOSPlanID
32753MO0790276
32753MO0790277
32753MO0790323
32753MO0790324
32753MO0790325
32753MO0790326
32753MO0790327
32753MO0790328
32753MO0790329
32753MO0790330
32753MO0790331
On/Off
Exchange MetalLevel
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Off
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
Gold
BenefitPlan
Factor
1.2797
1.2797
1.2607
1.2607
1.2229
1.1882
1.1751
1.1309
1.1128
1.1662
1.1737
NetworkName
MOSG::BlueAccess
MOSG::BlueAccess
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
MOSG::BluePreferred
Area(s)Offered
06
02,05,07,08,09,10
02,05,07,08,09,10
06
02
05
06
07
08
09
10
2014HIOSPlanID
Mapping
32753MO0790076
32753MO0790004
None
None
None
None
None
None
None
None
None
PlanSpecificRate
Increase*
(excludingaging)
4.45%
3.08%
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
NOTES:
BenefitPlanFactorsabovereflectplanbyplandifferencesfromtheindexrateforallowableadjustmentsasdescribedindetailintheMarketReformandPaymentParametersRegulationsandillustratedinExhibitP.Theweightedaverageoftheseadjustmentsfor
theentireriskpoolincludedinthisratefilingisdetailedinExhibitH.
Planlevelincreasesinratesdonotincludedemographicchangesinthepopulation.
29
Exhibit J - Age and Tobacco Factors

Small Group
Age
017
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64+
AgeRatingFactor
0.635
0.635
0.635
0.635
1.000
1.000
1.000
1.000
1.004
1.024
1.048
1.087
1.119
1.135
1.159
1.183
1.198
1.214
1.222
1.230
1.238
1.246
1.262
1.278
1.302
1.325
1.357
1.397
1.444
1.500
1.563
1.635
1.706
1.786
1.865
1.952
2.040
2.135
2.230
2.333
2.437
2.548
2.603
2.714
2.810
2.873
2.952
3.000
TobaccoRatingFactor
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.000
1.050
1.050
1.050
1.050
1.050
1.100
1.100
1.100
1.100
1.100
1.200
1.200
1.200
1.200
1.200
1.300
1.300
1.300
1.300
1.300
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
1.400
NOTES:
{1}TheweightedaveragesofthesefactorsfortheentireriskpoolincludedinthisratefilingisdetailedinExhibitH.
Exhibit K - Area Factors

Small Group
RatingAreaDescription
RatingArea2Northeast
RatingArea5Central
RatingArea6St.LouisMetro
RatingArea7Joplin
RatingArea8Springfield
RatingArea9SouthCentral
RatingArea10Southeast
AreaRatingFactor
1.1246
1.0305
0.9570
0.9439
1.0124
1.0789
1.2519
NOTES:
{1}Theweightedaverageofthesefactorsfortheentireriskpoolincluded
inthisratefilingisdetailedinExhibitH.
Exhibit L - Sample Rate Calculation

