NYC-ADM90109-109 Carrier Trend Report 2014...January 2014 levels, while group dental indemnity and PPO products remained unchanged. The group dental median trends have converged to

Consulting Actuaries

CARRIER TREND REPORTJULY 2014 ANALYSIS

1. REPORT OVERVIEW 1

2. EXECUTIVE SUMMARY 2

3. RESULTS FOR JULY 2014 3

4. HISTORICAL EXPERIENCE 12

5. PARTICIPATING PROVIDERS 18

6. EXPOSURES BY LINE OF BUSINESS 19

7. ABOUT US 20

CONTENTS

Karen K. Bender, FCA, ASA, MAAA

Beth R. Fritchen, FSA, MAAA

We help you evaluate and manage risk.

Oliver Wyman Actuarial Consulting, Inc.

411 East Wisconsin AvenueSuite 1300Milwaukee, WI 53202-4419414 223 7989

155 North Wacker DriveSuite 1500Chicago, IL 60606312 345 3378

www.oliverwyman.com

1. REPORT OVERVIEW

Oliver Wyman Actuarial Consulting, Inc. developed the Carrier Trend Survey in order to conduct market research in

the health insurance and HMO industry. Specific individual carrier or HMO responses are held in strict confidence.

This report summarizes the July 2014 trends from the survey

that Oliver Wyman sent to healthcare carriers in April 2014.

A summary of the median trends is shown in the table to the right.

The coverage specific results are discussed in the Executive

Summary. We intend this report to be of use to carriers, brokers,

state insurance agencies and other interested parties who are

affected by the trends in the cost of healthcare.

This report presents pricing trends used by the participating

companies in the development of their rates for July 20141.

These trends are used to develop premiums for approximately

103.9 million group members as reported by the participating

companies. (We have made no attempt to eliminate the effects

that dual coverage may have on these trends.) In addition, this

edition of the report reflects pricing trends for about 4.5 million

members with individual health policies, about 7.3 million

Medicare members and 2.4 million Medicaid members.

Note that the survey results shown in Section 3 of this report are

aggregated and stratified by percentile. The intent is to show

the range of trends currently being employed by the insurance

community as of July 2014. The 100th percentile represents the

highest trend reported. The 0th percentile represents the lowest

trend reported.

To a limited extent, we asked respondents to provide trends

for specific benefit designs. We have not made adjustments to

the reported trends if respondents provided trends for benefit

designs other than those specified.

Section 4 of this report contains the historical median trends.

1 There are some categories that experienced a significant change in membership from the January 2014 report. Some of the changes in trends may be attributable to a different mix in respondents.

CATEGORY MEDIAN TREND

Group Medical Indemnity 9.25%

Group Medical PPO 7.80%

Group Medical POS 7.99%

Group Medical HMO 6.40%

Prescription Drug 9.25%

Group Dental Indemnity 5.00%

Group Dental PPO 5.00%

Group Dental DHMO 5.00%

Group Vision Indemnity 4.00%

Group Vision PPO 2.50%

Group Vision Prepaid 2.00%

Medicare Supplement with Drug 4.40%

Medicare Supplement without Drug 3.40%

Medicare Advantage with Drug 3.70%

Medicare Advantage without Drug 3.20%

Medicare Part D Standard Plan 3.60%

Individual Medical Indemnity 8.86%

Individual Medical PPO 6.50%

Individual Medical POS 8.40%

Individual Medical HMO 8.30%

Group Medical HSA with Drug 9.40%

Group Medical HSA without Drug 7.30%

Individual Medical HSA with Drug 9.50%

Individual Medical HSA without Drug 7.30%

Specific Stop Loss $50,000 12.65%

Specific Stop Loss $150,000 15.04%

ASO Fees 3.00%

Medicaid 2.55%

Copyright © 2014 Oliver Wyman 1

2. EXECUTIVE SUMMARY

The median trend, weighted average, and sample

average decreased from the January 2014 survey for

all categories of the group medical products. While

PPO products experienced the largest decrease, HMO

products continue to have the lowest median trend

at 6.40%. Group indemnity products are showing the

highest median trend at 9.25%.

