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PA Bulletin, Doc. No. 02-59


Keystone Health Plan West; Filing #4-RATPROC-01-KHPW

[32 Pa.B. 291]

   On December 20, 2001, Keystone Health Plan West submitted filing # 4-RATPROC-01-KHPW requesting approval of an Experience Rating Formula for Employer Groups with 51 or more employees enrolled in all coverages with Keystone West and Highmark Blue Cross Blue Shield.

   The proposed methodology will combine the group's most recent 12-months incurred claims experience from the Keystone West and Highmark Blue Cross Blue Shield products into a single risk pool for each group. The claims would be trended, using approved trends, to the rating period. The approved retention would then be added. This required income would be divided by the income at current rates, yielding the experience modifier. The Experience Modifier is multiplied by the credibility factor, while an Average Rate Adjustment factor is multiplied by (1-credibility). The weighted average of these two factors yields the Indicated Percent Change that is applied to current rates.

   The method will be effective upon approval.

   This filing is available for public inspection during normal working hours at the Insurance Department's regional offices in Pittsburgh and Harrisburg.

   Interested parties are invited to submit written comments, suggestions or objections to Cherri Sanders-Jones, Actuary, Insurance Department, Bureau of Accident and Health Insurance, Office of Rate and Policy Regulation, 1311 Strawberry Square, Harrisburg, PA 17120, within 30 days of publication of this notice in the Pennsylvania Bulletin.

Insurance Commissioner

[Pa.B. Doc. No. 02-59. Filed for public inspection January 11, 2002, 9:00 a.m.]

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