Small Group
GroupName:
EffectiveDate:
On/OffExchange:
MetalLevel:
PlanID:
RatingArea:
SampleGroup
1/1/2015
Off
Silver
32753MO0790300
RatingArea7Joplin
GroupCensus:
Employee11
Employee12
Employee13
Employee14
Employee15
Employee16
Employee17
Employee18
Employee19
Employee110
Employee111
Employee112
Age
24
26
28
32
30
45
53
41
56
39
62
64
Employee
Tobacco
User
Yes
No
No
Yes
No
No
Yes
No
No
No
No
No
CalculationofMonthlyPremium:
BaseRate=
xBenefitPlanFactor
xAreaFactor
BaseRateAdjustedforPlan/Area=
Spouse
Age
23
Tobacco
User
No
33
No
45
55
No
Yes
64
Child11
Tobacco
User
Age
0
No
Child12
Tobacco
User
Age
Child13
Tobacco
User
Age
2
18
No
No
4
15
No
No
12
16
No
13
No
25
Yes
No
No
$267.92 ExhibitA
0.9042 ExhibitI
0.9439 ExhibitK
$228.66
Age/TobaccoFactors:
ExhibitJ
Employee11
Employee12
Employee13
Employee14
Employee15
Employee16
Employee17
Employee18
Employee19
Employee110
Employee111
Employee112
Employee
Age
Tobacco
Factor
Factor
1.000
1.0000
1.024
1.0000
1.087
1.0000
1.183
1.0500
1.135
1.0000
1.444
1.0000
2.040
1.4000
1.302
1.0000
2.333
1.0000
1.262
1.0000
2.873
1.0000
3.000
1.0000
Spouse
Age
Factor
1.000
Tobacco
Factor
1.0000
1.198
1.0000
1.444
2.230
1.0000
1.4000
3.000
Age
Factor
0.635
Child11
Tobacco
Factor
1.0000
Age
Factor
Child12
Tobacco
Factor
0.635
0.635
1.0000
1.0000
0.635
0.635
1.0000
1.0000
0.635
1.0000
0.635
1.0000
1.004
1.0000
Age
Factor
0.635
Child13
Tobacco
Factor
1.0000
1.0000
FinalMonthlyPremiumPMPM:
Employee11
Employee12
Employee13
Employee14
Employee15
Employee16
Employee17
Employee18
Employee19
Employee110
Employee111
Employee112
Employee
$228.66
$234.15
$248.55
$284.03
$259.53
$330.19
$653.05
$297.72
$533.46
$288.57
$656.94
$685.98
Spouse
Children
Total
$228.66
$145.20
$602.52
$234.15
$248.55
$273.93
$557.96
$290.40
$549.93
$330.19
$435.60
$1,095.98
$713.88
$1,366.93
$290.40
$588.12
$533.46
$229.57
$518.14
$656.94
$685.98
$1,371.96
NOTES:
{1}AspertheMarketReformRule,whencomputingfamilypremiumsnomorethanthethreeoldestcoveredchildrenundertheageof21aretakenintoaccountwhereasthepremiumsassociatedwitheachchildage21+a
{2}ThissamplecalculationignoresthetobaccooffsetunderaWellnessProgramasdescribedintheMarketReformRule.
{3}Minorratevariancesmayoccurduetodifferencesinroundingmethodology.
Exhibit M - Federal MLR Estimated Calculation