The prescription drug median trend increased from

January 2014 levels. This is the second consecutive

survey that the median has increased nearly half a

percentage point. The median drug trend is at 9.25%.

The median trend for dental DHMO increased from

January 2014 levels, while group dental indemnity and

PPO products remained unchanged. The group dental

median trends have converged to 5.00%.

The median trend remained at January 2014 levels for

group vision indemnity and prepaid products, while the

median trend for group vision PPO products decreased.

Indemnity products have the highest median trend

among group vision products at 4.00%.

Medicare Supplement products with prescription drug

coverage experienced an increase in the median trend

of 1.90 percentage points from January 2014 levels,

while products without drug coverage experienced a

decrease of 0.60 percentage points. The median trends

for Medicare supplement products have been trending

downward for several surveys.

The median trends remained relatively flat for Medicare

Advantage (MA) products and Medicare Part D, while the

sample average decreased half a percentage point for

MA products and increased over a percentage point for

Medicare Part D. The median trend for MA products with

drug coverage continues to show a higher median trend

than MA products without drug coverage.

The median trend increased from the January 2014

survey for individual medical HSA plans with drug

coverage. The median trends for individual medical HSA

plans without drug coverage and group medical HSA

products remained the same as the January 2014 trends.

HSA products with drug coverage have median trends

that are roughly two percentage points higher than HSA

products not offering drug coverage.

The median trend for individual medical HMO and PPO

products decreased from the January 2014 survey, while

the median trend for individual medical indemnity and

POS products increased from the January 2014 survey.

The highest median trend is among the individual

medical indemnity products at 8.86%.

The median trend for $50,000 Specific Stop Loss

decreased from the January 2014 survey by 1.30

percentage points to 12.65%. The median trend for

$150,000 Specific Stop Loss decreased from the January

2014 survey by 2.26 percentage points to 15.04%.

The Medicaid weighted average decreased from

the January 2014 survey, while the sample average

and median trend increased. The median trend is

currently 2.55%.

ASO fees median trend remained the same as the

January 2014 survey trend at 3.00%.


3. RESULTS FOR JULY 2014

The following charts show trends for:

• Group Medical

• Prescription Drug and Dental

• Group Vision

• Medicare Supplement Products

• Medicare Advantage Products

• High Deductible Health Plans

• Individual Medical

• Stop Loss, ASO Fees and Medicaid


EXHIBIT 1: GROUP MEDICAL PRICING TRENDS

5%

10%

15%

20%

25%

Group MedicalIndemnity

# of Responses

Exposures1*

75th Percentile

Median

25th Percentile

0th Percentile

Group MedicalPPO

Group MedicalPOS2*

Group MedicalHMO

ANNUAL TREND

12.25%

9.25%

8.05%

4.00%

42

2,386,696

8.53%

7.80%

6.80%

2.50%

66

56,009,459

9.39%

7.99%

6.29%

4.30%

41

18,644,264

64

16,000,949

100th Percentile 16.79% 13.60% 13.00% 12.43%

8.30%

6.40%

5.50%

0.40%

Sample Average

Weighted Average

9.28%

9.94%

7.95%

7.99%

7.91%

9.42%

7.35%

6.81%

0%

1* Based on member count

2* Percentiles for Group Medical POS are based on the number of respondents, as opposed to members


