BCVT-128904800

RATE FILING SUMMARY

Third-Fourth Quarter 2013 BCBSVT Trend Filing

• Blue Cross Blue Shield of Vermont (BCBSVT) is a Vermont company that exists to
provide health benefits and financing to Vermonters.

• BCBSVT is proposing allowed, capped (at $200,000 per member) trends of 4.7
percent for medical and 6.8 percent for drug.

• These trends are converted to an uncapped, benefit paid trend basis (Exhibit IV
of the filing), which, along with the Benefit Leveraging Factors in that Exhibit,
will be used in rating BCBSVT products with effective dates during the third and
fourth quarters of 2013.

• There are an estimated 45,981 contracts (78,649 members) with BCBSVT
products expected to renew during the third and fourth quarters of 2013.

The proposed trends are developed from statistical analyses of claims incurred by
BCBSVT members during the period of June 2008 through October 2012, using the following steps:

• Allowed charges (i.e. total claim amount before cost sharing) are used to
eliminate the effect of benefit changes.

• Charge amounts in excess of $200,000 for any member for any 12 month period are removed to minimize distortion from unusually large claims.

• Projected trends for capped allowed charges are then set.

• Projected trends for uncapped allowed charges are calculated from the capped allowed charge trends, using insurance industry data.

• Benefit leveraged trends are then developed, and are based on the following characteristics of benefit plans:

• product type (medical, drug, or combined, e.g. Consumer Driven Health Plans, CDHP’s).
• deductible or copay level.
• coinsurance.

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Once the actuarial opinion has been received by the Department and the Commissioner’s recommendation concerning this filing has been made, these documents will be found at the Green Mountain Care Board’s rate review website: http://gmcboard.vermont.gov/rate_review      You can search the Board’s website using the SERFF tracking number at the top of this page.  Once the decision has been issued by the Board we will update the status of the filing on our website.  Please note there is a time lapse between when the filing is submitted to our Department and when the Board issues the decision.