Small Group
Numerator:
IncurredClaims
+QualityImprovementExpense
+RiskCorridorContributions
+RiskAdjustmentNetTransfer
+ReinsuranceReceipts
+RiskCorridorReceipts
+ReductiontoRxIncurredClaims(ACAMLR)
=Estimated FederalMLRNumerator
$ 289.57
$3.27
$
$
$
$
$ (6.84)
$ 286.00
ExhibitA
ExhibitG
Denominator:
Premiums
FederalandStateTaxes
PremiumTaxes
RiskAdjustmentUserFee
ReinsuranceContributions
LicensingandRegulatoryFees
=Estimated FederalMLRDenominator
$ 376.45
$ 11.07
$1.28
$0.08
$3.55
$ 14.86
$ 345.60
ExhibitA
ExhibitA(Line13)xExhibitG(IncomeTaxes)
ExhibitA(Line13)xExhibitG(PremiumTax)
ExhibitF
ExhibitF
ExhibitA(Line13)xExhibitG(Fees)
Estimated FederalMLR
ExhibitF
ExhibitF
{5}
82.76%
NOTES:
TheabovecalculationispurelyanestimateandnotmeanttobecomparedtotheminimumMLRbenchmarkforfederal/stateMLRrebatepurposes:
{1}Theabovecalculationrepresentsonlytheproductsinthisfiling.FederalMLRwillbecalculatedatthelegalentityandmarketlevel.
{2}Notallnumerator/denominatorcomponentsarecapturedabove(forexample,fraudandpreventionprogramcosts,payrolltaxes,assessmentsfor
statehighriskpoolsetc.).
{3}OtheradjustmentsmayalsobeappliedwithinthefederalMLRcalculationsuchas3yearaveraging,newbusiness,credibility,deductibleanddual
option.Theseareignoredintheabovecalculation.
{4}LicensingandRegulatoryFeesincludeACArelatedfeesasallowedundertheMLRFinalRule.
{5}Thisisthepercentageof2015pharmacyclaimsthatareattributabletoPBMAdministrativeExpenses(i.e.the"retailspread"or"pharmacyclaims
margin").Itiscalculatedbyapplyingthe3rdpartymarginpercentagetothe2015projectedPharmacyclaimsincludingprojectedrebates.
ExhibitNIndexRateDevelopment
Small Group
1)
2)
3)
4)
5)
6)
7)
8)
ProjectedPaidClaimCost
NonEHBsEmbeddedinLineItem1)Above
=ProjectedPaidClaims,ExcludingALLNonEHBs
+RxRebates
+AdditionalEHBs{1}
=ProjectedPaidClaimsReflectingonlyEHBs
PaidtoAllowedRatio
=ProjectedAllowedClaimsReflectingonlyEHBs
NOTE:
{1} PediatricDentalandPediatricVision
$ 293.79
$
$ 293.79
$ (6.50)
$1.79
$ 289.08
0.7165
$ 403.46
ExhibitA,LineItem8
ExhibitE
ExhibitE
=IndexRate
Exhibit O - Quarterly Index, Base, and Market Adjusted Index Rate Development
Small Group
RatesEffective:
RenewingMemberMonths
1Q15
316,513
2Q15
322,876
3Q15
386,061
4Q15
803,007
2.19%
2.19%
2.19%
QuarterlyAllowedTrend
IndexRate
$ 403.46 $ 412.31 $421.36 $ 430.60 $ 420.72
ReinsuranceContribution
ExpectedReinsurancePayments
RiskAdjustmentFee
RiskAdjustmentNetTransfer
ExchangeFee
$ 3.55
$
$ 0.08
$
$ 1.32
$ 3.21
$
$ 0.08
$
$ 1.35
$ 2.87
$
$ 0.08
$
$ 1.38
$ 2.53
$
$ 0.08
$
$ 1.41
PaidtoallowedRatio
0.7165
0.7165
0.7165
0.7165
MarketAdjustedIndexRate
QuarterlyBaseRateTrend
BaseRate
MemberWeighted
Average
1,828,457
$ 410.37 $ 418.79 $427.40 $ 436.20 $ 426.80

