2015 anthem small group 4-1-2015 rate filing.pdf

ACTUARIAL MEMORANDUM Company Identifying Information

Company Legal Name: Healthy Alliance Life Insurance Company

1. General Information

HIOS Issuer ID: 32753State: Missouri

Company Contact InformationPrimary Contact Name: Andy Dare

Effective Date: April 1, 2015Market: Small Group

2. Scope and Purpose of the Filing

Primary Contact Email Address: [email protected] Contact Telephone Number: (314) 923-8947

Policy Form Number(s):ABCBS MO - SG PPO - ON - v01

To the best of Anthem's knowledge and current understanding, this filing complies with the most recent regulations and related guidance. To the extent relevant rules or guidance on the rules are updated or changed, amendments to this filing may be required.

The purpose of this rate filing is to establish rates that are reasonable relative to the benefits provided and to demonstrate compliance with state laws and provisions of the Affordable Care Act (ACA). The rates will be in-force for effective dates on or after April 1, 2015. Subsequent rate changes will be implemented quarterly as discussed in more detail in Section 16: Index Rate. These rates will apply to plans offered both On-Exchange and Off-Exchange. This rate filing is not intended to be used for other purposes.

ABCBS MO - SG BPO - OFF - v01ABCBS MO - SG PPO - OFF - v01

3. Introduction

This filing includes an average rate increase of 4.0%, with range by plan between -13.9% and 23.9%. More details are provided below in Section 5: Proposed Rate Increase, and in Exhibit I: Non-Grandfathered Benefit Plan Factors and Rate Increases.

Changes from prior 2015 Small Group ACA filing

4. Description of How the Base Rate Is Determined

The methodology used to develop the rates this year is consistent with the methodology that was used last year. The development of the Base Rate is detailed in Exhibit A: Base Rate Development. Further details on how the base rate is developed can be found in Section 9: Credibility Manual Rate Development, Section 12: Risk Adjustment and Reinsurance, Section 13: Non-Benefit Expenses, Profit and Risk, and Section 19: Calibration. A description of the methodology used to determine the base rate is as follows:

The projection period has been moved to May 1, 2015 - April 30, 2016.

The assumed reinsurance contribution for 2016 has been revised -- see Exhibit F: Risk Adjustment and Reinsurance - Contributions and Payments.

Trend has been updated -- see Exhibit D: Projection Period Adjustments and Exhibit O: Quarterly Index, Base, and Market Adjusted Index Rate Development .

Profit and Risk and assumed Federal Income tax expense have been revised -- see Exhibit G: Non-Benefit Expenses and Profit & Risk.

Adjustments for risk adjustment and reinsurance are applied to the projected claims cost.

Non-benefit expenses, profit, and risk are applied to the projected claims cost to determine the required projection period premium.

The projected claims cost is calculated by adjusting the normalized claims for the impact of benefit changes, population morbidity, trend factors, etc. Adjustment is not based on the health status of the member.

The projection period is May 1, 2015 - April 30, 2016. Small Group Business renews on a quarterly basis; therefore the middle month of the second quarter is May 2015 .

Small Group manual rates are developed based on historical experience of Grandfathered and Non-Grandfathered business.

The experience data is normalized to reflect anticipated changes in age/gender, area/network and benefit plan from the experience period to the projection period based on expected distribution of membership.

The projection period premium is adjusted by the average rating factors in the projection period to determine the base rate.

The base rate represents an average benefit plan and area for an age 21 non-tobacco user in Missouri.

The average proposed rate increase is 4.0%. Factors that affect the proposed rate increase for all plans include:

Changes in benefit design

Premiums at the member level are determined by multiplying the base rate by the applicable factor for each of the allowable rating criteria: age, tobacco, area and benefit plan. An example of this calculation is shown in Exhibit L: Sample Rate Calculation.

5. Proposed Rate Increase

The rate increase is shown in Exhibit I: Non-Grandfathered Benefit Plan Factors and Rate Increases.

Although rates are based on the same single risk pool of experience, proposed rate increases vary by plan from -13.9% to 23.9%. Factors that affect the variation in the proposed rate increase by plan include:

Anticipated changes in payments to the Federal Transitional Reinsurance Program

Changes in taxes, fees, and other non-benefit expenses

Anticipated changes in the market-wide morbidity of the covered population in the projection period

Changing trends in medical costs and utilization and other cost of care impacts

Anticipated changes due to network contracting by pricing area.

In 2014, the area factors varied by plan based on actuarially justified network cost differences for each geographic rating area. Effective January 1, 2015, a single area factor will apply to all plans in each geographic rating area. To retain the actuarially justified network cost differences for each geographic area and comply with 45 CFR part 147.102, several new plans have been added, each of which is available in a single geographic rating area. New plans have been mapped to comparable 2014 plans for purposes of determining the rate increase. Refer to Exhibit I: Non-Grandfathered Benefit Plan Factors and Rate Increases and Exhibit K: Area Factors for details.

Changes in Non-Benefit Expenses that are applied on a PMPM basis

Changes in the underlying area rating factors, which are included in the plan-level increase for plans not offered in all areas

Changes in benefit design that vary by plan

Changes in the adjustment factor for Catastrophic eligibility

These rate increases by plan are shown in Exhibit I: Non-Grandfathered Benefit Plan Factors and Rate Increases.

6. Experience Period Premium and Claims

Paid Through Date

Claims shown in Worksheet 1, Section I of the Unified Rate Review Template are paid through March 31, 2014.

Experience shown in Worksheet 1, Section I of the Unified Rate Review Template is for the Missouri Small Group Single Risk Pool Non-Grandfathered Business. Consistent with last year, Anthem is assigning 0% credibility to the single risk pool experience, thus it is not used for developing manual rates. The manual rate development is fully detailed in Section 9: Credibility Manual Rate Development.

Claims experience in Worksheet 1, Section I of the Unified Rate Review Template reflects dates of service from January 1, 2013 through December 31, 2013.

The estimated Non-Grandfathered gross earned premium for Missouri Small Group is $472,782,616 and net of MLR rebates is $471,520,390, where earned premium is the pro-rata share of premium owed to Anthem due to subscribers actively purchasing insurance coverage during the experience period.

The MLR Rebate is -$1,262,226. This represents the portion of the final rebate allocated to the Non-Grandfathered portion of Small Group.

Allowed and incurred claims are completed using the chain ladder method, an industry standard, by using historic paid vs. incurred claims patterns. The method calculates historic completion percentages, representing the percent of claims paid for a particular month after one month of run out, two months, etc., for a forty-eight month view of history. Claim backlog files are reviewed on a monthly basis and are accounted for in the historical completion factor estimates.

Premiums (net of MLR Rebate) in Experience Period

Allowed and Incurred Claims Incurred During the Experience Period

The allowed claims are determined by subtracting non-covered benefits, provider discounts, and coordination of benefits amounts from the billed amount.

Inpatient Hospital: Includes non-capitated facility services for medical, surgical, maternity, mental health and substance abuse, skilled nursing, and other services provided in an inpatient facility setting and billed by the facility.

7. Benefit Categories

The methodology used to determine benefit categories in Worksheet 1, Section II of the Unified Rate Review Template is as follows:

Professional: Includes non-capitated primary care, specialist, therapy, the professional component of laboratory and radiology, and other professional services, other than hospital-based professionals whose payments are included in facility fees.

Other Medical: Includes non-capitated ambulance, home health care, DME, prosthetics, supplies, vision exams, dental services and other services.

Outpatient Hospital: Includes non-capitated facility services for surgery, emergency room, lab, radiology, therapy, observation and other services provided in an outpatient facility setting and billed by the facility.

Changes in the Morbidity of the Population Insured

n/a - see Credibility Manual Rate Development

8. Projection Factors

As previously indicated, the credibility level assigned to the experience in Worksheet 1, Section III of the Unified Rate Review Template is 0%. Consequently, factors to project experience claims are not provided as they are not applicable. However, the factors used to develop the manual rates are fully detailed in Section 9: Credibility Manual Rate Development.

Prescription Drug: Includes drugs dispensed by a pharmacy and rebates received from drug manufacturers.

Other Adjustments


Changes in Demographics


Changes in Benefits


9. Credibility Manual Rate Development

Consistent with last year's methodology, experience developed and projected herein is Anthem's Small Group Business based on plan liability amounts. The rate development is shown in Exhibit A: Base Rate Development.

Trend Factors (cost/utilization)


Source and Appropriateness of Experience Data Used

Adjustments Made to the Data

The development of the projected claims is summarized in Exhibit A: Base Rate Development, items (1) - (10), and described in detail below.

Other than completing the incurred claims, no further explicit adjustments are made to the experience data.

For more detail, see Exhibit B: Claims Experience for Manual Rate Development.

The source data underlying the development of the manual rate consists of claims for all Grandfathered and Non-Grandfathered Small Group business, incurred during the period January 1, 2013 December 31, 2013 and paid through March 31, 2014. Completion factors are then calculated to reflect additional months of runout after March 31, 2014. Anthem expects a large portion of the Grandfathered policyholders to migrate to ACA-compliant policies prior to and during the projection period.

In developing rates effective April 1, 2015, only limited 2014 experience is available. This experience is not deemed credible for purposes of rate development.

Area/Network: The area claims factors are developed based on an analysis of Small Group and Individual allowed claims by network, mapped to the prescribed 2015 rating areas using 5-digit zip code.

The source data was normalized to reflect anticipated changes in age/gender, area, network, and benefit plan from the experience period to the projection period. The purpose of these factors is to adjust current experience to be reflective of expected claim experience in the projection period. See Section 23: Membership Projections for additional information on membership movement. The normalization factors and their aggregate impact on the underlying experience data are detailed in Exhibit C: Normalization Factors.

Age/Gender: The assumed claims cost is applied by age and gender to the experience period distribution and the projection period distribution.

The projected claims cost is calculated by multiplying the normalized claims cost by the impact of benefit changes, anticipated changes in population morbidity, and cost of care impacts. The adjustments are described below, and the factors are presented in Exhibit D: Projection Period Adjustments. In addition, the source data is normalized for changes in the provider contracts.

Changes in Demographics (Normalization)

Benefit Plan: The experience period claims are normalized to an average 2015 plan using benefit relativities. The benefit relativities include the value of cost shares and anticipated changes in utilization due to the difference in average cost share requirements.