EXHIBIT 2: PRESCRIPTION DRUG AND DENTAL PRICING TRENDS

5%

10%

15%

20%

25%

# of Responses

Exposures1*

75th Percentile

Median

25th Percentile

0th Percentile

ANNUAL TREND

10.20%

9.25%

9.00%

3.00%

79

59,803,301

5.94%

5.00%

4.06%

2.50%

35

4,892,862

5.75%

5.00%

4.00%

0.00%

44

39,436,608

15

4,322,568

100th Percentile 22.10% 7.50% 7.50% 6.00%

5.00%

5.00%

4.38%

3.00%

Sample Average

Weighted Average

8.63%

8.88%

5.07%

5.04%

4.47%

5.17%

4.68%

4.42%

0%

Group DentalPPO2*,3*

Group DentalDHMO2*,4*

Group DentalIndemnity2*

PrescriptionDrug

1* Based on member count

2* Percentiles for all dental products are based on the number of respondents, as opposed to members

3* The zero trend is not an error; at least one carrier reported a zero or negative trend

4* The 75th percentile and the 50th percentile are the same for Group Dental DHMO. These reflect trends from multiple carriers


EXHIBIT 3: GROUP VISION PRICING TRENDS

5%

10%

15%

20%

25%

Group VisionIndemnity2*

# of Responses

Exposures1*

75th Percentile

Median

25th Percentile

0th Percentile

Group Vision PPO2*,3*

Group VisionPrepaid2*

ANNUAL TREND

100th Percentile

Sample Average

Weighted Average

5.00%

2.50%

1.00%

0.00%

21

36,773,910

8.53%

2.97%

2.56%

-

2.00%

-

-

2.43%

4.79%

7

741,868

-

4.75%

4.00%

3.25%

1.00%

19

4,351,364

5.00%

3.70%

4.05%

0%

1* Based on member counts

2* Percentiles for all vision products are based on the number of respondents, as opposed to members



EXHIBIT 4: MEDICARE SUPPLEMENT PRODUCTS PRICING TRENDS

5%

10%

15%

20%

25%

Medicare Supplementwith Rx2*

# of Responses

Exposures1*

75th Percentile

Median

25th Percentile

0th Percentile

Medicare Supplementwithout Rx

ANNUAL TREND

100th Percentile

Sample Average

Weighted Average

5.10%

4.40%

3.59%

0.00%

29

408,279

7.00%

4.12%

4.03%

4.00%

3.40%

1.00%

0.50%

48

1,928,276

8.00%

3.80%

3.02%

0%




EXHIBIT 5: MEDICARE ADVANTAGE PRODUCTS PRICING TRENDS

5%

10%

15%

20%

25%

# of Responses

Exposures1*

75th Percentile

Median

25th Percentile

0th Percentile

ANNUAL TREND

100th Percentile

Sample Average

Weighted Average

3.50%

3.20%

2.00%

1.06%

22

657,641

6.06%

3.09%

3.66%

6.43%

3.60%

1.90%

0.00%

4.52%

5.84%

24

2,273,783

15.00%

3.80%

3.70%

2.88%

0.00%

31

2,019,194

8.60%

3.04%

3.24%

0%

Medicare Advantagewith Rx2*

Medicare Advantagewithout Rx3*

Medicare Part D Standard Plan2*,3*



3* Percentiles for Medicare Advantage without Rx and Medicare Part D are based on the number of respondents, as opposed to members