2.17%
2.18%
2.20%
$ 267.92 $ 273.73 $279.70 $ 285.85 $ 279.31
NOTES:
{1}The1Q15indexratewasderivedinExhibitN.
{2}The1Q15indexrateisassumedtoincreasewithquarterlyallowedtrendasillustratedabove.
{3}The1Q15reinsuranceandriskadjustmentfeesandpaymentsareshowninExhibitF.Thereinsurancecontributionforothereffectivedatesiscalculatedby
thesamemethodshowninExhibitF.
{4}MarketAdjustedIndexRate=IndexRate+((Reinsurance+RiskAdjustmentFee+ExchangeFee)PaidtoallowedRatio)
{5}The1Q15baseratewasderivedinExhibitA.
{6}The1Q15baserateisassumedtoincreasewithquarterlypaidtrendasillustratedabove.Thistrendratediffersfromtheindexratetrendinthatitincludes
anticipatedchangesfornonEHBs,deductibleleveraging,fees,andriskmitigationprograms.
{7}Minorratevariancesmayoccurduetodifferencesinroundingmethodology.
ExhibitPPlanAdjustedIndexRateandConsumerAdjustedPremiumRates
Small Group
HIOSPlanName
AnthemBronzeBlueAccess4500E/0%/6350w/HSA
AnthemBronzeBlueAccessChoice4500E/0%/6350w/HSA
AnthemBronzeBlueAccessChoice6000/0%/6600Plus
AnthemBronzeBlueAccess6000/0%/6600Plus
AnthemSilverBlueAccessChoice3000/20%/4500Plus
AnthemSilverBlueAccess3000/20%/4500Plus
AnthemSilverBluePreferredOptions2750/40%/6600
HIOSPlanID
32753MO0780011
32753MO0780012
32753MO0780013
32753MO0780014
32753MO0780015
32753MO0780016
32753MO0780017
32753MO0780018
32753MO0780019
32753MO0780020
32753MO0780021
32753MO0780022
32753MO0780023
32753MO0780024
32753MO0780004
32753MO0780005
32753MO0780006
32753MO0780007
32753MO0780008
32753MO0780009
32753MO0780010
32753MO0790260
32753MO0790261
32753MO0790262
32753MO0790263
32753MO0790264
32753MO0790265
32753MO0790266
32753MO0790267
32753MO0790268
32753MO0790287
32753MO0790288
32753MO0790289
32753MO0790290
32753MO0790291
32753MO0790292
32753MO0790293
32753MO0790294
32753MO0790295
32753MO0790195
32753MO0790196
32753MO0790197
32753MO0790198
32753MO0790199
32753MO0790200
32753MO0790201
32753MO0790202
32753MO0790203
32753MO0790259
MarketAdjusted
IndexRate
(ExhibitO)
CostSharing
Adjustment
Provider
Network
Adjustment
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
0.5746
0.5746
0.5746
0.5746
0.5746
0.5746
0.5746
0.7479
0.7479
0.7479
0.7479
0.7479
0.7479
0.7479
0.8330
0.8330
0.8330
0.8330
0.8330
0.8330
0.8330
0.6328
0.6328
0.6328
0.6328
0.6328
0.6328
0.6328
0.6328
0.6328
0.6327
0.6327
0.6327
0.6327
0.6327
0.6327
0.6327
0.6327
0.6327
0.7084
0.7084
0.7084
0.7084
0.7084
0.7084
0.7084
0.7084
0.7084
0.7074
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
0.9089
Adjustmentfor
CatastrophicPlan
Benefitsin
Adjustment
Additiontothe
{1}
AdministrativeCosts
EHBS
1.0110
1.0110
1.0110
1.0110
1.0110
1.0110
1.0110
1.0085
1.0085
1.0085
1.0085
1.0085
1.0085
1.0085
1.0076
1.0076
1.0076
1.0076
1.0076
1.0076
1.0076
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0100
1.0100
1.0100
1.0100
1.0100
1.0100
1.0100
1.0100
1.0100
1.0089
1.0089
1.0089
1.0089
1.0089
1.0089
1.0089
1.0089
1.0089
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
$68.82
$66.88
$66.15
$63.66
$62.65
$65.64
$66.07
$89.34
$86.82
$85.87
$82.65
$81.33
$85.22
$85.77
$99.44
$96.62
$95.57
$91.98
$90.52
