Form 440-4872 - Standards For Filing Individual And Small Group Health Benefit Plan Rates - Oregon Department Of Consumer And Business Service Page 10

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GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS
Category
Reference
Description of review standards requirements
Answers
Page #
impact
SUMMARY OF
Please refer to provided template
Yes
N/A
OAR 836-053-
RATE
0473 (2)(f)
INCREASES
A document labeled SUMMARY OF RATE INCREASES including:
(Exhibit 3)
Table showing the following for all effective dates (quarterly for small
group, for example):
o Effective date
o Membership count
o Requested average annual rate change
o Minimum annual rate impact
o Maximum annual rate impact
o Rate change from prior effective date (if not annual)
If applicable, a table showing a meaningful distribution of rate
increases across the entire pool.
Estimate the contributing factors to the rate increase: trend, rating
changes, margin changes, benefit changes, other
TREND
OAR 836-053-
A document labeled TREND INFORMATION AND PROJECTION that
Yes
N/A
INFORMATION
includes:
0473 (2)(g)
AND
PROJECTION
Presentation of all significant variables of trend by these categories, if
used.
o Utilization trend
(Exhibit 4)
o Cost trends by major service category, with a distribution of
claims
Hospital
Physician
Pharmacy
Other
o Deductible leveraging, if not reflected in the Plan Relativity
exhibit
o Technology/intensity
o Other factors (please specify)
Cost trends should be supported by known contractual increases in
hospital and professional agreements. Support needs to be
440-4872 (4/4/13 INS)
10

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