EXHIBIT 6: HIGH DEDUCTIBLE HEALTH PLANS PRICING TRENDS

5%

10%

15%

20%

25%

# of Responses

Exposures1*

75th Percentile

Median

25th Percentile

0th Percentile

ANNUAL TREND

9.50%

9.40%

7.80%

2.20%

54

6,113,365

9.40%

7.30%

7.00%

1.90%

23

4,760,340

10.00%

9.50%

8.01%

4.00%

40

527,885

13

266,260

100th Percentile 13.60% 10.60% 12.25% 9.52%

8.01%

7.30%

5.60%

5.04%

Sample Average

Weighted Average

8.62%

8.63%

7.92%

8.04%

8.05%

8.64%

7.46%

7.32%

0%

Group MedicalHSA with Rx

Group MedicalHSA without Rx

Individual MedicalHSA with Rx

Individual MedicalHSA without Rx



EXHIBIT 7: INDIVIDUAL MEDICAL PRICING TRENDS

5%

10%

15%

20%

25%

# of Responses

Exposures1*

75th Percentile

Median

25th Percentile

0th Percentile

ANNUAL TREND

10.83%

8.86%

8.00%

4.00%

22

87,848

9.52%

6.50%

5.60%

4.00%

41

2,937,888

9.20%

8.40%

7.00%

5.04%

9

230,302

30

458,906

100th Percentile 16.79% 18.00% 10.00% 11.75%

9.52%

8.30%

7.00%

0.00%

Sample Average

Weighted Average

9.47%

12.07%

7.82%

7.68%

8.03%

8.90%

7.53%

8.00%

0%

Individual MedicalIndemnity2*

Individual MedicalPPO

Individual MedicalPOS2*

Individual MedicalHMO3*


2* Percentiles for Individual Medical Indemnity and Individual Medical POS are based on the number of respondents, as opposed to members



EXHIBIT 8: STOP LOSS, ASO FEES AND MEDICAID PRICING TRENDS

5%

10%

15%

20%

25%

# of Responses

Exposures1*

75th Percentile

Median

25th Percentile

0th Percentile

ANNUAL TREND

14.15%

12.65%

9.49%

4.94%

15

1,595,062

17.38%

15.04%

8.57%

8.00%

16

2,011,888

4.15%

3.00%

2.59%

0.00%

32

18,755,967

14

2,413,483

100th Percentile 16.13% 21.70% 11.09% 7.40%

3.45%

2.55%

1.30%

0.85%

Sample Average

Weighted Average

11.60%

11.80%

14.04%

14.96%

3.95%

8.35%

3.05%

2.27%

0%

$50,000 SpecificStop Loss2*

$150,000 SpecificStop Loss2*

ASO Fees2*,3* Medicaid2*


2* Percentiles for Stop Loss products, ASO fees, and Medicaid are based on the number of respondents, as opposed to members



4. HISTORICAL EXPERIENCE

This section shows the median of the trends reported by carriers from July 2004 forward.

EXHIBIT 9: MEDIAN GROUP MEDICAL TRENDS

14%

18%

16%

10%

8%

12%

6%

20%

Indemnity

PPO

POS

HMO

Jul.1

4

Jul.0

4

Jan

.05

Jul.0

5

Jan

.06

Jul.0

6

Jan

.07

Jul.0

7

Jan

.08

Jul.0

8

Jan

.09

Jul.0

9

Jan

.10

Jul.1

0

Jan

.11

Jul.1

1

Jan

.12

Jul.1

2

Jan

.13

Jul.1

3

Jan

.14

ANNUAL TREND

The median trend for all group medical products continue their downward trend as all

these products experienced a decrease from January 2014 levels. Group medical indemnity

products show the highest median trend at 9.25%.

EXHIBIT 10: MEDIAN PRESCRIPTION DRUG TREND

14%

18%

16%

10%

8%

12%

6%

20%

Median

ANNUAL TREND

Jul.1

4

Jul.0

4

Jan

.05

Jul.0

5

Jan

.06

Jul.0

6

Jan

.07

Jul.0

7

Jan

.08

Jul.0

8

Jan

.09

Jul.0

9

Jan

.10

Jul.1

0

Jan

.11

Jul.1

1

Jan

.12

Jul.1

2

Jan

.13

Jul.1

3

Jan

.14

The prescription drug median trend increased from the January 2014 survey. The median trend for this product has increased three out of the last four surveys after experiencing five consecutive decreases between 2010 and 2012. The median trend is currently at 9.25%.


