BLUE CROSS AND BLUE SHIELD OF MONTANA - PowerPoint Presentation

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BLUE CROSS AND BLUE SHIELD OF MONTANA

2018 Individual and Small Group Rate Filings

7/24/2017

Product PortfolioRetail

7/24/2017

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CategoryMetal20172018Number of PlansPlatinum00Gold32Silver53Bronze53Catastrophic11Range of Individual DeductiblesPlatinumNot AvailableNot AvailableGold$500 - $1,650$0 - $450Silver$2,500 - $3,850$1,000 - $3,500Bronze$5,000 - $6,500$2,700 - $4,000Catastrophic$7,150 $7,350 Range of Individual Out-of-Pocket Maximums (Including Deductibles)PlatinumNot AvailableNot AvailableGold$3,350 - $5,250$7,350 Silver$4,500 - $7,150$7,350 Bronze$6,500 - $7,150$6,550 - $7,350Catastrophic$7,150 $7,350 Range of General CoinsurancePlatinumNot AvailableNot AvailableGold70% - 80%60% - 70%Silver70% - 80%50% - 70%Bronze60% - 100%50% - 70%Catastrophic100%100%

The networks being offered and the rating areas in which they are available have not changed from 2017 to 2018.

Initial proposed rates are not final. Subject to change prior to final rate filing deadline.

2018 Increases by Metallic Level, by Rating Area, & By Network Retail

Initial proposed rates are not final. Subject to change prior to final rate filing deadline.

7/24/2017

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Metallic LevelBlue PreferredBlue Focus POSCatastrophic31.1%N/ABronze23.6%13.5%Silver25.3%19.8%Gold14.6%14.4%

Rating Area

Blue Preferred

Blue Focus POS

1: Billings

18.7%

17.5%

2: Great Falls

24.1%

N/A

3: Missoula

22.6%

17.3%

4: Non MSA

24.7%

N/A

Sources of 2018 ChangeRetail

The Impact of Medicaid Expansion was estimated to be a 6.6% decrease in market average risk between the 2015 experience period and the 2017 projection period when developing the 2017 rates.No adjustment was made to the 2018 rates for the Impact of Medicaid Expansion in addition to what was already built into the 2017 rates.

 ImpactTrend9.6%Market Stabilization Rule-1.4%2017 Rate Sufficiency-6.0%2018 Risk Deterioration0.8%Miscellaneous-0.1%  Average Increase Before ACA Provisions2.3%  ACA Provisions (CSR/Mandate/Etc)17.3%Insurer Fee2.6%  Average Rate Increase23.1%

7/24/2017

Initial proposed rates are not final. Subject to change prior to final rate filing deadline.

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Administrative Expense LoadRetail

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20172018Administrative Expense Load as a Percentage9.2%7.0%Administrative Expense Load as a PMPM Dollar Amount$56.09$47.24

Initial proposed rates are not final. Subject to change prior to final rate filing deadline.

Contribution to RESERVESRetail

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Reserves Load (Pre-Tax) as a Percentage6.9%Reserves Load (Pre-Tax) as a PMPM Dollar Amount$46.83Reserves Load (Post-Tax) as a Percentage5.5%Reserves Load (Post-Tax) as a PMPM Dollar Amount$37.47

Initial proposed rates are not final. Subject to change prior to final rate filing deadline.

Membership ProjectionsRetail

7/24/2017

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Initial proposed rates are not final. Subject to change prior to final rate filing deadline.

The 2018 membership projection is variable, depending on certain factors such as potential regulatory changes, final product pricing and consumers’ purchasing decisions.

Product PortfolioSmall Group

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CategoryMetal20172018Number of PlansPlatinum22Gold99Silver55Bronze23Range of Individual DeductiblesPlatinum$250 - $750$250 - $750Gold$0 - $4,000$750 - $4,200Silver$2,250 - $3,650$3,000 -$6,500Bronze$5,500 - $6,000$5,500 -$7,350Range of Individual Out-of-Pocket Maximums (Including Deductibles)Platinum$1,250 - $1,500$1,250 - $1,500Gold$2,000 - $6,850$2,000 - $4,700Silver$3,650 - $7,000$3,700 - $7,350Bronze$6,450 - $6,550$6,450 - $7,350Range of General CoinsurancePlatinum80%80%Gold50% - 100%50% - 100%Silver70% - 100%70% - 100%Bronze70% - 80%70% - 100%

The networks being offered and the rating areas in which they are available have not changed from 2017 to 2018.

Initial proposed rates are not final. Subject to change prior to final rate filing deadline.

2018 Quarterly Increases by Metallic Level and by Rating Area Small Group

Rating AreaQ1Q2Q3Q41: Billings1.6%0.6%-0.4%6.7%2: Great Falls4.8%3.8%2.7%10.2%3: Missoula4.4%3.4%2.3%9.7%4: Non MSA5.7%4.6%3.6%11.1%

Metallic LevelQ1Q2Q3Q4Bronze4.7%3.6%2.6%10.0%Silver1.9%0.9%-0.1%7.1%Gold5.4%4.3%3.3%10.7%Platinum8.3%7.2%6.1%13.8%

Initial proposed rates are not final. Subject to change prior to final rate filing deadline.

7/24/2017

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Sources of Change 2018Q1Small Group

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No adjustment was made to the 2018 rates for the Impact of Medicaid Expansion.

Initial proposed rates are not final. Subject to change prior to final rate filing deadline.

Impact

Trend

9.8%

Market Stabilization Rule

0.0%

2017 Rate Sufficiency

-6.1%

2018 Risk Deterioration

-0.2%

Miscellaneous

-0.8%

Average Increase Before ACA Provisions

2.1%

ACA Provisions (CSR/Mandate/

Etc

)

0.0%

Insurer Fee

2.3%

Average Rate Increase

4.4%

Administrative Expense LoadSmall Group

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20172018Administrative Expense Load as a Percentage8.03%7.98%Administrative Expense Load as a PMPM Dollar Amount$38.65$38.51

Initial proposed rates are not final. Subject to change prior to final rate filing deadline.

Contribution to RESERVESSmall Group

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Reserves (Pre-Tax) as a Percentage5.0%Reserves (Pre-Tax) as a PMPM Dollar Amount$24.11Reserves (Post-Tax) as a Percentage4.0%Reserves (Post-Tax) as a PMPM Dollar Amount$19.29

Initial proposed rates are not final. Subject to change prior to final rate filing deadline.

Membership ProjectionsSmall Group

7/24/2017

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2018 Projected Members36,385

Initial proposed rates are not final. Subject to change prior to final rate filing deadline.