$94.84
$95.46
$77.22
$77.22
$74.91
$72.79
$72.00
$69.29
$68.19
$71.45
$71.91
$75.63
$73.49
$72.69
$69.96
$68.84
$72.14
$72.60
$77.96
$77.96
$87.22
$87.22
$84.61
$82.22
$81.32
$78.26
$77.02
$80.70
$81.22
$76.39
PlanAdjusted
IndexRate
{2}
Calibration
Factor
{3}
Adjustto
1Q15eff
date
ConsumerAdjusted
PremiumRate
{4}
$315.96
$307.00
$303.63
$292.19
$287.52
$301.32
$303.27
$410.22
$398.58
$394.20
$379.36
$373.29
$391.21
$393.74
$456.51
$443.56
$438.69
$422.17
$415.42
$435.35
$438.18
$354.77
$354.77
$344.13
$334.37
$330.70
$318.24
$313.15
$328.18
$330.31
$347.49
$337.63
$333.92
$321.34
$316.21
$331.38
$333.53
$358.23
$358.23
$400.67
$400.67
$388.66
$377.63
$373.49
$359.42
$353.67
$370.65
$373.05
$350.79
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
$216.39
$210.25
$207.94
$200.11
$196.91
$206.36
$207.70
$280.94
$272.97
$269.97
$259.80
$255.65
$267.92
$269.65
$312.64
$303.77
$300.44
$289.12
$284.50
$298.15
$300.09
$242.96
$242.96
$235.68
$228.99
$226.48
$217.95
$214.46
$224.76
$226.21
$237.98
$231.23
$228.69
$220.07
$216.55
$226.95
$228.42
$245.33
$245.33
$274.40
$274.40
$266.18
$258.62
$255.78
$246.15
$242.21
$253.84
$255.48
$240.24
Small Group
HIOSPlanName
AnthemGoldBlueAccessChoice1000/20%/2500Plus
AnthemGoldBlueAccess1000/20%/2500Plus
AnthemGoldBluePreferredOptions500/20%/4000
HIOSPlanID
32753MO0790278
32753MO0790279
32753MO0790280
32753MO0790281
32753MO0790282
32753MO0790283
32753MO0790284
32753MO0790285
32753MO0790286
32753MO0790296
32753MO0790297
32753MO0790298
32753MO0790299
32753MO0790300
32753MO0790301
32753MO0790302
32753MO0790303
32753MO0790304
32753MO0790305
32753MO0790306
32753MO0790307
32753MO0790308
32753MO0790309
32753MO0790310
32753MO0790311
32753MO0790312
32753MO0790313
32753MO0790314
32753MO0790315
32753MO0790316
32753MO0790317
32753MO0790318
32753MO0790319
32753MO0790320
32753MO0790321
32753MO0790322
32753MO0790186
32753MO0790187
32753MO0790188
32753MO0790189
32753MO0790190
32753MO0790191
32753MO0790192
32753MO0790193
32753MO0790194
32753MO0790204
32753MO0790205
32753MO0790206
32753MO0790207
MarketAdjusted
IndexRate
(ExhibitO)
CostSharing
Adjustment
Provider
Network
Adjustment
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
0.6779
0.6779
0.6779
0.6779
0.6779
0.6779
0.6779
0.6779
0.6779
0.7033
0.7033
0.7033
0.7033
0.7033
0.7033
0.7033
0.7033
0.7033
0.6651
0.6651
0.6651
0.6651
0.6651
0.6651
0.6651
0.6651
0.6651
0.6734
0.6734
0.6734
0.6734
0.6734
0.6734
0.6734
0.6734
0.6734
0.8530
0.8530
0.8530
0.8530
0.8530
0.8530
0.8530
0.8530
0.8530
0.9012
0.8273
0.8273
0.8273
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
0.9089
1.0276
0.9968
0.9685
Adjustmentfor
CatastrophicPlan
Benefitsin
Adjustment
Additiontothe
{1}
AdministrativeCosts
EHBS
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0074
1.0074
1.0074
1.0074
1.0074
1.0074
1.0074
1.0074
1.0074
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
$82.71
$80.24
$77.97
$77.12
$74.22
$73.04
$76.53
$77.03
$82.71
$85.89
$83.32
$80.97
$80.08
$77.08
$75.85
$79.47
$79.99
$85.89
$78.71
$76.49
$75.65
$72.81
$71.65
$75.08
$75.56
$81.14
$81.14