EXHIBIT 11: MEDIAN GROUP DENTAL TRENDS

8%

4%

2%

6%

0%

10%

Indemnity

PPO

HMO

ANNUAL TREND

Jul.1

4

Jul.0

4

Jan

.05

Jul.0

5

Jan

.06

Jul.0

6

Jan

.07

Jul.0

7

Jan

.08

Jul.0

8

Jan

.09

Jul.0

9

Jan

.10

Jul.1

0

Jan

.11

Jul.1

1

Jan

.12

Jul.1

2

Jan

.13

Jul.1

3

Jan

.14

Median trends for group dental products have been relatively stable since January 2012.

The median trends for indemnity and PPO remained unchanged from the January 2014

survey, while the median trend for dental DHMO increased. The median trends for all dental

products have converged to 5.00%.

EXHIBIT 12: MEDIAN GROUP VISION TRENDS

8%

4%

2%

6%

0%

10%

Indemnity

PPO

Prepaid

ANNUAL TREND

Jul.1

4

Jul.0

4

Jan

.05

Jul.0

5

Jan

.06

Jul.0

6

Jan

.07

Jul.0

7

Jan

.08

Jul.0

8

Jan

.09

Jul.0

9

Jan

.10

Jul.1

0

Jan

.11

Jul.1

1

Jan

.12

Jul.1

2

Jan

.13

Jul.1

3

Jan

.14

The median trend for group vision indemnity and prepaid products remain unchanged from

the January 2014 survey, while the median trend for group vision PPO products experienced

a decrease. The fluctuation in historical median trend for prepaid products could be due to

the small number of respondents, rather than actual pricing trends.


EXHIBIT 13: MEDIAN MEDICARE SUPPLEMENT TRENDS

8%

4%

2%

6%

0%

12%

10%

ANNUAL TREND

Withoutprescription drugs

Withprescription drugs

Jul.1

4

Jul.0

4

Jan

.05

Jul.0

5

Jan

.06

Jul.0

6

Jan

.07

Jul.0

7

Jan

.08

Jul.0

8

Jan

.09

Jul.0

9

Jan

.10

Jul.1

0

Jan

.11

Jul.1

1

Jan

.12

Jul.1

2

Jan

.13

Jul.1

3

Jan

.14

Medicare Supplement products with drug coverage experienced an increase of 1.90

percentage points in the median trend from January 2014 levels. Products without drug

coverage experienced a decrease of 0.60 percentage points.

EXHIBIT 14: MEDIAN MEDICARE ADVANTAGE TRENDS

8%

4%

2%

6%

0%

12%

10%

ANNUAL TREND

Withoutprescription drugs

Part D –standard plan

Withprescription drugs

Jul.1

4

Jul.0

4

Jan

.05

Jul.0

5

Jan

.06

Jul.0

6

Jan

.07

Jul.0

7

Jan

.08

Jul.0

8

Jan

.09

Jul.0

9

Jan

.10

Jul.1

0

Jan

.11

Jul.1

1

Jan

.12

Jul.1

2

Jan

.13

Jul.1

3

Jan

.14

Median trends for all Medicare products have been relatively stable since July 2013. The

Medicare median trends for all products are within a tight range of each other and are

roughly 3.50%.


EXHIBIT 15: MEDIAN HIGH DEDUCTIBLE HEALTH PLAN TRENDS

16%

10%

8%

12%

14%

6%

18%

Jul.1

4

Jan

.05

Jul.0

5

Jan

.06

Jul.0

6

Jan

.07

Jul.0

7

Jan

.08

Jul.0

8

Jan

.09

Jul.0

9

Jan

.10

Jul.1

0

Jan

.11

Jul.1

1

Jan

.12

Jul.1

2

Jan

.13

Jul.1

3

Jan

.14

ANNUAL TREND

Individual Medicalwithout Rx

Group Medicalwithout Rx

Individual Medicalwith Rx

Group Medicalwith Rx

The median trend increased from the January 2014 survey for individual medical HSA plans

with drug coverage, while the median trends for all other HSA products remained the same as

the January 2014 trends. The median trends for HSA products with drug coverage are roughly

two percentage points higher than HSA products not offering drug coverage.