Changes in the Morbidity of the Population Insured

The claims are adjusted to reflect shifts in health insurance coverage as a result of the provisions of the ACA. The market shifts, or population movements, affecting the morbidity of the Small Group market in the projection period include:

Preventive Rx (over the counter): The claims are adjusted for 100% coverage of benefits for specific over the counter drugs obtained with a prescription from a physician.

Rx Adjustments: The claims are adjusted for differences in the Rx formulary as well as for the impact of moving drugs into different tiers in the projection period relative to what is reflected in the base experience data.

Changes in Benefits

Benefit changes include the following:

Small Groups electing to remain on their current (non-ACA) products in 2015.

Small Group members electing to forego COBRA coverage upon termination

Small Groups moving to self-funded coverage

Small Group members moving to Medicaid

Small Groups electing to drop coverage

Small Group members electing to be uninsured

Trend Factors

The annual pricing trend used in the development of the rates is 8.3%. The trend is developed by normalizing historical benefit expense for changes in the underlying population and known cost drivers, and the result is projected forward. The trend includes a volatility provision in accordance with Actuarial Standards of Practice. The claims are trended 28 months from the midpoint of the experience period, which is July 1, 2013, to the midpoint of the projection period, which is November 1, 2015.

The movement assumptions above are based on market research and assumptions on the employer opt-out and consumer uptake rates. The morbidity impacts of population movement are based on health status determined from internal risk score data.

Projected trends include the estimated cost during 2014 and 2015 of the pharmaceutical Sovaldi and other high-cost drugs for treating Hepatitis C. These cost estimates were based on claims experience for Missouri Small Group business, together with CDC recommendations and Industry and Enterprise data.

Other Cost of Care Impacts

Other Claim Adjustments

The adjustments described below are presented in Exhibit E: Other Claim Adjustments.

Change in Medical Management: medical management savings not already included in the claims experience and trend.

Change in Provider Contracts: anticipated changes in provider contracts are reflected in the benefit plan factors and the region rating factors.

Utilization or cost-per-service change: anticipated changes are reflected in the morbidity changes and trend.

10. Credibility of Experience

The combination of both Grandfathered and Non-Grandfathered experience data most reasonably reflects Small Group claims experience under the future projection period. Actuarial judgment has been exercised to determine that rates will be developed giving full credibility to the data underlying the manual rate in Section 9: Credibility Manual Rate Development.

Capitation Payments

Capitation arrangements do not exist for this business.

Rx Rebates: The projected claims cost is adjusted to reflect anticipated Rx rebates. These projections take into account the most up-to-date information regarding anticipated rebate contracts, drug prices, anticipated price inflation, and upcoming patent expirations.

The cost of adding benefits for pediatric dental and vision are included.

11. Paid to Allowed Ratio

Resulting Credibility Level Assigned to Base Period Experience

The credibility level assigned to the experience in Worksheet 1, Section III of the Unified Rate Review Template is 0%.

12. Risk Adjustment and Reinsurance

Projected Risk Adjustment

The Paid to Allowed Average Factor in Projection Period shown in Worksheet 1, Section III of the Unified Rate Review Template is developed by membership-weighted essential health benefit paid claims divided by membership-weighted essential health benefit allowed claims of each plan. The projected membership by plan is shown in Worksheet 2, Section II.

13. Non-Benefit Expenses, Profit and Risk

Non-Benefit expenses are detailed in Exhibit G: Non-Benefit Expenses and Profit & Risk.

Projected ACA Reinsurance Recoveries Net of Reinsurance Premium

The transitional reinsurance risk mitigation program collects funds from all insurance issuers and TPAs and redistributes them to high cost claimants in the Non-Grandfathered Individual market. The reinsurance contribution is equal to the national per capita reinsurance contribution rate as shown in Exhibit F: Risk Adjustment and Reinsurance - Contributions and Payments.

The Risk Adjustment program transfers funds from lower risk plans to higher risk plans in the Non-Grandfathered Individual and Small Group market. The HHS operated Risk Adjustment program is supported by a user fee, as shown in Exhibit F: Risk Adjustment and Reinsurance - Contributions and Payments.

Anthem is assuming the risk for the plans in this filing are no better or worse than other plans in the market, resulting in no estimated risk transfer value as shown in Exhibit F: Risk Adjustment and Reinsurance - Contributions and Payments.

Quality Improvement Expense

Administrative Expense

Administrative Expenses are expected to be consistent with historical levels and are developed utilizing the same methodology as previous filings, they are not varied by product or plan. Maintenance costs are assumed to be flat on a per member basis with savings from administrative efficiencies and the elimination of underwriting offset by new expenses for risk management and regulatory compliance.

The quality improvement expense represents Anthem's dedication to providing the highest standard of customer care and consistently seeking to improve health care quality, outcomes and value in a cost efficient manner.

Taxes and Fees

Patient-Centered Outcomes Research Institute (PCORI) Fee: The PCORI fee is a federally-mandated fee designed to help fund the Patient-Centered Outcomes Research Trust Fund. For plan years ending before October 1, 2014, the fee is $2 per member per year. Thereafter, for every plan year ending before October 1, 2019, the fee will increase by the percentage increase in National Healthcare Expenditures.

Selling Expense

Selling Expense represents broker commissions and bonuses associated with the broker distribution channel using historical and projected commission levels. Commissions will be paid both On-Exchange and Off-Exchange.

The QI Expense assumptions are based on historical amounts related to the following initiatives: Improve Health Outcomes, Activities to Prevent Hospital Readmissions, Improve Patient Safety and Reduce Medical Errors, Wellness and Health Promotion Activities, HIT Expenses for Health Care Quality Improvements, Other Cost Containment and ICD-10.

Profit is reflected on a post-tax basis as a percent that does not vary by product or plan. The profit percentage does not include any assumed risk corridor payments or receipts.

14. Projected Loss Ratio

Premium taxes, federal income taxes and state income taxes are also included in the retention items.

Profit

ACA Insurer Fee: The health insurance industry will be assessed a permanent fee, based on market share of net premium, which is not tax deductible. The tax impact of non-deductibility is captured in this fee.

Exchange Fee: The Exchange User Fee applies to Exchange business only, but the cost is spread across all Small Group plans. A blended fee/percentage is determined based on an assumed 10.0% of members that will purchase products On-Exchange. The resulting fee/percentage is applied evenly to all plans in the risk pool, both On and Off Exchange.

Projected Federal MLR

16. Index Rate

Experience Period Index Rate

15. Single Risk Pool

As described above in Section 4: Description of How the Base Rate Is Determined, the Anthem Index Rate for Small Group business in Missouri is based on total combined claims costs for providing essential health benefits within the single risk pool of non-grandfathered Small Group plans in Missouri. The Index Rate is adjusted on a market-wide basis for the state based on the total expected market-wide payments and charges under the risk adjustment and reinsurance programs and Exchange user fees. The premium rates for all Anthem non-grandfathered plans in the Small Group market use the applicable market-wide adjusted index rate, subject only to the permitted plan-level adjustments. This demonstrates that the Single Risk Pool for Anthem Small Group business is established according to the requirements in 45 CFR part 156, 156.80(d).

The projected Federal MLR for the products in this filing is estimated in Exhibit M: Federal MLR Estimated Calculation. Please note that this calculation is purely an estimate and not meant to be a true measure for Federal or State MLR rebate purposes. The products in this filing represent only a subset of Anthem's Small Group business. The MLR for Anthem's entire book of Small Group business will be compared to the minimum Federal benchmark for purposes of determining regulation-related premium refunds. Also note that the projected Federal MLR presented here does not capture all adjustments, including but not limited to: three-year averaging, credibility, dual option, and deductible. Anthem's projected MLR is expected to meet or exceed the minimum MLR standards at the market level after including all adjustments.

The index rate represents the average allowed claims PMPM of essential health benefits for Anthem's Small Group Non-Grandfathered Business. The experience period index rate shown in Worksheet 1, Section I (cell G17) of the Unified Rate Review Template is $316.00 and is the same, although rounded, as the experience period allowed claims (cell G16 in the same location). A comparison to the benchmark was performed, and only essential health benefits were covered during the experience period.

Projection Period Index Rate

Quarterly index and base rate changes will be implemented On-Exchange and Off-Exchange. See Exhibit O: Quarterly Index, Base, and Market Adjusted Index Rate Development.

17. Market Adjusted Index Rate

The index rate represents the average allowed claims PMPM of essential health benefits for Anthem's Small Group Non-Grandfathered Business. The projection period index rate was developed as shown in Exhibit N: Index Rate Development by adjusting the projected incurred claims PMPM described in Section 9: Credibility Manual Rate Development of this memorandum. Covered benefits in excess of essential health benefits that are included in the projection period allowed claims (cell T30 of Worksheet 1, Section II of the Unified Rate Review Template) but excluded from Exhibit N: Index Rate Development's projection period index rate (also shown in cell V44 of Worksheet 1, Section III of the Unified Rate Review Template) are wellness benefits including online fitness trainers, tobacco-free certification, and fitness reimbursement.

Quarterly Index and Base Rate

Cost Sharing Adjustments: This is a multiplicative factor that adjusts for the projected paid/allowed ratio of each plan, based on the AV metal value with an adjustment for utilization differences due to differences in cost sharing. This also includes an adjustment for the average tobacco factor shown in Exhibit H: Calibration .

Provider Network Adjustments: This is a multiplicative factor that adjusts for differences in projected claims cost due to different network discounts.

The Plan Adjusted Index Rate is calculated as the Market Adjusted Index Rate adjusted for all allowable plan level modifiers defined in the market rating rules. This development is presented in Exhibit P: Plan Adjusted Index Rate and Consumer Adjusted Premium Rates.

Plan Level Modifiers

The Market Adjusted Index rate is calculated as the Index Rate adjusted for all allowable market wide modifiers defined in the market rating rules. This development is presented in Exhibit N: Index Rate Development and Exhibit O: Quarterly Index, Base, and Market Adjusted Index Rate Development.

18. Plan Adjusted Index Rate

19. Calibration

Adjustments for Benefits in Addition to EHBs: This multiplicative factor adjusts for additional benefits that are not EHBs.

Adjustments for administrative cost: This is an additive adjustment that includes all the Selling Expense, Administration and Other Retention Items shown in Exhibit G: Non-Benefit Expenses and Profit & Risk, with the exception of the Exchange User Fee.

