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[]
[]
[]
[]
[]
[null,null,null,"Per the Instructions, health insurance issuers proposing rate increases that meet or exceed the threshold fill in only those cells that are highlighted in GREY."]
[null,null,null,"The other cells are auto-populated."]
[]
[]
[]
[null,null,null,"A.  Base Period Data"]
[]
[{"$nulls":7},"Start Period: ","2009-05-01",{"$nulls":10},"End Period: ","2010-04-30"]
[]
[null,null,null,"Service\nCategories",{"$nulls":6},"Member\nMonths",{"$nulls":5},"Total\nAllowed",{"$nulls":5},"Net\nClaims",{"$nulls":5},"\nCost Sharing",{"$nulls":5},"Cost\nSharing PMPM",{"$nulls":5},"Net\nPMPM",{"$nulls":5},"Allowed\nPMPM"]
[null,null,null,"Inpatient",{"$nulls":6},10000,{"$nulls":5},313250,{"$nulls":5},244355,{"$nulls":5},68895,{"$nulls":5},6.8895,{"$nulls":5},24.4355,{"$nulls":5},31.325]
[null,null,null,"Outpatient",{"$nulls":6},10000,{"$nulls":5},311000,{"$nulls":5},242580,{"$nulls":5},68420,{"$nulls":5},6.842,{"$nulls":5},24.258,{"$nulls":5},31.1]
[null,null,null,"Professional",{"$nulls":6},10000,{"$nulls":5},774000,{"$nulls":5},603720,{"$nulls":5},170280,{"$nulls":5},17.028,{"$nulls":5},60.372,{"$nulls":5},77.4]
[null,null,null,"Prescription Drugs",{"$nulls":6},10000,{"$nulls":5},498000,{"$nulls":5},368500,{"$nulls":5},129500,{"$nulls":5},12.95,{"$nulls":5},36.85,{"$nulls":5},49.8]
[null,null,null,"Ancillary Services",{"$nulls":6},10000,{"$nulls":5},45800,{"$nulls":5},35700,{"$nulls":5},10100,{"$nulls":5},1.01,{"$nulls":5},3.57,{"$nulls":5},4.58]
[null,null,null,"Capitation",{"$nulls":6},10000,{"$nulls":5},75000,{"$nulls":5},75000,{"$nulls":5},0,{"$nulls":5},0,{"$nulls":5},7.5,{"$nulls":5},7.5]
[null,null,null,"Total",{"$nulls":6},10000,{"$nulls":5},2017050,{"$nulls":5},1569855,{"$nulls":5},447195,{"$nulls":5},44.7195,{"$nulls":5},156.9855,{"$nulls":5},201.705]
{"$rows_empty":7}
[null,null,null,"B. Claim Projections"]
[]
[null,null,null,"B1. Adjustment to the Current Rate",{"$nulls":32},"B2. Claims Projection for Future Rate"]
[]
[{"$nulls":7},"Start Period: ","2010-01-01",{"$nulls":10},"End Period: ","2010-12-31",{"$nulls":19},"Start Period: ","2011-01-01",{"$nulls":10},"End Period: ","2011-12-31"]
[]
[null,null,null,"Service\nCategories",{"$nulls":6},"Overall\nMedical Trend",{"$nulls":5},"Projected\nAllowed PMPM",{"$nulls":5},"Net\nClaims",{"$nulls":5},"\nCost Sharing",{"$nulls":7},"Service\nCategories",{"$nulls":6},"Overall\nMedical Trend",{"$nulls":5},"Projected\nAllowed PMPM",{"$nulls":5},"Net\nClaims",{"$nulls":5},"\nCost Sharing"]
[null,null,null,"Inpatient",{"$nulls":6},1.01539845,{"$nulls":5},31.807356446249997,{"$nulls":5},25.127811592537498,{"$nulls":5},0.21,{"$nulls":7},"Inpatient",{"$nulls":6},1.07825,{"$nulls":5},34.29628208816906,{"$nulls":5},26.751100028771866,{"$nulls":5},0.22]
[null,null,null,"Outpatient",{"$nulls":6},1.0461681,{"$nulls":5},32.53582791,{"$nulls":5},25.7033040489,{"$nulls":5},0.21,{"$nulls":7},"Outpatient",{"$nulls":6},1.1185,{"$nulls":5},36.391323517335,{"$nulls":5},28.385232343521302,{"$nulls":5},0.22]
[null,null,null,"Professional",{"$nulls":6},1.0284242685,{"$nulls":5},79.6000383819,{"$nulls":5},62.884030321701005,{"$nulls":5},0.21,{"$nulls":7},"Professional",{"$nulls":6},1.08767,{"$nulls":5},86.57857374684117,{"$nulls":5},67.53128752253612,{"$nulls":5},0.22]
[null,null,null,"Prescription Drugs",{"$nulls":6},1.0668843,{"$nulls":5},53.130838139999994,{"$nulls":5},39.848128605,{"$nulls":5},0.25,{"$nulls":7},"Prescription Drugs",{"$nulls":6},1.13155,{"$nulls":5},60.12019989731699,{"$nulls":5},44.78954892350116,{"$nulls":5},0.255]
[null,null,null,"Ancillary Services",{"$nulls":6},1.0155,{"$nulls":5},4.65099,{"$nulls":5},3.6742821,{"$nulls":5},0.21,{"$nulls":7},"Ancillary Services",{"$nulls":6},1.0812,{"$nulls":5},5.028650388,{"$nulls":5},3.92234730264,{"$nulls":5},0.22]
