965 Rate filing information for Pennsylvania issuers requesting Affordable Care Act-compliant premium rates effective January 1, 2017, through December 31, 2017  

  • 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: $3,987,212

    Company 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 million

    Company 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 million

    Company 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: $300,000

    Company 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 million

    Company 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 million

    Company 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 million

    Company 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: $672,000

    Company 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: $23,000

    Company 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: -$200,000

    Company 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 million

    Company 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/A

    Company 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: $615,400

    Company 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: $159

    Company 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: $4,040,017

    Company 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 million

     For 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: $58,325,726

    Company 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: $5,283,974

    Company 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: $14,597,052

    Company 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: $1,255,206

    Company 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: $92,941,894

    Company 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: $22,820,674

    Company 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: $69,514,211

    Company 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: $19,018,056

    Company 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: $0

    Company 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: $0

    Company 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: $40,809,723

    Company 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: $4,783,328

     For 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 million

    Company 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 million

    Company 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 million

    Company 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 million

     For 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 million

    Company 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 million

    Company 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: $17,131

    Company 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: $13,426

    Company 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 million

    Company 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: $363,790

    TERESA 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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