CurrentBlue Cross Blue Shield - WisconsinPolicy N/A

California Plain‑Language Rate Filing Description (template for web posting)

Template/form for insurers to describe and justify proposed rate changes for posting on a public website per California Health & Safety Code 1385.07(d) and Insurance Code 10181.7(d); affects insurers filing rate changes in California.

Policy Summary

PayerBlue Cross Blue Shield - Wisconsin

PolicyCalifornia Plain‑Language Rate Filing Description (template for web posting)

Policy CodePolicy N/A

Change TypeAdministrative/template publication

Effective Date

Next Review Date

Key ActionSubmit justification for any unreasonable rate increases and attach supporting documentation as part of the SERFF filing for public posting.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

Sections 1-4numbered submission sections in form

Multiplecategories listed for cost and trend reporting

3trend drivers per category

Submission Fields and Requirements

Submission fields

Instructions/fields insurers must complete for the plain‑language rate filing description:

Submit justification for any unreasonable rate increases and attach supporting documentation to the filing.

Actual Costs by Aggregate Benefit Category

Hospital Inpatient - Dollar Cost
Hospital Inpatient - Cost as Percentage of Medicare
Hospital Outpatient (including ER) - Dollar Cost
Hospital Outpatient (including ER) - Cost as Percentage of Medicare

Policy Summary

PayerBlue Cross Blue Shield - Wisconsin

PolicyCalifornia Plain‑Language Rate Filing Description (template for web posting)

Policy CodePolicy N/A

Change TypeAdministrative/template publication

Effective Date

Next Review Date

Key ActionSubmit justification for any unreasonable rate increases and attach supporting documentation as part of the SERFF filing for public posting.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Physician/other professional services - Dollar Cost

Physician/other professional services - Cost as Percentage of Medicare

Prescription Drug - Dollar Cost

Prescription Drug - Cost as Percentage of Medicare

Laboratory (other than inpatient) - Dollar Cost

Laboratory (other than inpatient) - Cost as Percentage of Medicare

Radiology (other than inpatient) - Dollar Cost

Radiology (other than inpatient) - Cost as Percentage of Medicare

Capitation (professional) - Dollar Cost and Description

Capitation (institutional) - Dollar Cost and Description

Capitation (other) - Dollar Cost and Description

Other (describe) - Dollar Cost and Description

Projected Trend by Aggregate Benefit Category

For each aggregate benefit category, report trend attributable to use of services
For each aggregate benefit category, report trend attributable to inflation: price
For each aggregate benefit category, report trend attributable to fees and risk

Provide company name and SERFF Tracking Number; Department File Number will be completed by Department.

Aggregate Benefit Categories and Trend Components

Aggregate benefit categoriesmixed

No codes listed

Trend components required

Trend components requiredReport trend attributable to use of services, price inflation, and fees & risk for each aggregate benefit category.

Per-category breakdownProvide three trend fields for every listed aggregate benefit category: (1) trend attributable to use of services, (2) trend attributable to inflation: price, and (3) trend attributable to fees and risk.

Categories referencedApply the trend components to each category listed in the form (e.g., Hospital Inpatient, Hospital Outpatient, Physician/other professional services, Prescription Drug, Laboratory, Radiology, Capitation categories, Other).

Rate Increase Justification and Filing Requirements

Documentation Required

Rate increase justification — include supporting documentation in SERFF filing

Submit justification for any unreasonable rate increases and attach supporting documentation to the SERFF filing for public posting; include all information as to why the rate increase is justified.

Attach supporting documentation to the PDF/serff filing.
Provide a clear explanation of why the increase is justified as part of the submission.

Form Identifiers and Category Definitions

SERFF Tracking Number

Field nameSERFF Tracking Number

Location on formTop section under Company Name; insurers must enter the SERFF Tracking Number in the provided field for the filing.

PurposeIdentifies the insurer's rate filing submission for departmental tracking and public posting per the plain-language description form.

Aggregate benefit categories

DefinitionAggregate benefit categories are the named groups (e.g., Hospital Inpatient; Hospital Outpatient (including ER); Physician/other professional services; Prescription Drug; Laboratory; Radiology; Capitation (professional, institutional, other); Other) used to report actual costs and projected trend.

Use on formReport dollar cost and cost as percentage of Medicare for each aggregate benefit category in the 'Actual Costs' section.

Trend reportingFor each aggregate benefit category, report projected trend broken down by use of services, price inflation, and fees & risk in the 'Amount of Projected Trend' section.

Custom/Other categoryInclude an 'Other (describe)' category with dollar cost, description, and the same three trend components as applicable.