[null,null,null,"Capitation",{"$nulls":6},1.01,{"$nulls":5},7.575,{"$nulls":5},6.666,{"$nulls":5},0.12,{"$nulls":7},"Capitation",{"$nulls":6},1.021,{"$nulls":5},7.734075,{"$nulls":5},7.734075,{"$nulls":5},0]
[null,null,null,"Total",{"$nulls":12},209.30005087814996,{"$nulls":5},163.9035566681385,{"$nulls":5},0.21689671846491976,{"$nulls":7},"Total",{"$nulls":12},230.14910463766222,{"$nulls":5},179.11359112097043,{"$nulls":5},0.2217497808520269]
[]
[null,null,null,"B3. Medical Trend Breakout "]
[]
[null,null,null,"Factor",{"$nulls":6},"Impact"]
[]
[null,null,null,"Utilization",{"$nulls":6},0.5]
[null,null,null,"Unit Cost ",{"$nulls":6},0.4]
[null,null,null,"Other Factors",{"$nulls":6},0.1]
[]
[null,null,null,"C. Components of Current and Future Rates"]
[]
[{"$nulls":14},"Future Rate",{"$nulls":11},"Prior Estimate of Current Rate",{"$nulls":11},"Difference"]
[{"$nulls":14},"PMPM",{"$nulls":5},"%",{"$nulls":5},"PMPM",{"$nulls":5},"%",{"$nulls":5},"PMPM",{"$nulls":5},"%"]
[null,null,null,"1. Projected Net Claims",{"$nulls":10},179.11359112097043,{"$nulls":5},0.7620117193988734,{"$nulls":5},159.2,{"$nulls":5},0.7572658516862485,{"$nulls":5},19.913591120970437,{"$nulls":5},0.802204283172706]
[null,null,null,"2. Administrative Costs",{"$nulls":10},45.75,{"$nulls":5},0.19463646473903368,{"$nulls":5},43.33,{"$nulls":5},0.20610759644199214,{"$nulls":5},2.4200000000000017,{"$nulls":5},0.09748790931202687]
[null,null,null,"3. Underwritng Gain/Loss",{"$nulls":10},10.19,{"$nulls":5},0.04335181586209296,{"$nulls":5},7.7,{"$nulls":5},0.03662655187175951,{"$nulls":5},2.4899999999999993,{"$nulls":5},0.10030780751526723]
[null,null,null,"4. Total Rate",{"$nulls":10},235.05359112097042,{"$nulls":5},1,{"$nulls":5},210.22999999999996,{"$nulls":5},1,{"$nulls":5},24.823591120970438,{"$nulls":5},1]
[]
[null,null,null,"5. Overall Rate Increase",{"$nulls":16},0.11807825296565899]
[]
[null,null,null,"D. Components of Rate Increase",{"$nulls":28},"E. List of Annual Average Rate Changes Requested and Implemented in the Past Three Calendar Years "]
[]
[{"$nulls":18},"Impact\non Rate",{"$nulls":5},"Percent \n",{"$nulls":7},"Calendar Year",{"$nulls":5},"New Form",{"$nulls":5},"Requested ",{"$nulls":4},"Implemented"]
[{"$nulls":32},2010,{"$nulls":5},"N",{"$nulls":5},0.1,{"$nulls":4},0.1]
[null,null,null,"Claims Components",{"$nulls":28},2009,{"$nulls":5},"N",{"$nulls":5},0.08,{"$nulls":4},0.08]
[null,null,null,"1.",null,"Inpatient",{"$nulls":12},1.9662512571160575,{"$nulls":5},0.09873915986180179,{"$nulls":7},2008,{"$nulls":5},"N",{"$nulls":5},0.07,{"$nulls":4},0.07]
[null,null,null,"2.",null,"Outpatient",{"$nulls":12},3.0458415297946515,{"$nulls":5},0.15295290092539668]
[null,null,null,"3.",null,"Professional",{"$nulls":12},5.5130429383035215,{"$nulls":5},0.276848254280861,{"$nulls":7},"F. Range and Scope of Proposed Increase"]
[null,null,null,"4.",null,"Prescription Drugs",{"$nulls":12},5.242021317987752,{"$nulls":5},0.2632383725337981]
[null,null,null,"5.",null,"Other",{"$nulls":12},0.29835170651999976,{"$nulls":5},0.014982315580729884,{"$nulls":7},"Number of Covered Individuals"]
[null,null,null,"6.",null,"Capitation",{"$nulls":12},0.1399859999999994,{"$nulls":5},0.007029671300852615,{"$nulls":7},900]
[null,null,null,"7.",null,"Cost Share",{"$nulls":12},-0.995460296890039,{"$nulls":5},-0.049988989471705464]
[null,null,null,"8.",null,"Correction of Prior Net Claims Estimate",{"$nulls":12},4.7035566681385035,{"$nulls":5},0.23619831498826546]
[null,null,null,"9.",null,"Total",{"$nulls":12},19.913591120970445,{"$nulls":5},1]
[null,null,null,"Claims Restatement for Current Rate Period (1/1/2010-12/31/2010)",{"$nulls":35},"Range of Rate Increase\n"]
[]
[null,null,null,"8.a. Prior Net Claims Estimate for Current Rate Period",{"$nulls":20},159.2,{"$nulls":7},"Minimum % Increase",{"$nulls":6},0.05]
[null,null,null,"8.b. Re-Estimate of Net Claims PMPM for Current Rate Period",{"$nulls":20},163.9035566681385,{"$nulls":7},"Maximum % Increase",{"$nulls":6},0.136]