The required premium in the projection period is calibrated by the average rating calibration factors (Age, Area, and Plan Factor), which are used to develop the Consumer Adjusted Premium Rates. The average rating factors are shown in Exhibit H: Calibration, Exhibit P: Plan Adjusted Index Rate and Consumer Adjusted Premium Rates, and applied in line item 14 of Exhibit A: Base Rate Development.

Pediatric Dental and Vision Benefits: For plans excluding the pediatric dental benefit and pediatric vision benefit, the benefit plan factor reflects reduced benefits.

Non-EHBs: For plans including benefits in addition to EHBs, the benefit plan factor reflects enhanced benefits.

Benefit plan factors also consider the following adjustments, as applicable.

Benefit Richness Factor Adjustment: This adjustment accounts for member behavior variations depending on the richness of the benefit design.

Benefit Plan Factors

The benefit plan rating factors are applied to the projection period distribution.

In 2014, the area factors varied by plan based on actuarially justified network cost differences for each geographic rating area. Effective January 1, 2015, a single area factor will apply to all plans in each geographic rating area.

Area factors have been adjusted to reflect the most current experience. Refer to Exhibit K: Area Factors.

Age Factors

Area Factors

Provider Network: This factor accounts for differences in contracted rates and network structure.

Refer to Exhibit I: Non-Grandfathered Benefit Plan Factors and Rate Increases.

21. Actuarial Value Metal Values

20. Consumer Adjusted Premium Rate

The Consumer Adjusted Premium Rate is calculated as the Plan Adjusted Index Rate calibrated as described in the previous section. This development is presented in Exhibit P: Plan Adjusted Index Rate and Consumer Adjusted Premium Rates. The calibration is shown in Exhibit H: Calibration.

22. Actuarial Value Pricing Values

The AV Pricing Values for each Product ID are in Worksheet 2, Section I of the Unified Rate Review Template. The AV Pricing Value represents the cumulative effect of adjustments made by the issuer to move from the Market Adjusted Index Rate to the Plan Adjusted Index Rate. Consistent with final Market rules, utilization adjustments are made to account for member behavior variations based upon cost-share variations of the benefit design and not the health status of the member. The average allowable modifiers to the Index Rate can be found in Exhibit P: Plan Adjusted Index Rate and Consumer Adjusted Premium Rates.

The Actuarial Value (AV) Metal Values included in Worksheet 2 of the Unified Rate Review Template are based on the AV Calculator. To the extent a component of the benefit design was not accommodated by an available input within the AV Calculator, the benefit characteristic was adjusted to be actuarially equivalent to an available input within the AV Calculator for purposes of utilizing the AV Calculator as the basis for the AV Metal Values. Benefits for Plans that are not compatible with the parameters of the AV Calculator have been separately identified and documented in the Unique Plan Design Supporting Documentation and Justification that supports the Plan & Benefits Template.

Small Group members electing to forego COBRA coverage upon termination

Small Groups dropping coverage

Small Group members opting out of coverage

23. Membership Projections

Membership projections in Worksheet 2 of the Unified Rate Review Template are developed using a population movement model plus adjustments for sales expectations. This model projects the membership in the projection period by taking into account:

25. Terminated Products

The list of terminated products is shown in Exhibit Q: Terminated Products.

24. Warning Alerts

There are no warning alerts in the Unified Rate Review Template.

The plan distribution is based on assumed metal tier and network distributions. Some 2014 preliminary enrollment information has been considered in projecting membership distributions.

The projected morbidity changes shown in Exhibit D: Projection Period Adjustments include expected morbidity changes due to population movement.

26. Plan Type

In support of this rate development, various data and analyses were provided by other members of Anthem's internal actuarial staff, including data and analysis related to cost of care, valuation, and pricing. I have reviewed these data and analyses for reasonableness and consistency. I have also relied on Brian Renshaw, FSA, MAAA to provide the actuarial certification for the Unique Plan Design Supporting Documentation and Justification for plans included in this filing.

28. Actuarial Certification

Plan types in Worksheet 2, Section I of the URRT adequately describe Anthem's plans.

27. Reliance

Reasonable in relation to the benefits provided and the population anticipated to be covered

Neither excessive nor deficient.

In compliance with all applicable State and Federal Statutes and Regulations (45 CFR 156.80(d)(1)),

Developed in compliance with the applicable Actuarial Standards of Practice

I, Jennifer Kraus, FSA, MAAA, am an actuary for Anthem. I am a member of the American Academy of Actuaries and a Fellow of the Society of Actuaries. I meet the Qualification Standards of the American Academy of Actuaries to render the actuarial opinion contained herein. I hereby certify that the following statements are true to the best of my knowledge with regards to this filing:

(1) The projected Index Rate is:

(4) The AV Calculator was used to determine the AV Metal Values shown in Worksheet 2 of the Part I Unified Rate Review Template for all plans.

(2) The Index Rate and only the allowable modifiers as described in 45 CFR 156.80(d)(1) and 45 CFR 156.80(d)(2) were used to generate plan level rates.

(3) The percent of total premium that represents essential health benefits included in Worksheet 2, Sections III and IV is calculated in accordance with actuarial standards of practice.

The Part I Unified Rate Review Template does not demonstrate the process used by the issuer to develop the rates. Rather it represents information required by Federal regulation to be provided in support of the review of rate increases, for certification of Qualified Health Plans for Federally-Facilitated Exchanges, and for certification that the Index Rate is developed in accordance with Federal regulation, used consistently, and only adjusted by the allowable modifiers. However, this Actuarial Memo does accurately describe the process used by the issuer to develop the rates.

DateDecember 11, 2014

Jennifer Kraus, FSA, MAAADirector and Actuary III

Paid Claims1) Experience Period Cost PMPM 253.96$ Exhibit B2) x Normalization Factor 0.8777 Exhibit C3) = Normalized Claims 222.90$ = (1) x (2)

4) x Benefit Changes 0.9918 Exhibit D5) x Morbidity Changes 1.1022 Exhibit D6) x Trend Factor 1.2048 Exhibit D7) x Other Cost of Care Impacts 1.0000 Exhibit D8) = Projected Claim Cost 293.57$ = (3) x (4) x (5) x (6) x (7)

9) + Other Claim Adjustments (4.22)$ Exhibit E

10) = Claims Projected to Projection Period 289.35$ = (8) + (9)

11) + Risk Adjustment and Reinsurance - Contributions and Payments 3.29$ Exhibit F12) + Non-Benefit Expenses and Profit & Risk {1} 80.18$ Exhibit G13) = Required Premium in Projection Period 372.82$ = (10) + (11) + (12)

14) Calibration Factor 1.4006 Exhibit H15) Tobacco Average Rating Factor 1.0032 Exhibit H16) = Required Base Rate (Average Plan Level - Age 21 - Non-Tobacco) 265.33$ = (13) (14) (15)

17) Projected Loss Ratio (Conventional Basis) 78.5% = [(10) + (11)] (13)

NOTES:{1} Equivalent to PMPM expenses on Exhibit G + % of premium expenses on Exhibit G applied to Required Premium (Row 13 above).

Exhibit A - Base Rate Development

Healthy Alliance Life Insurance CompanySmall Group

Rates Effective April 1, 2015

Total Member TotalMedical Drug Medical Drug Medical Drug Capitation Benefit Expense Months PMPM314,414,330$ 112,466,759$ 33,311,813$ 4,155,407$ 347,726,143$ 116,622,166$ -$ 464,348,309$ 1,828,457 253.96$

Total Member TotalMedical Drug Medical Drug Medical Drug Capitation Benefit Expense Months PMPM422,452,256$ 138,035,690$ 45,310,539$ 5,079,151$ 467,762,795$ 143,114,841$ -$ 610,877,636$ 1,828,457 334.09$

Paid through March 31, 2014

Exhibit B - Claims Experience for Manual Rate Development


Incurred January 1, 2013 through December 31, 2013

PAID CLAIMS:Incurred and Paid Claims: IBNR: Fully Incurred Claims:

ALLOWED CLAIMS:Incurred and Paid Claims: IBNR: Fully Incurred Claims:

Experience Period Population

Future Population

Normalization Factor

Age/Gender 0.9696 1.0223 1.0544Area/Network 1.0108 0.9932 0.9826Benefit Plan 0.8098 0.6860 0.8472Total 0.8777

Exhibit C - Normalization Factors



Average Claim Factors

Adjustment FactorBenefit changes

Preventive Rx (over the counter) 1.0001Rx Adjustments {1} 0.9917Total Benefit Changes 0.9918

Morbidity changesTotal Morbidity Changes 1.1022

Cost of care impactsAnnual Medical/Rx Trend Rate 8.31%1 Months of Projection 28Trend Factor 1.2048

Total other Impacts 1.0000

NOTES:{1} Includes Rx formulary and impacts for moving drugs into different tiers

Exhibit D - Projection Period Adjustments



Impact of Changes Between Experience Period and Projection Period:

PMPMRx Rebates ($6.50)Pediatric Dental $0.80Pediatric Vision $0.99CCP Packages $0.49Total ($4.22)

NOTES:Adjustments above reflect ONLY additional costs beyond those already captured in line Item 8 of Exhibit A.

Exhibit E - Other Claim Adjustments



Adjustments to projection period claims to reflect covered benefits not included in experience period data:

Risk Adjustment:PMPM User Fee Net Transfer Federal Program $0.08 $0.00

Note:

Reinsurance:

PMPM Contributions Made Expected Receipts

Federal Program $3.21 $0.00

Source:

Grand Total of All Risk Mitigation Programs $3.29

NOTES:$3.21 = $3.67*(8 months/12 months)+$2.30*(4 months/ 12 months)$3.67 = 2015 contribution$2.30 = 2016 contribution

Small Group Plans contribute funds but only Individual Plans are eligible to receive payments

HHS estimates a national per capita contribution rate of $3.67 per month ($44 per year) in benefit year 2015 (per Payment Parameter Rule).

Exhibit F - Risk Adjustment and Reinsurance - Contributions and Payments



It is assumed the risk for the plans included in this rate filing is no better/worse than any other plans within this market.