EXHIBIT 16: MEDIAN INDIVIDUAL MEDICAL TRENDS

14%

18%

16%

10%

8%

12%

6%

20%

Indemnity

PPO

HMO

POS

ANNUAL TREND

Jul.1

4

Jul.0

4

Jan

.05

Jul.0

5

Jan

.06

Jul.0

6

Jan

.07

Jul.0

7

Jan

.08

Jul.0

8

Jan

.09

Jul.0

9

Jan

.10

Jul.1

0

Jan

.11

Jul.1

1

Jan

.12

Jul.1

2

Jan

.13

Jul.1

3

Jan

.14

The median trend for individual medical HMO and PPO products decreased from the January

2014 survey, while the median trend for individual medical indemnity and POS products

increased from the January 2014 survey. The highest median trend is among the individual

medical indemnity products at 8.86%.


EXHIBIT 17: MEDIAN SPECIFIC STOP LOSS TRENDS

20%

10%

0%

40%

30%

ANNUAL TREND

$150,000Stop Loss

$50,000Stop Loss

Jul.1

4

Jul.0

4

Jan

.05

Jul.0

5

Jan

.06

Jul.0

6

Jan

.07

Jul.0

7

Jan

.08

Jul.0

8

Jan

.09

Jul.0

9

Jan

.10

Jul.1

0

Jan

.11

Jul.1

1

Jan

.12

Jul.1

2

Jan

.13

Jul.1

3

Jan

.14

While the stop loss median trends decreased from the January 2014 survey, these trends

have remained relatively stable since January 2008.

EXHIBIT 18: MEDIAN MEDICAID TREND

6%

4%

2%

0%

10%

8%

ANNUAL TREND

Median

Jul.1

4

Jul.0

4

Jan

.05

Jul.0

5

Jan

.06

Jul.0

6

Jan

.07

Jul.0

7

Jan

.08

Jul.0

8

Jan

.09

Jul.0

9

Jan

.10

Jul.1

0

Jan

.11

Jul.1

1

Jan

.12

Jul.1

2

Jan

.13

Jul.1

3

Jan

.14

The median Medicaid trend increased from the January 2014 survey to 2.55%. The

fluctuation in historical median trend for Medicaid products could be due to the small

number of respondents, rather than actual pricing trends.


EXHIBIT 19: MEDIAN ASO FEES TREND

6%

4%

2%

0%

10%

8%

ANNUAL TREND

Median

Jul.1

4

Jul.0

4

Jan

.05

Jul.0

5

Jan

.06

Jul.0

6

Jan

.07

Jul.0

7

Jan

.08

Jul.0

8

Jan

.09

Jul.0

9

Jan

.10

Jul.1

0

Jan

.11

Jul.1

1

Jan

.12

Jul.1

2

Jan

.13

Jul.1

3

Jan

.14

The median trend for ASO is 3.00%, which is unchanged from the January 2014 survey. The

median trend has been relatively stable since July 2009.


5. PARTICIPATING PROVIDERS

Aetna Guarantee Trust Life Insurance Company

Altius Health Plans Harvard Pilgrim Health Care

American Enterprise Health America

Ameritas Life Insurance Corp. Health Care Service Corporation

Anthem Blue Cross and Blue Shield (Colorado) Health Net of California, Inc.

Anthem Blue Cross and Blue Shield (Connecticut) HealthAmerica Pennsylvania, Inc.