$82.21
$82.21
$79.75
$77.50
$76.65
$73.77
$72.60
$76.07
$76.56
$104.93
$104.93
$101.80
$98.92
$97.84
$94.17
$92.67
$97.10
$97.72
$97.45
$100.97
$97.96
$95.19
PlanAdjusted
IndexRate
{2}
Calibration
Factor
{3}
Adjustto
1Q15eff
date
ConsumerAdjusted
PremiumRate
{4}
$380.02
$368.62
$358.16
$354.23
$340.89
$335.44
$351.54
$353.82
$380.02
$394.36
$382.54
$371.69
$367.61
$353.76
$348.11
$364.82
$367.18
$394.36
$361.67
$351.41
$347.55
$334.46
$329.11
$344.91
$347.14
$372.85
$372.85
$377.54
$377.54
$366.22
$355.83
$351.93
$338.67
$333.26
$349.25
$351.51
$481.84
$481.84
$467.40
$454.14
$449.16
$432.24
$425.33
$445.74
$448.63
$447.03
$463.80
$449.90
$437.13
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
$260.26
$252.45
$245.29
$242.60
$233.46
$229.73
$240.75
$242.31
$260.26
$270.08
$261.99
$254.55
$251.76
$242.28
$238.41
$249.85
$251.46
$270.08
$247.69
$240.66
$238.02
$229.06
$225.39
$236.21
$237.74
$255.35
$255.35
$258.56
$258.56
$250.81
$243.69
$241.02
$231.94
$228.23
$239.18
$240.73
$329.99
$329.99
$320.10
$311.02
$307.61
$296.02
$291.29
$305.27
$307.24
$306.15
$317.64
$308.12
$299.37
Small Group
HIOSPlanName
HIOSPlanID
32753MO0790208
32753MO0790209
32753MO0790210
32753MO0790211
32753MO0790212
32753MO0790213
32753MO0790214
32753MO0790215
32753MO0790216
32753MO0790217
32753MO0790218
32753MO0790219
32753MO0790220
32753MO0790221
32753MO0790222
32753MO0790223
32753MO0790224
32753MO0790225
32753MO0790226
32753MO0790227
32753MO0790228
32753MO0790229
32753MO0790230
32753MO0790231
32753MO0790232
32753MO0790233
32753MO0790234
32753MO0790235
32753MO0790236
32753MO0790237
32753MO0790238
32753MO0790239
32753MO0790240
32753MO0790241
32753MO0790242
32753MO0790243
32753MO0790244
32753MO0790245
32753MO0790246
32753MO0790247
32753MO0790248
32753MO0790249
32753MO0790250
32753MO0790251
32753MO0790252
32753MO0790253
32753MO0790254
32753MO0790255
32753MO0790256
MarketAdjusted
IndexRate
(ExhibitO)
CostSharing
Adjustment
Provider
Network
Adjustment
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
0.8273
0.8273
0.8273
0.8273
0.8273
0.8273
0.7892
0.7892
0.7892
0.7892
0.7892
0.7892
0.7892
0.7892
0.7892
0.8378
0.8378
0.8378
0.8378
0.8378
0.8378
0.8378
0.8378
0.8378
0.8739
0.8739
0.8739
0.8739
0.8739
0.8739
0.8739
0.8739
0.8739
0.8147
0.8147
0.8147
0.8147
0.8147
0.8147
0.8147
0.8147
0.8147
0.8561
0.8561
0.8561
0.8561
0.8561
0.8561
0.8561
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
Adjustmentfor
CatastrophicPlan
Benefitsin
Adjustment
Additiontothe
{1}
AdministrativeCosts
EHBS
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
$94.15
$90.61
$89.17
$93.43
$94.04
$100.97
$96.23
$96.23
$93.35
$90.70
$89.71
$86.34
$84.96
$89.03
$89.61
$99.11
$96.30
$95.25
$91.67
$90.21
$94.53
$95.14
$102.16
$102.16
$106.70
$106.70
$103.52
$100.59
$99.49
$95.75
$94.23
$98.73
$99.37
$99.38
$99.38
$96.41
$93.68
$92.66
$89.18
$87.76
$91.95
$92.55
$104.48
$104.48
$101.35
$98.49
$97.41
$93.75
$92.26
PlanAdjusted
IndexRate
{2}
Calibration
Factor
{3}
Adjustto
1Q15eff
date
ConsumerAdjusted
PremiumRate
{4}
$432.34
$416.05
$409.40
$429.05
$431.83
$463.80
$442.37