Expenses Applied As a PMPM Cost

Expenses Applied as a % of Premium

Expressed as a PMPM {1}

Administrative ExpensesAdministrative Costs $17.42Quality Improvement Expense $3.27Selling Expense $14.52Specialty Expenses $0.31

Total Administrative Expenses $35.52 0.00% $35.52Taxes and Fees

PCORI Fee $0.18ACA Insurer Fee 3.55%Exchange Fee 0.35%Premium Tax 0.34%MLR-Deductible Federal/State Income Taxes {2} 2.69%

Total Taxes and Fees $0.18 6.93% $26.02Profit and Risk {3} 5.00% $18.64Total Non-Benefit Expenses, Profit, and Risk $35.70 11.93% $80.18

NOTES:

{3} Profit shown here is post-tax profit, net of those federal and state income taxes which are deductible from the MLR denominator.

Exhibit G - Non-Benefit Expenses and Profit & Risk



{1} The sum of the rounded percentages shown may not equal the total at the bottom of the table due to rounding.{2} Includes only those income taxes which are deductible from the MLR denominator; in particular, Federal income taxes on investment income are excluded.

Average Rating FactorTobacco 1.0032

Calibration FactorsAge 1.4008Area 0.9999Benefit Plan 1.0000Total Calibration Factor 1.4006

Total Average Rating Factor 1.4051

NOTES:

The base rate is developed by dividing the required premium in the projection period by the total average rating factor shown above.

Exhibit H - Calibration



Average 2015 rating factors for 2015 population:

See Line Item 14 on Exhibit A.

1HIOS Plan Name 2015 HIOS Plan IDOn/Off

Exchange Metal LevelBenefit Plan

Factor Network Name Area(s) Offered2014 HIOS Plan ID

Mapping

Plan Specific Rate Increase*

(excluding aging)Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780011 On/Off Bronze 0.8076 MO SG:-:Blue Preferred 02 32753MO0780003 6.68%Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780012 On/Off Bronze 0.7847 MO SG:-:Blue Preferred 05 32753MO0780003 2.77%Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780013 On/Off Bronze 0.7760 MO SG:-:Blue Preferred 06 32753MO0780003 -0.08%Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780014 On/Off Bronze 0.7468 MO SG:-:Blue Preferred 07 32753MO0780003 -8.11%Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780015 On/Off Bronze 0.7349 MO SG:-:Blue Preferred 08 32753MO0780003 -12.27%Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780016 On/Off Bronze 0.7701 MO SG:-:Blue Preferred 09 32753MO0780003 2.33%Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780017 On/Off Bronze 0.7751 MO SG:-:Blue Preferred 10 32753MO0780003 0.55%Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780018 On/Off Silver 1.0485 MO SG:-:Blue Preferred 02 32753MO0780002 21.76%Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780019 On/Off Silver 1.0187 MO SG:-:Blue Preferred 05 32753MO0780002 17.29%Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780020 On/Off Silver 1.0076 MO SG:-:Blue Preferred 06 32753MO0780002 14.04%Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780021 On/Off Silver 0.9696 MO SG:-:Blue Preferred 07 32753MO0780002 4.88%Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780022 On/Off Silver 0.9541 MO SG:-:Blue Preferred 08 32753MO0780002 0.13%Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780023 On/Off Silver 0.9999 MO SG:-:Blue Preferred 09 32753MO0780002 16.79%Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780024 On/Off Silver 1.0064 MO SG:-:Blue Preferred 10 32753MO0780002 14.76%Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780004 On/Off Gold 1.1668 MO SG:-:Blue Preferred 02 32753MO0780001 9.03%Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780005 On/Off Gold 1.1337 MO SG:-:Blue Preferred 05 32753MO0780001 5.03%Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780006 On/Off Gold 1.1213 MO SG:-:Blue Preferred 06 32753MO0780001 2.11%Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780007 On/Off Gold 1.0790 MO SG:-:Blue Preferred 07 32753MO0780001 -6.09%Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780008 On/Off Gold 1.0618 MO SG:-:Blue Preferred 08 32753MO0780001 -10.34%Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780009 On/Off Gold 1.1127 MO SG:-:Blue Preferred 09 32753MO0780001 4.58%Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780010 On/Off Gold 1.1199 MO SG:-:Blue Preferred 10 32753MO0780001 2.76%Anthem Bronze Blue Access 4500E/0%/6350 w/HSA 32753MO0790260 Off Bronze 0.9067 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790023 5.05%Anthem Bronze Blue Access Choice 4500E/0%/6350 w/HSA 32753MO0790261 Off Bronze 0.9067 MO SG:-:Blue Access Choice 06 32753MO0790114 6.45%Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790262 Off Bronze 0.8796 MO SG:-:Blue Preferred 02 32753MO0790115 13.66%Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790263 Off Bronze 0.8546 MO SG:-:Blue Preferred 05 32753MO0790115 9.49%Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790264 Off Bronze 0.8452 MO SG:-:Blue Preferred 06 32753MO0790115 6.45%Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790265 Off Bronze 0.8134 MO SG:-:Blue Preferred 07 32753MO0790115 -2.10%Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790266 Off Bronze 0.8004 MO SG:-:Blue Preferred 08 32753MO0790115 -6.54%Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790267 Off Bronze 0.8388 MO SG:-:Blue Preferred 09 32753MO0790115 9.02%Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790268 Off Bronze 0.8442 MO SG:-:Blue Preferred 10 32753MO0790115 7.12%Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790287 Off Bronze 0.8882 MO SG:-:Blue Preferred 02 32753MO0790185 23.86%Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790288 Off Bronze 0.8629 MO SG:-:Blue Preferred 05 32753MO0790185 19.32%Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790289 Off Bronze 0.8535 MO SG:-:Blue Preferred 06 32753MO0790185 16.01%Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790290 Off Bronze 0.8213 MO SG:-:Blue Preferred 07 32753MO0790185 6.69%Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790291 Off Bronze 0.8082 MO SG:-:Blue Preferred 08 32753MO0790185 1.85%Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790292 Off Bronze 0.8470 MO SG:-:Blue Preferred 09 32753MO0790185 18.81%Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790293 Off Bronze 0.8525 MO SG:-:Blue Preferred 10 32753MO0790185 16.74%Anthem Bronze Blue Access Choice 6000/0%/6600 Plus 32753MO0790294 Off Bronze 0.9156 MO SG:-:Blue Access Choice 06 32753MO0790184 16.00%Anthem Bronze Blue Access 6000/0%/6600 Plus 32753MO0790295 Off Bronze 0.9156 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790071 14.48%

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






Mapping


(excluding aging)




Anthem Silver Blue Access Choice 3000/20%/4500 Plus 32753MO0790195 Off Silver 1.0241 MO SG:-:Blue Access Choice 06 32753MO0790174 11.96%Anthem Silver Blue Access 3000/20%/4500 Plus 32753MO0790196 Off Silver 1.0241 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790057 10.49%Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790197 Off Silver 0.9934 MO SG:-:Blue Preferred 02 32753MO0790175 19.55%Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790198 Off Silver 0.9652 MO SG:-:Blue Preferred 05 32753MO0790175 15.16%Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790199 Off Silver 0.9546 MO SG:-:Blue Preferred 06 32753MO0790175 11.97%Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790200 Off Silver 0.9186 MO SG:-:Blue Preferred 07 32753MO0790175 2.97%Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790201 Off Silver 0.9040 MO SG:-:Blue Preferred 08 32753MO0790175 -1.69%Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790202 Off Silver 0.9473 MO SG:-:Blue Preferred 09 32753MO0790175 14.67%Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790203 Off Silver 0.9535 MO SG:-:Blue Preferred 10 32753MO0790175 12.67%Anthem Silver Blue Preferred Options 2750/40%/6600 32753MO0790259 Off Silver 0.8966 MO SG:-:Blue Preferred Options 10 None n/aAnthem Silver Blue Access 4000E/0%/5000 w/HSA 32753MO0790278 Off Silver 0.9713 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790033 4.42%Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790279 Off Silver 0.9422 MO SG:-:Blue Preferred 02 32753MO0790129 12.98%Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790280 Off Silver 0.9154 MO SG:-:Blue Preferred 05 32753MO0790129 8.84%Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790281 Off Silver 0.9054 MO SG:-:Blue Preferred 06 32753MO0790129 5.82%Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790282 Off Silver 0.8713 MO SG:-:Blue Preferred 07 32753MO0790129 -2.68%Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790283 Off Silver 0.8573 MO SG:-:Blue Preferred 08 32753MO0790129 -7.09%Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790284 Off Silver 0.8985 MO SG:-:Blue Preferred 09 32753MO0790129 8.37%Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790285 Off Silver 0.9043 MO SG:-:Blue Preferred 10 32753MO0790129 6.48%Anthem Silver Blue Access Choice 4000E/0%/5000 w/HSA 32753MO0790286 Off Silver 0.9713 MO SG:-:Blue Access Choice 06 32753MO0790128 5.81%Anthem Silver Blue Access Choice 2000/30%/6600 32753MO0790296 Off Silver 1.0079 MO SG:-:Blue Access Choice 06 None n/aAnthem Silver Blue Preferred 2000/30%/6600 32753MO0790297 Off Silver 0.9777 MO SG:-:Blue Preferred 02 32753MO0790149 11.17%Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790298 Off Silver 0.9500 MO SG:-:Blue Preferred 05 32753MO0790149 7.09%Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790299 Off Silver 0.9396 MO SG:-:Blue Preferred 06 32753MO0790149 4.12%Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790300 Off Silver 0.9042 MO SG:-:Blue Preferred 07 32753MO0790149 -4.24%Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790301 Off Silver 0.8897 MO SG:-:Blue Preferred 08 32753MO0790149 -8.58%Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790302 Off Silver 0.9324 MO SG:-:Blue Preferred 09 32753MO0790149 6.63%Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790303 Off Silver 0.9385 MO SG:-:Blue Preferred 10 32753MO0790149 4.78%Anthem Silver Blue Access 2000/30%/6600 32753MO0790304 Off Silver 1.0079 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 None n/aAnthem Silver Blue Preferred 5000/20%/6600 32753MO0790305 Off Silver 0.9244 MO SG:-:Blue Preferred 02 32753MO0790163 10.81%Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790306 Off Silver 0.8982 MO SG:-:Blue Preferred 05 32753MO0790163 6.75%Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790307 Off Silver 0.8883 MO SG:-:Blue Preferred 06 32753MO0790163 3.79%Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790308 Off Silver 0.8548 MO SG:-:Blue Preferred 07 32753MO0790163 -4.55%Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790309 Off Silver 0.8412 MO SG:-:Blue Preferred 08 32753MO0790163 -8.88%Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790310 Off Silver 0.8815 MO SG:-:Blue Preferred 09 32753MO0790163 6.29%Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790311 Off Silver 0.8873 MO SG:-:Blue Preferred 10 32753MO0790163 4.44%Anthem Silver Blue Access Choice 5000/20%/6600 32753MO0790312 Off Silver 0.9530 MO SG:-:Blue Access Choice 06 32753MO0790162 3.78%Anthem Silver Blue Access 5000/20%/6600 32753MO0790313 Off Silver 0.9530 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790051 2.42%Anthem Silver Blue Access 2600E/20%/5500 w/HSA 32753MO0790314 Off Silver 0.9649 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790016 -3.20%Anthem Silver Blue Access Choice 2600E/20%/5500 w/HSA 32753MO0790315 Off Silver 0.9649 MO SG:-:Blue Access Choice 06 32753MO0790100 -1.91%




