Anthem Blue Cross moving grandmothered plans to ACA compliance
Anthem Blue Cross of California has released an infographic summarizing the factors which cause a grandmothered or legacy small group to realize a higher than expected increase in rates. In 2016 all small group plans must become ACA compliant. This means they must include certain new medical elements, but how the rates are determined are also affected.
- No more RAF or Rate Adjustment Factor. In California small groups could have received a multiplier to their small group rates from anywhere from .90 to 1.1. All small groups will now have a RAF of 1.
- The most expensive rate for a 65 year old can be no more than three times the least expensive rate for the plan.
- All new plans will have all the essential health benefits mandated by the ACA.
- Rates will be based on groups in you community instead of just the small groups profile.
- Employee rates will be based on their home zip code and no longer on the employer address.
- Rates will be based on the exact age of the employee and dependents at the time of renewal. There will be no more age bands.
- Rates will be based on California’s 19 rating regions, developed by Covered California, which is the same for individual and family plans also.