Anthem Blue Cross and Blue Shield (Maine) Highmark Blue Cross Blue Shield

Anthem Blue Cross and Blue Shield (Nevada) Highmark Blue Cross Blue Shield of Delaware

Anthem Blue Cross and Blue Shield (New Hampshire) Highmark Blue Cross Blue Shield of West Virginia

Anthem Blue Cross and Blue Shield of Indiana Highmark Blue Shield

Anthem Blue Cross and Blue Shield of Kentucky HM Insurance Group

Anthem Blue Cross and Blue Shield of Missouri Horizon Blue Cross Blue Shield New Jersey

Anthem Blue Cross and Blue Shield of Ohio Humana

Anthem Blue Cross and Blue Shield of Virginia HumanaOne

Anthem Blue Cross and Blue Shield United of Wisconsin Humana Specialty Benefits

Blue Care Network of Michigan Independence Blue Cross

Blue Cross and Blue Shield of Kansas City ING Reliastar

Blue Cross and Blue Shield of Nebraska Kaiser Permanente

Blue Cross and Blue Shield of North Carolina Medical Mutual of Ohio

Blue Cross Blue Shield of Arizona Moda Health

Blue Cross Blue Shield of Illinois Network Health Plan

Blue Cross Blue Shield of Louisiana Nippon Life Insurance Company of America

Blue Cross Blue Shield of Massachusetts Northeast Delta Dental

Blue Cross Blue Shield of Michigan Optima Health

Blue Cross Blue Shield of Minnesota Paramount Health Care

Blue Cross Blue Shield of New Mexico Personal Care

Blue Cross Blue Shield of Oklahoma Physicians Health Plan of Northern Indiana, Inc.

Blue Cross Blue Shield of Texas Preferred Health Systems

BlueCross BlueShield of Tennessee Premera Blue Cross of Alaska

Blue Cross and Blue Shield of Georgia Premera Blue Cross of Washington

Blue Cross of California Priority Health

Blue Cross of Idaho Providence Health Plan

Capital Blue Cross Regence Blue Cross Blue Shield of Oregon

CareFirst BlueCross BlueShield Regence Blue Cross Blue Shield of Utah

Carefirst BCBS Maryland Regence Blue Shield of Idaho

Carelink Regence Blue Shield of Washington

CIGNA Health Care Security Health

Coventry SelectHealth

Davis Vision, Inc. Sentry Life Insurance Company

Dean Health Plan Southern Health

Delta Dental of Iowa The Health Plan of the Upper Ohio Valley/THP Insurance

Delta Dental of Kansas Transamerica Life Insurance Company

Empire Blue Cross and Blue Shield (New York) Trustmark Life Insurance Company

EPIC Life Insurance Company Tufts Health Plan

Everence United Concordia Dental

Excellus BlueCross BlueShield (Central New York) UnitedHealthcare

Excellus BlueCross BlueShield (Rochester) Unity Health Plans Insurance Corporation

Excellus BlueCross BlueShield (Utica) Universal American

Florida Blue WEA Insurance Corporation

Group Health Cooperative Wellmark Blue Cross and Blue Shield of Iowa

Group Health Options, Incorporated Wellmark Blue Cross and Blue Shield of South Dakota


6. EXPOSURES BY LINE OF BUSINESS

NUMBER OF CARRIERS RESPONDING NUMBER OF RESPONSES

TOTAL REPORTED EXPOSURE

GROUP MEDICAL

IndemnityPPOPOSHMO

31473441

42664164

2,386,69656,009,45918,644,26416,000,949

93,041,368

INDIVIDUAL MEDICAL

IndemnityPPOPOSHMO

1827

924

2241

930

87,8482,937,888

230,302458,906

3,714,944

HIGH DEDUCTIBLE HEALTH PLANS

Group Medical HSA with RxGroup Medical HSA without RxIndividual Medical HSA with RxIndividual Medical HSA without Rx