Mapping


(excluding aging)




Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790316 Off Silver 0.9360 MO SG:-:Blue Preferred 02 32753MO0790101 4.74%Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790317 Off Silver 0.9095 MO SG:-:Blue Preferred 05 32753MO0790101 0.90%Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790318 Off Silver 0.8995 MO SG:-:Blue Preferred 06 32753MO0790101 -1.90%Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790319 Off Silver 0.8656 MO SG:-:Blue Preferred 07 32753MO0790101 -9.78%Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790320 Off Silver 0.8518 MO SG:-:Blue Preferred 08 32753MO0790101 -13.87%Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790321 Off Silver 0.8926 MO SG:-:Blue Preferred 09 32753MO0790101 0.46%Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790322 Off Silver 0.8984 MO SG:-:Blue Preferred 10 32753MO0790101 -1.29%Anthem Gold Blue Access Choice 1000/20%/2500 Plus 32753MO0790186 Off Gold 1.2315 MO SG:-:Blue Access Choice 06 32753MO0790166 5.53%Anthem Gold Blue Access 1000/20%/2500 Plus 32753MO0790187 Off Gold 1.2315 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790053 4.14%Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790188 Off Gold 1.1946 MO SG:-:Blue Preferred 02 32753MO0790167 12.68%Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790189 Off Gold 1.1607 MO SG:-:Blue Preferred 05 32753MO0790167 8.55%Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790190 Off Gold 1.1480 MO SG:-:Blue Preferred 06 32753MO0790167 5.53%Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790191 Off Gold 1.1048 MO SG:-:Blue Preferred 07 32753MO0790167 -2.94%Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790192 Off Gold 1.0871 MO SG:-:Blue Preferred 08 32753MO0790167 -7.34%Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790193 Off Gold 1.1393 MO SG:-:Blue Preferred 09 32753MO0790167 8.08%Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790194 Off Gold 1.1467 MO SG:-:Blue Preferred 10 32753MO0790167 6.20%Anthem Gold Blue Preferred Options 500/20%/4000 32753MO0790204 Off Gold 1.1426 MO SG:-:Blue Preferred Options 10 None n/aAnthem Gold Blue Access Choice 1500/30%/5000 32753MO0790205 Off Gold 1.1854 MO SG:-:Blue Access Choice 06 32753MO0790140 2.36%Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790206 Off Gold 1.1499 MO SG:-:Blue Preferred 02 32753MO0790141 9.30%Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790207 Off Gold 1.1173 MO SG:-:Blue Preferred 05 32753MO0790141 5.29%Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790208 Off Gold 1.1050 MO SG:-:Blue Preferred 06 32753MO0790141 2.37%Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790209 Off Gold 1.0634 MO SG:-:Blue Preferred 07 32753MO0790141 -5.86%Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790210 Off Gold 1.0464 MO SG:-:Blue Preferred 08 32753MO0790141 -10.12%Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790211 Off Gold 1.0966 MO SG:-:Blue Preferred 09 32753MO0790141 4.84%Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790212 Off Gold 1.1037 MO SG:-:Blue Preferred 10 32753MO0790141 3.01%Anthem Gold Blue Access 1500/30%/5000 32753MO0790213 Off Gold 1.1854 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790039 1.02%Anthem Gold Blue Access Choice 5000/0%/5000 32753MO0790214 Off Gold 1.1306 MO SG:-:Blue Access Choice 06 32753MO0790158 2.65%Anthem Gold Blue Access 5000/0%/5000 32753MO0790215 Off Gold 1.1306 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790049 1.30%Anthem Gold Blue Preferred 5000/0%/5000 32753MO0790216 Off Gold 1.0967 MO SG:-:Blue Preferred 02 32753MO0790159 9.60%Anthem Gold Blue Preferred 5000/0%/5000 32753MO0790217 Off Gold 1.0656 MO SG:-:Blue Preferred 05 32753MO0790159 5.58%Anthem Gold Blue Preferred 5000/0%/5000 32753MO0790218 Off Gold 1.0539 MO SG:-:Blue Preferred 06 32753MO0790159 2.65%Anthem Gold Blue Preferred 5000/0%/5000 32753MO0790219 Off Gold 1.0142 MO SG:-:Blue Preferred 07 32753MO0790159 -5.60%Anthem Gold Blue Preferred 5000/0%/5000 32753MO0790220 Off Gold 0.9980 MO SG:-:Blue Preferred 08 32753MO0790159 -9.87%Anthem Gold Blue Preferred 5000/0%/5000 32753MO0790221 Off Gold 1.0459 MO SG:-:Blue Preferred 09 32753MO0790159 5.13%Anthem Gold Blue Preferred 5000/0%/5000 32753MO0790222 Off Gold 1.0527 MO SG:-:Blue Preferred 10 32753MO0790159 3.30%Anthem Gold Blue Preferred 3500/0%/4000 32753MO0790223 Off Gold 1.1643 MO SG:-:Blue Preferred 02 32753MO0790157 7.10%Anthem Gold Blue Preferred 3500/0%/4000 32753MO0790224 Off Gold 1.1312 MO SG:-:Blue Preferred 05 32753MO0790157 3.17%Anthem Gold Blue Preferred 3500/0%/4000 32753MO0790225 Off Gold 1.1188 MO SG:-:Blue Preferred 06 32753MO0790157 0.31%Anthem Gold Blue Preferred 3500/0%/4000 32753MO0790226 Off Gold 1.0766 MO SG:-:Blue Preferred 07 32753MO0790157 -7.75%




Mapping


(excluding aging)




Anthem Gold Blue Preferred 3500/0%/4000 32753MO0790227 Off Gold 1.0594 MO SG:-:Blue Preferred 08 32753MO0790157 -11.93%Anthem Gold Blue Preferred 3500/0%/4000 32753MO0790228 Off Gold 1.1103 MO SG:-:Blue Preferred 09 32753MO0790157 2.73%Anthem Gold Blue Preferred 3500/0%/4000 32753MO0790229 Off Gold 1.1175 MO SG:-:Blue Preferred 10 32753MO0790157 0.94%Anthem Gold Blue Access 3500/0%/4000 32753MO0790230 Off Gold 1.2002 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790048 -1.01%Anthem Gold Blue Access Choice 3500/0%/4000 32753MO0790231 Off Gold 1.2002 MO SG:-:Blue Access Choice 06 32753MO0790156 0.30%Anthem Gold Blue Access Choice 1000/20%/3500 32753MO0790232 Off Gold 1.2524 MO SG:-:Blue Access Choice 06 None n/aAnthem Gold Blue Access 1000/20%/3500 32753MO0790233 Off Gold 1.2524 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 None n/aAnthem Gold Blue Preferred 1000/20%/3500 32753MO0790234 Off Gold 1.2148 MO SG:-:Blue Preferred 02 32753MO0790042 7.33%Anthem Gold Blue Preferred 1000/20%/3500 32753MO0790235 Off Gold 1.1804 MO SG:-:Blue Preferred 05 32753MO0790042 3.40%Anthem Gold Blue Preferred 1000/20%/3500 32753MO0790236 Off Gold 1.1674 MO SG:-:Blue Preferred 06 32753MO0790042 0.53%Anthem Gold Blue Preferred 1000/20%/3500 32753MO0790237 Off Gold 1.1234 MO SG:-:Blue Preferred 07 32753MO0790042 -7.55%Anthem Gold Blue Preferred 1000/20%/3500 32753MO0790238 Off Gold 1.1055 MO SG:-:Blue Preferred 08 32753MO0790042 -11.74%Anthem Gold Blue Preferred 1000/20%/3500 32753MO0790239 Off Gold 1.1585 MO SG:-:Blue Preferred 09 32753MO0790042 2.95%Anthem Gold Blue Preferred 1000/20%/3500 32753MO0790240 Off Gold 1.1660 MO SG:-:Blue Preferred 10 32753MO0790042 1.16%Anthem Gold Blue Access 2500/20%/4500 32753MO0790241 Off Gold 1.1673 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790041 0.80%Anthem Gold Blue Access Choice 2500/20%/4500 32753MO0790242 Off Gold 1.1673 MO SG:-:Blue Access Choice 06 32753MO0790144 2.14%Anthem Gold Blue Preferred 2500/20%/4500 32753MO0790243 Off Gold 1.1323 MO SG:-:Blue Preferred 02 32753MO0790145 9.06%Anthem Gold Blue Preferred 2500/20%/4500 32753MO0790244 Off Gold 1.1001 MO SG:-:Blue Preferred 05 32753MO0790145 5.06%Anthem Gold Blue Preferred 2500/20%/4500 32753MO0790245 Off Gold 1.0881 MO SG:-:Blue Preferred 06 32753MO0790145 2.14%Anthem Gold Blue Preferred 2500/20%/4500 32753MO0790246 Off Gold 1.0471 MO SG:-:Blue Preferred 07 32753MO0790145 -6.06%Anthem Gold Blue Preferred 2500/20%/4500 32753MO0790247 Off Gold 1.0303 MO SG:-:Blue Preferred 08 32753MO0790145 -10.32%Anthem Gold Blue Preferred 2500/20%/4500 32753MO0790248 Off Gold 1.0798 MO SG:-:Blue Preferred 09 32753MO0790145 4.61%Anthem Gold Blue Preferred 2500/20%/4500 32753MO0790249 Off Gold 1.0868 MO SG:-:Blue Preferred 10 32753MO0790145 2.78%Anthem Gold Blue Access Choice 1500/20%/4000 32753MO0790250 Off Gold 1.2267 MO SG:-:Blue Access Choice 06 32753MO0790154 2.18%Anthem Gold Blue Access 1500/20%/4000 32753MO0790251 Off Gold 1.2267 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790047 0.84%Anthem Gold Blue Preferred 1500/20%/4000 32753MO0790252 Off Gold 1.1899 MO SG:-:Blue Preferred 02 32753MO0790155 9.11%Anthem Gold Blue Preferred 1500/20%/4000 32753MO0790253 Off Gold 1.1561 MO SG:-:Blue Preferred 05 32753MO0790155 5.10%Anthem Gold Blue Preferred 1500/20%/4000 32753MO0790254 Off Gold 1.1435 MO SG:-:Blue Preferred 06 32753MO0790155 2.19%Anthem Gold Blue Preferred 1500/20%/4000 32753MO0790255 Off Gold 1.1004 MO SG:-:Blue Preferred 07 32753MO0790155 -6.02%Anthem Gold Blue Preferred 1500/20%/4000 32753MO0790256 Off Gold 1.0828 MO SG:-:Blue Preferred 08 32753MO0790155 -10.28%Anthem Gold Blue Preferred 1500/20%/4000 32753MO0790257 Off Gold 1.1348 MO SG:-:Blue Preferred 09 32753MO0790155 4.65%Anthem Gold Blue Preferred 1500/20%/4000 32753MO0790258 Off Gold 1.1421 MO SG:-:Blue Preferred 10 32753MO0790155 2.83%Anthem Gold Blue Preferred 500/20%/3500 32753MO0790269 Off Gold 1.2414 MO SG:-:Blue Preferred 02 32753MO0790077 7.72%Anthem Gold Blue Preferred 500/20%/3500 32753MO0790270 Off Gold 1.2062 MO SG:-:Blue Preferred 05 32753MO0790077 3.77%Anthem Gold Blue Preferred 500/20%/3500 32753MO0790271 Off Gold 1.1929 MO SG:-:Blue Preferred 06 32753MO0790077 0.89%Anthem Gold Blue Preferred 500/20%/3500 32753MO0790272 Off Gold 1.1480 MO SG:-:Blue Preferred 07 32753MO0790077 -7.21%Anthem Gold Blue Preferred 500/20%/3500 32753MO0790273 Off Gold 1.1297 MO SG:-:Blue Preferred 08 32753MO0790077 -11.42%Anthem Gold Blue Preferred 500/20%/3500 32753MO0790274 Off Gold 1.1839 MO SG:-:Blue Preferred 09 32753MO0790077 3.33%Anthem Gold Blue Preferred 500/20%/3500 32753MO0790275 Off Gold 1.1915 MO SG:-:Blue Preferred 10 32753MO0790077 1.53%