$442.37
$429.11
$416.93
$412.35
$396.81
$390.47
$409.21
$411.86
$455.52
$442.59
$437.73
$421.24
$414.50
$434.40
$437.22
$469.60
$469.60
$490.00
$490.00
$475.31
$461.82
$456.76
$439.55
$432.53
$453.28
$456.22
$456.69
$456.69
$443.00
$430.43
$425.71
$409.67
$403.12
$422.47
$425.21
$479.94
$479.94
$465.55
$452.34
$447.38
$430.53
$423.64
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
$296.09
$284.93
$280.38
$293.84
$295.74
$317.64
$302.96
$302.96
$293.87
$285.53
$282.40
$271.76
$267.41
$280.25
$282.07
$311.96
$303.11
$299.78
$288.49
$283.88
$297.50
$299.43
$321.61
$321.61
$335.58
$335.58
$325.52
$316.28
$312.81
$301.03
$296.22
$310.43
$312.44
$312.77
$312.77
$303.39
$294.78
$291.55
$280.56
$276.08
$289.33
$291.20
$328.69
$328.69
$318.84
$309.79
$306.39
$294.85
$290.13
Small Group
HIOSPlanName
HIOSPlanID
32753MO0790257
32753MO0790258
32753MO0790269
32753MO0790270
32753MO0790271
32753MO0790272
32753MO0790273
32753MO0790274
32753MO0790275
32753MO0790276
32753MO0790277
32753MO0790323
32753MO0790324
32753MO0790325
32753MO0790326
32753MO0790327
32753MO0790328
32753MO0790329
32753MO0790330
32753MO0790331
MarketAdjusted
IndexRate
(ExhibitO)
CostSharing
Adjustment
Provider
Network
Adjustment
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
$426.80
0.8561
0.8561
0.8929
0.8929
0.8929
0.8929
0.8929
0.8929
0.8929
0.8929
0.8929
0.8799
0.8799
0.8799
0.8799
0.8799
0.8799
0.8799
0.8799
0.8799
0.9505
0.9567
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
1.0276
1.0276
1.0276
1.0276
0.9968
0.9685
0.9578
0.9217
0.9070
0.9505
0.9567
Adjustmentfor
CatastrophicPlan
Benefitsin
Adjustment
Additiontothe
{1}
AdministrativeCosts
EHBS
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
1.0000
$96.67
$97.30
$105.84
$102.85
$101.73
$97.91
$96.35
$100.96
$101.61
$109.10
$109.10
$107.34
$107.34
$104.14
$101.19
$100.08
$96.32
$94.79
$99.32
$99.96
PlanAdjusted
IndexRate
{2}
Calibration
Factor
{3}
Adjustto
1Q15eff
date
ConsumerAdjusted
PremiumRate
{4}
$443.98
$446.85
$485.70
$471.92
$466.74
$449.16
$441.98
$463.19
$466.19
$500.70
$500.70
$493.24
$493.24
$478.45
$464.87
$459.77
$442.45
$435.38
$456.27
$459.23
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
1.4006
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
0.9592
$304.06
$306.03
$332.63
$323.19
$319.65
$307.61
$302.69
$317.22
$319.27
$342.91
$342.91
$337.80
$337.80
$327.67
$318.37
$314.88
$303.01
$298.17
$312.48
$314.51
Notes:
{1}Thisadjustmentassumesahealthierthanaveragepopulationwillselectthecatastrophicplan.Thecatastrophicadjustmentfactorisnormalizedto1.0acrossallplansforrevenueneutralityacrosstheentireblock.
{2}ThePlanAdjustedIndexRateiscalculatedbymultiplyingtheMarketAdjustedIndexRatebytheAVandcostsharing,providernetwork,benefitsinadditiontotheEHBs,andcatastrophicplanadjustmentsandthenaddingtheadministrativecosts.ThePlanAdjustedIndexRatecanalsobe
describedasaPlanLevelRequiredPremium.
{3}SeeExhibitHCalibration.
{4}TheConsumerAdjustedPremiumRateiscalculatedbydividingbyCalibrationFactorandthenmultiplyingbyAdjustto1Q15effectivedatefactor.
Exhibit Q - Terminated Products