381727

6

54234013

6,113,3654,760,340

527,885266,260

11,667,850

PRESCRIPTION DRUG 49 79 59,803,301

MEDICARE SUPPLEMENT

Products with Rx benefitsProducts without Rx benefits

2337

2948

408,2791,928,276

2,336,555

MEDICARE ADVANTAGE

Products with Rx benefitsProducts without Rx benefits

2216

3122

2,019,194657,641

2,676,835

MEDICARE PART D STANDARD PLAN 18 24 2,273,783

MEDICAID 11 14 2,413,483

GROUP DENTAL

IndemnityPPODHMO

233415

354415

4,892,86239,436,608

4,322,56848,652,038

GROUP VISION

IndemnityPPOPrepaid

1219

3

1921

7

4,351,36436,773,910

741,86841,867,142

SPECIFIC STOP-LOSS

$50,000$150,000

1314

1516

1,595,0622,011,888

3,606,950

ASO FEES 23 32 18,755,967

This table shows the number of responses and the exposure by type of coverage. Not all carriers provide the entire range of products surveyed. Some carriers returned more than one response to distinguish trends by region.

The “Number of Responses” and “Total Reported Exposure” columns match the first and second summary rows of the graphs named “# of Responses” and “Exposures” found in Section 3 of the report. The exposure numbers shown are those reported. No attempt has been made to account for any “double counting” resulting from dual coverage.


7. ABOUT US

Oliver Wyman is an international management consulting firm. With more than

3,000 professionals in over 50 cities around the globe, Oliver Wyman combines deep

industry knowledge with specialized expertise in strategy, operations, risk management,

organizational transformation leadership development. The firm helps clients optimize their

businesses, improve their operations and risk profile, and accelerate their organizational

performance to seize the most attractive opportunities. As part of Marsh & McLennan

Companies (NYSE: MMC), Oliver Wyman is also able to draw on experts from our sister

companies in the areas of brand and identity management, microeconomics, human capital

strategies, insurance security.

The actuarial consulting practice of Oliver Wyman employs over 90 credentialed actuaries

in North America across 13 offices. The firm’s actuaries provide independent, objective

advice by combining a broad range of expertise with specialized knowledge of specific

risks. Oliver Wyman is committed to unparalleled mastery in actuarial and risk sciences,

continually renewed by the breadth of each consultant’s experiences and independent

research. The actuarial practice continuously researches methods for evaluating, measuring

reporting on risk and provides clear, timely communications in the three primary areas of risk

for organizations: property and casualty, life and annuities, and healthcare.

Oliver Wyman’s team of health actuaries are the leaders in innovative solutions to the ever

changing healthcare environment. As the trusted advisors to insurers, healthcare providers,

government agencies, law firms and regulators, clients turn to Oliver Wyman for high-level

strategic advice, and the ability to model proposed reforms and respond to changes in

regulations on both the state and federal levels. In addition to traditional actuarial services,

such as the estimation of premium rates and claim liabilities, Oliver Wyman’s health actuarial

services include product pricing, rating models, annual statement certification, product

feasibility, due diligence, reserve certifications, Medicare Advantage and Medicare Part D

pricing and attestations, expert witness testimony and provider contracting models.


DISCLAIMERThe trends and exposures in the Carrier Trend Report are the trends and exposures that carriers provided in the Carrier Trend Survey. No audit was performed on the trends and exposures reported to ensure accuracy. We did follow up with a few carriers that had responses outside the normal range of replies.

Oliver Wyman is providing this Carrier Trend Report as a sample of current carrier pricing trends without endorsing, certifying, or recommending these trends for specific application.

www.oliverwyman.com

For more information about this report or if you would like to participate in future surveys, please contact Karen K. Bender, FCA, ASA, MAAA or Beth R. Fritchen, FSA, MAAA.

Karen K. Bender FCA, ASA, MAAA

+1 920 826 2422 [email protected]

Beth R. Fritchen FSA, MAAA

+1 312 345 3378 [email protected]

NYC-ADM90109-109 Carrier Trend Report 2014...January 2014 levels, while group dental indemnity and PPO products remained unchanged. The group dental median trends have converged to

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