Mapping


(excluding aging)




Anthem Gold Blue Access Choice 500/20%/3500 32753MO0790276 Off Gold 1.2797 MO SG:-:Blue Access Choice 06 32753MO0790076 0.88%Anthem Gold Blue Access 500/20%/3500 32753MO0790277 Off Gold 1.2797 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 32753MO0790004 -0.44%Anthem Gold Blue Access 2000/0%/4000 32753MO0790323 Off Gold 1.2607 MO SG:-:Blue Access 02, 05, 07, 08, 09, 10 None n/aAnthem Gold Blue Access Choice 2000/0%/4000 32753MO0790324 Off Gold 1.2607 MO SG:-:Blue Access Choice 06 None n/aAnthem Gold Blue Preferred 2000/0%/4000 32753MO0790325 Off Gold 1.2229 MO SG:-:Blue Preferred 02 None n/aAnthem Gold Blue Preferred 2000/0%/4000 32753MO0790326 Off Gold 1.1882 MO SG:-:Blue Preferred 05 None n/aAnthem Gold Blue Preferred 2000/0%/4000 32753MO0790327 Off Gold 1.1751 MO SG:-:Blue Preferred 06 None n/aAnthem Gold Blue Preferred 2000/0%/4000 32753MO0790328 Off Gold 1.1309 MO SG:-:Blue Preferred 07 None n/aAnthem Gold Blue Preferred 2000/0%/4000 32753MO0790329 Off Gold 1.1128 MO SG:-:Blue Preferred 08 None n/aAnthem Gold Blue Preferred 2000/0%/4000 32753MO0790330 Off Gold 1.1662 MO SG:-:Blue Preferred 09 None n/aAnthem Gold Blue Preferred 2000/0%/4000 32753MO0790331 Off Gold 1.1737 MO SG:-:Blue Preferred 10 None n/a

NOTES:

Plan level increases in rates do not include demographic changes in the population.

Benefit Plan Factors above reflect plan by plan differences from the index rate for allowable adjustments as described in detail in the Market Reform and Payment Parameters Regulations and illustrated in Exhibit P. The weighted average of these adjustments for the entire risk pool included in this rate filing is detailed in Exhibit H.

Age Age Rating Factor Tobacco Rating Factor0-17 0.635 1.00018 0.635 1.00019 0.635 1.00020 0.635 1.00021 1.000 1.00022 1.000 1.00023 1.000 1.00024 1.000 1.00025 1.004 1.00026 1.024 1.00027 1.048 1.00028 1.087 1.00029 1.119 1.00030 1.135 1.05031 1.159 1.05032 1.183 1.05033 1.198 1.05034 1.214 1.05035 1.222 1.10036 1.230 1.10037 1.238 1.10038 1.246 1.10039 1.262 1.10040 1.278 1.20041 1.302 1.20042 1.325 1.20043 1.357 1.20044 1.397 1.20045 1.444 1.30046 1.500 1.30047 1.563 1.30048 1.635 1.30049 1.706 1.30050 1.786 1.40051 1.865 1.40052 1.952 1.40053 2.040 1.40054 2.135 1.40055 2.230 1.40056 2.333 1.40057 2.437 1.40058 2.548 1.40059 2.603 1.40060 2.714 1.40061 2.810 1.40062 2.873 1.40063 2.952 1.400

64+ 3.000 1.400

NOTES:

Exhibit J - Age and Tobacco Factors



{1} The weighted averages of these factors for the entire risk pool included in this rate filing is detailed in Exhibit H.

Rating Area Description Area Rating FactorRating Area 2 - Northeast 1.1246Rating Area 5 - Central 1.0305Rating Area 6 - St. Louis Metro 0.9570Rating Area 7 - Joplin 0.9439Rating Area 8 - Springfield 1.0124Rating Area 9 - South Central 1.0789Rating Area 10 - Southeast 1.2519

NOTES:{1} The weighted average of these factors for the entire risk pool included in this rate filing is detailed in Exhibit H.

Exhibit K - Area Factors



Group Name: Sample GroupEffective Date: 4/1/2015On/Off Exchange: OffMetal Level: SilverPlan ID: 32753MO0790300Rating Area: Rating Area 7 - Joplin

Group Census:

AgeTobacco

User AgeTobacco

User AgeTobacco

User AgeTobacco

User AgeTobacco

UserEmployee 11 24 Yes 23 No 0 NoEmployee 12 26 NoEmployee 13 28 NoEmployee 14 32 Yes 33 NoEmployee 15 30 No 2 No 4 NoEmployee 16 45 No 45 No 18 No 15 No 12 NoEmployee 17 53 Yes 55 YesEmployee 18 41 No 16 No 13 NoEmployee 19 56 NoEmployee 110 39 No 25 YesEmployee 111 62 NoEmployee 112 64 No 64 No

Calculation of Monthly Premium:Base Rate = Exhibit Ax Benefit Plan Factor Exhibit Ix Area Factor Exhibit KBase Rate Adjusted for Plan/Area =

Age/Tobacco Factors: Exhibit J

Age Factor

Tobacco Factor

Age Factor

Tobacco Factor

Age Factor

Tobacco Factor

Age Factor

Tobacco Factor

Age Factor

Tobacco Factor

Employee 11 1.000 1.0000 1.000 1.0000 0.635 1.0000Employee 12 1.024 1.0000Employee 13 1.087 1.0000Employee 14 1.183 1.0500 1.198 1.0000Employee 15 1.135 1.0000 0.635 1.0000 0.635 1.0000Employee 16 1.444 1.0000 1.444 1.0000 0.635 1.0000 0.635 1.0000 0.635 1.0000Employee 17 2.040 1.4000 2.230 1.4000Employee 18 1.302 1.0000 0.635 1.0000 0.635 1.0000Employee 19 2.333 1.0000Employee 110 1.262 1.0000 1.004 1.0000Employee 111 2.873 1.0000Employee 112 3.000 1.0000 3.000 1.0000

Final Monthly Premium PMPM:

Employee 11Employee 12Employee 13Employee 14Employee 15Employee 16Employee 17Employee 18Employee 19Employee 110Employee 111Employee 112

NOTES:

{2} This sample calculation ignores the tobacco offset under a Wellness Program as described in the Market Reform Rule.{3} Minor rate variances may occur due to differences in rounding methodology.

Child 11 Child 12 Child 13

Exhibit L - Sample Rate Calculation



226.45$ 226.45$ 143.80$ 596.70$

$ 265.33 0.90420.9439$ 226.45

Employee Spouse Child 11 Child 12 Child 13

Employee Spouse

Employee Spouse Children Total

231.88$ 231.88$ 246.15$ 246.15$ 281.28$ 271.29$ 552.57$ 257.02$ 287.60$ 544.62$ 326.99$ 326.99$ 431.40$ 1,085.38$ 646.74$ 706.98$ 1,353.72$ 294.84$ 287.60$ 582.44$

679.35$ 679.35$ 1,358.70$

{1} As per the Market Reform Rule, when computing family premiums no more than the three oldest covered children under the age of 21 are taken into account whereas the premiums associated with each child age 21+ are includ

528.31$ 528.31$ 285.78$ 227.36$ 513.14$ 650.59$ 650.59$

Numerator: Incurred Claims 289.35$ Exhibit A+ Quality Improvement Expense 3.27$ Exhibit G+ Risk Corridor Contributions -$ + Risk Adjustment Net Transfer -$ Exhibit F+ Reinsurance Receipts -$ Exhibit F+ Risk Corridor Receipts -$ + Reduction to Rx Incurred Claims (ACA MLR) (6.83)$ {5}= Estimated Federal MLR Numerator 285.79$

Denominator: Premiums 372.82$ Exhibit A- Federal and State Taxes 10.03$ Exhibit A (Line 13) x Exhibit G (Income Taxes)- Premium Taxes 1.27$ Exhibit A (Line 13) x Exhibit G (Premium Tax)- Risk Adjustment User Fee 0.08$ Exhibit F- Reinsurance Contributions 3.21$ Exhibit F- Licensing and Regulatory Fees 14.72$ Exhibit A (Line 13) x Exhibit G (Fees)= Estimated Federal MLR Denominator 343.51$

Estimated Federal MLR 83.20%

NOTES:

The above calculation is purely an estimate and not meant to be compared to the minimum MLR benchmark for federal/state MLR rebate purposes:

Exhibit M - Federal MLR Estimated Calculation



{1} The above calculation represents only the products in this filing. Federal MLR will be calculated at the legal entity and market level.