Small Group
Effective January 1, 2015
Followingaretheproductsthatwillbeterminatedpriortotheeffectivedate:
ThisincludesproductsthathaveexperienceincludedintheURRTduringtheexperienceperiodand
anyproductsthatwerenotineffectduringtheexperienceperiodbutweremadeavailable
thereafter.
PreACATerminatedProducts
HIOSProductID
HIOSProductName
32753MO076
LumenosBluePreferredSelect
HIOSProductID
PostACATerminatedPlans
HIOSProductName

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ACTUARIAL

Company Contact Information

2. Scope and Purpose of the Filing

Changes from 2014 Filings

4. Description of How the Base Rate Is Determined

5. Proposed Rate Increase

6. Experience Period Premium and Claims

Paid Through Date

Allowed and Incurred Claims Incurred During the Experience Period

Premiums (net of MLR Rebate) in Experience Period

Changes in the Morbidity of the Population Insured

Trend Factors (cost/utilization)

9. Credibility Manual Rate Development

Source and Appropriateness of Experience Data Used

Adjustments Made to the Data

10. Credibility of Experience

Resulting Credibility Level Assigned to Base Period Experience

11. Paid to Allowed Ratio

12. Risk Adjustment and Reinsurance

Projected ACA Reinsurance Recoveries Net of Reinsurance Premium

13. NonBenefit Expenses, Profit and Risk

Quality Improvement Expense

Taxes and Fees

14. Projected Loss Ratio

15. Single Risk Pool

16. Index Rate

Projection Period Index Rate

Quarterly Index and Base Rate

17. Market Adjusted Index Rate

18. Plan Adjusted Index Rate

Benefit Plan Factors

20. Consumer Adjusted Premium Rate

21. Actuarial Value Metal Values

22. Actuarial Value Pricing Values

23. Membership Projections

24. Warning Alerts

25. Terminated Products

26. Plan Type

28. Actuarial Certification

Exhibit A - Base Rate Development

Exhibit B - Claims Experience for Manual Rate Development

Exhibit C - Normalization Factors

Exhibit D - Projection Period Adjustments

Exhibit E - Other Claim Adjustments

Exhibit F - Risk Adjustment and Reinsurance - Contributions and Payments

Exhibit G - Non-Benefit Expenses and Profit & Risk

ExpensesAppliedAsa ExpensesAppliedasa Expressedasa

Exhibit I - Non-Grandfathered Benefit Plan Factors and Rate Increases

Exhibit I - Non-Grandfathered Benefit Plan Factors and Rate Increases

Exhibit I - Non-Grandfathered Benefit Plan Factors and Rate Increases

Exhibit I - Non-Grandfathered Benefit Plan Factors and Rate Increases

Exhibit I - Non-Grandfathered Benefit Plan Factors and Rate Increases

Exhibit J - Age and Tobacco Factors

Exhibit K - Area Factors

Exhibit L - Sample Rate Calculation

Exhibit M - Federal MLR Estimated Calculation

$ 403.46 $ 412.31 $421.36 $ 430.60 $ 420.72

$ 410.37 $ 418.79 $427.40 $ 436.20 $ 426.80

$ 267.92 $ 273.73 $279.70 $ 285.85 $ 279.31

Exhibit Q - Terminated Products

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