- 1,745
Procedure check:
Anthem gave us a composite rate calculator to use. I came up with another way to get the same premium and keep the rate bands same as last year (just used the same ones, raised the old rates by the overall % increase of the plan. Also used the addition of EE+1 child to EE+children. Tested it, and it worked fine. We are using it on one group's 12/1/14 renewal.
A CPA/consultant at that employer group came up with 2 questions:
1. isn't the group out of compliance with the 9.5% of lowest salary affordability measure? Not for groups under 50
2. Are you sure you are allowed to do composite rates before 1/1/15?
Since our state came out with a composite rate calculation formula for insurers to use for small group when the insurer is offering it as a billing option to be effective 1/1/15, one of the CPA's broker contacts stated that "composite rates are not allowed until 1/1/15". Well, not exactly. The state says "if" a group is going to offer to bill composite instead of age rates for each EE, then there is a formula to use. It doesn't address the right of the employer to calculate their own way of setting up the employer/employee contributions. So now I have spent several hours reading the regs, which has been interesting, but what a time burner with all the other clients/quotes/appointments.
Anyone experienced this? Our BCBS rep says employer can do what they want with employee rates from the bill, don't have to charge each EE based exactly on the bill.
Anthem gave us a composite rate calculator to use. I came up with another way to get the same premium and keep the rate bands same as last year (just used the same ones, raised the old rates by the overall % increase of the plan. Also used the addition of EE+1 child to EE+children. Tested it, and it worked fine. We are using it on one group's 12/1/14 renewal.
A CPA/consultant at that employer group came up with 2 questions:
1. isn't the group out of compliance with the 9.5% of lowest salary affordability measure? Not for groups under 50
2. Are you sure you are allowed to do composite rates before 1/1/15?
Since our state came out with a composite rate calculation formula for insurers to use for small group when the insurer is offering it as a billing option to be effective 1/1/15, one of the CPA's broker contacts stated that "composite rates are not allowed until 1/1/15". Well, not exactly. The state says "if" a group is going to offer to bill composite instead of age rates for each EE, then there is a formula to use. It doesn't address the right of the employer to calculate their own way of setting up the employer/employee contributions. So now I have spent several hours reading the regs, which has been interesting, but what a time burner with all the other clients/quotes/appointments.
Anyone experienced this? Our BCBS rep says employer can do what they want with employee rates from the bill, don't have to charge each EE based exactly on the bill.