{2} Not all numerator/denominator components are captured above (for example, fraud and prevention program costs, payroll taxes, assessments for state high risk pools etc.).

{3} Other adjustments may also be applied within the federal MLR calculation such as 3-year averaging, new business, credibility, deductible and dual option. These are ignored in the above calculation.

{4} Licensing and Regulatory Fees include ACA-related fees as allowed under the MLR Final Rule.

{5} This is the percentage of 2015 pharmacy claims that are attributable to PBM Administrative Expenses (i.e. the "retail spread" or "pharmacy claims margin"). It is calculated by applying the 3rd party margin percentage to the 2015 projected Pharmacy claims including projected rebates.

1) Projected Paid Claim Cost 293.57$ Exhibit A, Line Item 82) - Non-EHBs Embedded in Line Item 1) Above -$ 3) = Projected Paid Claims, Excluding ALL Non-EHBs 293.57$ 4) + Rx Rebates (6.50)$ Exhibit E5) + Additional EHBs {1} 1.79$ Exhibit E6) = Projected Paid Claims Reflecting only EHBs 288.86$ 7) Paid to Allowed Ratio 0.716518) = Projected Allowed Claims Reflecting only EHBs 403.15$ = Index Rate

NOTE:{1} Pediatric Dental and Pediatric Vision

Exhibit N - Index Rate Development



2Q15 3Q15 4Q15Member Weighted

AverageRenewing Member Months 322,876 386,061 803,007 1,511,943

Quarterly Allowed Trend 1.58% 1.58%

Index Rate 403.15$ 409.51$ 415.98$ 411.59$

Reinsurance Contribution 3.21$ 2.87$ 2.53$ Expected Reinsurance Payments -$ -$ -$ Risk Adjustment Fee 0.08$ 0.08$ 0.08$ Risk Adjustment Net Transfer -$ -$ -$ Exchange Fee 1.30$ 1.33$ 1.35$

Paid-to-allowed Ratio 0.71651 0.71651 0.71651

Market Adjusted Index Rate 409.57$ 415.49$ 421.50$ 417.42$

Quarterly Base Rate Trend 1.63% 1.63%

Base Rate 265.33$ 269.65$ 274.05$ $ 271.07

NOTES:{1} The 2Q15 index rate was derived in Exhibit N.{2} The 2Q15 index rate is assumed to increase with quarterly allowed trend as illustrated above.

{5} The 2Q15 base rate was derived in Exhibit A.

{7} Minor rate variances may occur due to differences in rounding methodology.

{4} Market Adjusted Index Rate = Index Rate + ((Reinsurance + Risk Adjustment Fee + Exchange Fee) Paid-to-allowed Ratio)

{6} The 2Q15 base rate is assumed to increase with quarterly paid trend as illustrated above. This trend rate differs from the index rate trend in that it includes anticipated changes for non-EHBs, deductible leveraging, fees, and risk mitigation programs.

Exhibit O - Quarterly Index, Base, and Market Adjusted Index Rate Development


Rates Effective:

{3} The 2Q15 reinsurance and risk adjustment fees and payments are shown in Exhibit F. The reinsurance contribution for other effective dates is calculated by the same method shown in Exhibit F.

HIOS Plan Name HIOS Plan ID

Market Adjusted Index Rate (Exhibit O)

Cost Sharing Adjustment

Provider Network

Adjustment

Adjustment for Benefits in

Addition to the EHBS

Catastrophic Plan Adjustment

{1} Administrative Costs

Plan Adjusted Index Rate

{2}

Calibration Factor

{3}

Adjust to 2Q15 eff

date

Consumer Adjusted Premium Rate

{4}Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780011 $417.42 0.5757 0.9968 1.0110 1.0000 $64.45 $306.64 1.4006 0.9788 $214.30Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780012 $417.42 0.5757 0.9685 1.0110 1.0000 $62.63 $297.94 1.4006 0.9788 $208.22Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780013 $417.42 0.5757 0.9578 1.0110 1.0000 $61.94 $294.67 1.4006 0.9788 $205.93Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780014 $417.42 0.5757 0.9217 1.0110 1.0000 $59.62 $283.57 1.4006 0.9788 $198.18Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780015 $417.42 0.5757 0.9070 1.0110 1.0000 $58.67 $279.04 1.4006 0.9788 $195.01Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780016 $417.42 0.5757 0.9505 1.0110 1.0000 $61.47 $292.43 1.4006 0.9788 $204.37Anthem Bronze Blue Preferred X 3500/20%/6350 Plus w/HSA 32753MO0780017 $417.42 0.5757 0.9567 1.0110 1.0000 $61.87 $294.32 1.4006 0.9788 $205.69Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780018 $417.42 0.7494 0.9968 1.0085 1.0000 $83.67 $398.11 1.4006 0.9788 $278.22Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780019 $417.42 0.7494 0.9685 1.0085 1.0000 $81.30 $386.81 1.4006 0.9788 $270.33Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780020 $417.42 0.7494 0.9578 1.0085 1.0000 $80.41 $382.57 1.4006 0.9788 $267.36Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780021 $417.42 0.7494 0.9217 1.0085 1.0000 $77.40 $368.16 1.4006 0.9788 $257.29Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780022 $417.42 0.7494 0.9070 1.0085 1.0000 $76.16 $362.27 1.4006 0.9788 $253.18Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780023 $417.42 0.7494 0.9505 1.0085 1.0000 $79.80 $379.66 1.4006 0.9788 $265.33Anthem Silver Blue Preferred X 1500/30%/6600 Plus 32753MO0780024 $417.42 0.7494 0.9567 1.0085 1.0000 $80.32 $382.12 1.4006 0.9788 $267.05Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780004 $417.42 0.8346 0.9968 1.0076 1.0000 $93.12 $443.04 1.4006 0.9788 $309.62Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780005 $417.42 0.8346 0.9685 1.0076 1.0000 $90.48 $430.47 1.4006 0.9788 $300.84Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780006 $417.42 0.8346 0.9578 1.0076 1.0000 $89.50 $425.74 1.4006 0.9788 $297.54Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780007 $417.42 0.8346 0.9217 1.0076 1.0000 $86.14 $409.71 1.4006 0.9788 $286.33Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780008 $417.42 0.8346 0.9070 1.0076 1.0000 $84.77 $403.16 1.4006 0.9788 $281.75Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780009 $417.42 0.8346 0.9505 1.0076 1.0000 $88.82 $422.50 1.4006 0.9788 $295.27Anthem Gold Blue Preferred X 1000/20%/5500 Plus 32753MO0780010 $417.42 0.8346 0.9567 1.0076 1.0000 $89.39 $425.24 1.4006 0.9788 $297.19Anthem Bronze Blue Access 4500E/0%/6350 w/HSA 32753MO0790260 $417.42 0.6341 1.0276 1.0000 1.0000 $72.31 $344.29 1.4006 0.9788 $240.61Anthem Bronze Blue Access Choice 4500E/0%/6350 w/HSA 32753MO0790261 $417.42 0.6341 1.0276 1.0000 1.0000 $72.31 $344.29 1.4006 0.9788 $240.61Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790262 $417.42 0.6341 0.9968 1.0000 1.0000 $70.15 $333.97 1.4006 0.9788 $233.40Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790263 $417.42 0.6341 0.9685 1.0000 1.0000 $68.16 $324.49 1.4006 0.9788 $226.78Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790264 $417.42 0.6341 0.9578 1.0000 1.0000 $67.42 $320.93 1.4006 0.9788 $224.29Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790265 $417.42 0.6341 0.9217 1.0000 1.0000 $64.88 $308.84 1.4006 0.9788 $215.84Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790266 $417.42 0.6341 0.9070 1.0000 1.0000 $63.85 $303.91 1.4006 0.9788 $212.39Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790267 $417.42 0.6341 0.9505 1.0000 1.0000 $66.91 $318.49 1.4006 0.9788 $222.58Anthem Bronze Blue Preferred 4500E/0%/6350 w/HSA 32753MO0790268 $417.42 0.6341 0.9567 1.0000 1.0000 $67.34 $320.56 1.4006 0.9788 $224.02Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790287 $417.42 0.6339 0.9968 1.0100 1.0000 $70.82 $337.23 1.4006 0.9788 $235.68Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790288 $417.42 0.6339 0.9685 1.0100 1.0000 $68.82 $327.66 1.4006 0.9788 $228.99Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790289 $417.42 0.6339 0.9578 1.0100 1.0000 $68.07 $324.07 1.4006 0.9788 $226.48Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790290 $417.42 0.6339 0.9217 1.0100 1.0000 $65.51 $311.86 1.4006 0.9788 $217.94Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790291 $417.42 0.6339 0.9070 1.0100 1.0000 $64.47 $306.87 1.4006 0.9788 $214.46Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790292 $417.42 0.6339 0.9505 1.0100 1.0000 $67.55 $321.60 1.4006 0.9788 $224.75Anthem Bronze Blue Preferred 6000/0%/6600 Plus 32753MO0790293 $417.42 0.6339 0.9567 1.0100 1.0000 $67.99 $323.68 1.4006 0.9788 $226.21Anthem Bronze Blue Access Choice 6000/0%/6600 Plus 32753MO0790294 $417.42 0.6339 1.0276 1.0100 1.0000 $73.00 $347.65 1.4006 0.9788 $242.96Anthem Bronze Blue Access 6000/0%/6600 Plus 32753MO0790295 $417.42 0.6339 1.0276 1.0100 1.0000 $73.00 $347.65 1.4006 0.9788 $242.96Anthem Silver Blue Access Choice 3000/20%/4500 Plus 32753MO0790195 $417.42 0.7098 1.0276 1.0090 1.0000 $81.67 $388.84 1.4006 0.9788 $271.75Anthem Silver Blue Access 3000/20%/4500 Plus 32753MO0790196 $417.42 0.7098 1.0276 1.0090 1.0000 $81.67 $388.84 1.4006 0.9788 $271.75Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790197 $417.42 0.7098 0.9968 1.0090 1.0000 $79.23 $377.19 1.4006 0.9788 $263.60Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790198 $417.42 0.7098 0.9685 1.0090 1.0000 $76.99 $366.49 1.4006 0.9788 $256.12Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790199 $417.42 0.7098 0.9578 1.0090 1.0000 $76.15 $362.46 1.4006 0.9788 $253.31Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790200 $417.42 0.7098 0.9217 1.0090 1.0000 $73.29 $348.81 1.4006 0.9788 $243.77Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790201 $417.42 0.7098 0.9070 1.0090 1.0000 $72.12 $343.23 1.4006 0.9788 $239.87Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790202 $417.42 0.7098 0.9505 1.0090 1.0000 $75.57 $359.71 1.4006 0.9788 $251.39Anthem Silver Blue Preferred 3000/20%/4500 Plus 32753MO0790203 $417.42 0.7098 0.9567 1.0090 1.0000 $76.06 $362.04 1.4006 0.9788 $253.01Anthem Silver Blue Preferred Options 2750/40%/6600 32753MO0790259 $417.42 0.7088 0.9089 1.0000 1.0000 $71.54 $340.43 1.4006 0.9788 $237.92

Exhibit P - Plan Adjusted Index Rate and Consumer Adjusted Premium Rates






Provider Network

Adjustment






{2}

Calibration Factor

{3}

Adjust to 2Q15 eff

date


{4}




Anthem Silver Blue Access 4000E/0%/5000 w/HSA 32753MO0790278 $417.42 0.6792 1.0276 1.0000 1.0000 $77.45 $368.79 1.4006 0.9788 $257.74Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790279 $417.42 0.6792 0.9968 1.0000 1.0000 $75.14 $357.74 1.4006 0.9788 $250.01Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790280 $417.42 0.6792 0.9685 1.0000 1.0000 $73.01 $347.59 1.4006 0.9788 $242.92Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790281 $417.42 0.6792 0.9578 1.0000 1.0000 $72.21 $343.77 1.4006 0.9788 $240.25Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790282 $417.42 0.6792 0.9217 1.0000 1.0000 $69.50 $330.82 1.4006 0.9788 $231.20Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790283 $417.42 0.6792 0.9070 1.0000 1.0000 $68.39 $325.53 1.4006 0.9788 $227.50Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790284 $417.42 0.6792 0.9505 1.0000 1.0000 $71.66 $341.16 1.4006 0.9788 $238.42Anthem Silver Blue Preferred 4000E/0%/5000 w/HSA 32753MO0790285 $417.42 0.6792 0.9567 1.0000 1.0000 $72.13 $343.37 1.4006 0.9788 $239.97Anthem Silver Blue Access Choice 4000E/0%/5000 w/HSA 32753MO0790286 $417.42 0.6792 1.0276 1.0000 1.0000 $77.45 $368.79 1.4006 0.9788 $257.74Anthem Silver Blue Access Choice 2000/30%/6600 32753MO0790296 $417.42 0.7047 1.0276 1.0000 1.0000 $80.43 $382.72 1.4006 0.9788 $267.47Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790297 $417.42 0.7047 0.9968 1.0000 1.0000 $78.02 $371.25 1.4006 0.9788 $259.45Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790298 $417.42 0.7047 0.9685 1.0000 1.0000 $75.82 $360.71 1.4006 0.9788 $252.09Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790299 $417.42 0.7047 0.9578 1.0000 1.0000 $74.99 $356.76 1.4006 0.9788 $249.32Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790300 $417.42 0.7047 0.9217 1.0000 1.0000 $72.18 $343.32 1.4006 0.9788 $239.93Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790301 $417.42 0.7047 0.9070 1.0000 1.0000 $71.03 $337.83 1.4006 0.9788 $236.10Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790302 $417.42 0.7047 0.9505 1.0000 1.0000 $74.42 $354.04 1.4006 0.9788 $247.43Anthem Silver Blue Preferred 2000/30%/6600 32753MO0790303 $417.42 0.7047 0.9567 1.0000 1.0000 $74.90 $356.34 1.4006 0.9788 $249.03Anthem Silver Blue Access 2000/30%/6600 32753MO0790304 $417.42 0.7047 1.0276 1.0000 1.0000 $80.43 $382.72 1.4006 0.9788 $267.47Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790305 $417.42 0.6664 0.9968 1.0000 1.0000 $73.71 $350.99 1.4006 0.9788 $245.30Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790306 $417.42 0.6664 0.9685 1.0000 1.0000 $71.62 $341.03 1.4006 0.9788 $238.34Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790307 $417.42 0.6664 0.9578 1.0000 1.0000 $70.84 $337.29 1.4006 0.9788 $235.72Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790308 $417.42 0.6664 0.9217 1.0000 1.0000 $68.18 $324.58 1.4006 0.9788 $226.84Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790309 $417.42 0.6664 0.9070 1.0000 1.0000 $67.09 $319.39 1.4006 0.9788 $223.21Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790310 $417.42 0.6664 0.9505 1.0000 1.0000 $70.30 $334.72 1.4006 0.9788 $233.93Anthem Silver Blue Preferred 5000/20%/6600 32753MO0790311 $417.42 0.6664 0.9567 1.0000 1.0000 $70.75 $336.89 1.4006 0.9788 $235.44Anthem Silver Blue Access Choice 5000/20%/6600 32753MO0790312 $417.42 0.6664 1.0276 1.0000 1.0000 $75.98 $361.84 1.4006 0.9788 $252.88Anthem Silver Blue Access 5000/20%/6600 32753MO0790313 $417.42 0.6664 1.0276 1.0000 1.0000 $75.98 $361.84 1.4006 0.9788 $252.88Anthem Silver Blue Access 2600E/20%/5500 w/HSA 32753MO0790314 $417.42 0.6747 1.0276 1.0000 1.0000 $76.98 $366.39 1.4006 0.9788 $256.06Anthem Silver Blue Access Choice 2600E/20%/5500 w/HSA 32753MO0790315 $417.42 0.6747 1.0276 1.0000 1.0000 $76.98 $366.39 1.4006 0.9788 $256.06Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790316 $417.42 0.6747 0.9968 1.0000 1.0000 $74.68 $355.41 1.4006 0.9788 $248.38Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790317 $417.42 0.6747 0.9685 1.0000 1.0000 $72.57 $345.32 1.4006 0.9788 $241.33Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790318 $417.42 0.6747 0.9578 1.0000 1.0000 $71.77 $341.53 1.4006 0.9788 $238.69Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790319 $417.42 0.6747 0.9217 1.0000 1.0000 $69.08 $328.67 1.4006 0.9788 $229.70Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790320 $417.42 0.6747 0.9070 1.0000 1.0000 $67.98 $323.42 1.4006 0.9788 $226.02Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790321 $417.42 0.6747 0.9505 1.0000 1.0000 $71.23 $338.94 1.4006 0.9788 $236.87Anthem Silver Blue Preferred 2600E/20%/5500 w/HSA 32753MO0790322 $417.42 0.6747 0.9567 1.0000 1.0000 $71.69 $341.13 1.4006 0.9788 $238.41Anthem Gold Blue Access Choice 1000/20%/2500 Plus 32753MO0790186 $417.42 0.8547 1.0276 1.0074 1.0000 $98.26 $467.62 1.4006 0.9788 $326.80Anthem Gold Blue Access 1000/20%/2500 Plus 32753MO0790187 $417.42 0.8547 1.0276 1.0074 1.0000 $98.26 $467.62 1.4006 0.9788 $326.80Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790188 $417.42 0.8547 0.9968 1.0074 1.0000 $95.33 $453.61 1.4006 0.9788 $317.01Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790189 $417.42 0.8547 0.9685 1.0074 1.0000 $92.63 $440.73 1.4006 0.9788 $308.01Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790190 $417.42 0.8547 0.9578 1.0074 1.0000 $91.62 $435.90 1.4006 0.9788 $304.63Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790191 $417.42 0.8547 0.9217 1.0074 1.0000 $88.18 $419.48 1.4006 0.9788 $293.16Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790192 $417.42 0.8547 0.9070 1.0074 1.0000 $86.78 $412.78 1.4006 0.9788 $288.47Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790193 $417.42 0.8547 0.9505 1.0074 1.0000 $90.93 $432.58 1.4006 0.9788 $302.32Anthem Gold Blue Preferred 1000/20%/2500 Plus 32753MO0790194 $417.42 0.8547 0.9567 1.0074 1.0000 $91.51 $435.39 1.4006 0.9788 $304.27Anthem Gold Blue Preferred Options 500/20%/4000 32753MO0790204 $417.42 0.9030 0.9089 1.0000 1.0000 $91.26 $433.83 1.4006 0.9788 $303.19Anthem Gold Blue Access Choice 1500/30%/5000 32753MO0790205 $417.42 0.8289 1.0276 1.0000 1.0000 $94.55 $450.11 1.4006 0.9788 $314.57Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790206 $417.42 0.8289 0.9968 1.0000 1.0000 $91.73 $436.62 1.4006 0.9788 $305.14




Provider Network

Adjustment






{2}

Calibration Factor

{3}

Adjust to 2Q15 eff

date


{4}




Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790207 $417.42 0.8289 0.9685 1.0000 1.0000 $89.13 $424.23 1.4006 0.9788 $296.48Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790208 $417.42 0.8289 0.9578 1.0000 1.0000 $88.16 $419.57 1.4006 0.9788 $293.22Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790209 $417.42 0.8289 0.9217 1.0000 1.0000 $84.85 $403.77 1.4006 0.9788 $282.18Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790210 $417.42 0.8289 0.9070 1.0000 1.0000 $83.50 $397.31 1.4006 0.9788 $277.67Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790211 $417.42 0.8289 0.9505 1.0000 1.0000 $87.49 $416.38 1.4006 0.9788 $290.99Anthem Gold Blue Preferred 1500/30%/5000 32753MO0790212 $417.42 0.8289 0.9567 1.0000 1.0000 $88.06 $419.08 1.4006 0.9788 $292.88Anthem Gold Blue Access 1500/30%/5000 32753MO0790213 $417.42 0.8289 1.0276 1.0000 1.0000 $94.55 $450.11 1.4006 0

2015 anthem small group 4-1-2015 rate filing.pdf

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