Regence BlueCross BlueShield of Oregon — Individual Rate Filing transmittal and supporting exhibits
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This document contains transmittal, actuarial and certification materials for Regence BlueCross BlueShield of Oregon's individual health plan rate filing (effective April 1, 2008) including a Certificate of Compliance attesting the filing meets Oregon requirements and supporting rate exhibits.
No material clinical or coverage changes in this revision.
Coverage / Rate Content Summary
inv-01: Rate inputs and certifications
Rate-setting inputs, assumptions, and certifications included in the filing.
See Exhibit B referenced in filing memo.
Age relativities appear in Exhibit C.
Contract-type multipliers supplied for each age band.
Exhibits D and F discussed in memorandum.
Overall requested increase noted in filing memo and status.
Certification language present in transmittal.
inv-02: Rate tables and change nodes
Selected rate table fragments and change nodes shown for individual and family plans (age-banded premiums and percent changes).
See table fragments in Exhibits listing dollar premiums by age/contract type.
Percent-change lines present next to premium entries.
Relativity multipliers referenced in Exhibit C and used in tables.
inv-03: Coverage stance not specified
No medical coverage criteria or medical necessity rules are specified in these pages.
Filing is actuarial/rate material rather than clinical policy.
inv-04: coverage — not present
These pages present rate-change percentages and premium table fragments only.
Rate-change percentages and plan labels appear but no clinical coverage rules.
inv-05: Rate table fragments
Rate table fragments shown; no clinical coverage rules included.
OCRed premium rows and percent-change values in excerpt.
inv-06: coverage_information_not_present
No explicit coverage criteria or medical necessity rules in this excerpt.
Actuarial/financial content only.
inv-07: Rate filing content (no coverage rules)
Rate filing content contains premium tables and percent-change listings; no coverage rules specified.
Exhibits list premiums and deductible tiers (e.g., Premier $2,500 Deductible).
inv-08: Rate table excerpt (no coverage rules)
Rate table excerpt showing premium rows and deductible selections; no coverage rules present.
Plan/deductible labels and proposed rates shown in tables.
inv-09: No coverage criteria in excerpt
This excerpt contains premium and rate information only; no coverage criteria are stated.
Premium amounts (examples: $102, $179, $465) and age bands listed.
inv-10: Rate/premium data (informational)
Rate/premium tables and examples; no medical necessity or coverage rules included.
Proposed effective dates (e.g., March 1, 2008 / April 1, 2008) and premium figures appear in the fragments.
inv-11: Coverage information not present
Document fragments present rate/premium tables; no coverage criteria present.
Percent-change examples include values around 4.8%–6.1%.
inv-12: Pricing / Filing content (informational only)
Pricing and filing fragments provide premium/deductible options; no explicit clinical coverage criteria included.
Actuarial development and premium rows referenced in Exhibit descriptions.
inv-13: Rate table fragments
OCRed rate table fragments and rate factors; content limited to pricing data.
Examples include age-banded dollar premiums and percent-change values.
inv-14: Rate table data
Premium tables and rate-change lines displayed; no clinical coverage rules present.
Multiple sample monetary values and age categories are present.
inv-15: Rate table information
Plan options and premiums are shown; the filing does not state clinical coverage rules in these excerpts.
Exhibits referenced list proposed rates effective April 1, 2008.
Codes, Deductibles, and Key Rate Values
| H16I.005C | Filing code / product coding matrix for Individual Health – Major Medical |
| No clinical/procedural codes present in this excerpt; content is rate and deductible tables. |
| No medical coding (CPT/HCPCS/ICD-10) present in this excerpt; content is actuarial/rate tables. |
| No medical billing or procedure codes present in this excerpt. |
| No standardized medical codes present; content is actuarial/financial (premiums, percentages, deductibles). |
| No CPT/HCPCS/ICD codes present in this fragment; content is numeric rate/premium tables. |
| No procedure or diagnosis codes present in this excerpt. |
| No explicit procedure or diagnostic codes are present in this excerpt; content is numeric premium/rate tables. |
| No medical billing or procedure codes are present in these document fragments. |
| No clinical or billing codes present; document contains premium and deductible amounts |
| No CPT/HCPCS/ICD codes present; document contains rate/premium data only. |
| No medical procedure or diagnosis codes present in this section; content is rate/premium data. |
Provider / Filer Notices
Certificate of Compliance — authorized filer/officer certification
I, the undersigned authorized filer, certify the filing complies with Oregon laws, Oregon Administrative Rules, Oregon Insurance Bulletins and applicable filing requirements and product standards and that the filing is not false or misleading in any material respect; an authorized officer also certifies and acknowledges the Division will rely on this certificate and that corrective/disciplinary action including monetary penalties may be taken if the filing is materially false or misleading.
Include contract‑type relativity factors in rate review
Rate filing shows contract-type relativity factors used to scale base rates for different contract types (examples include Family, Married Couple, One Adult & Child and Child/Children); these relativity factors are provided in the filing and no provider prior-authorization rules are included in this excerpt.
- Examples of relativity values shown in the filing include Family and Married Couple multipliers and One Adult & Child = 1.54 (as printed in the contract-type relativity table).
Rate tables provided — no provider authorization rules
The filing includes rate change tables and proposed rates for individual plans (Blue Selections variants) for regulator review; the document excerpts contain only pricing/premium tables and do not include prior authorization, denial risk, or clinical authorization rules.
Rate table fragments — pricing only, no authorization rules
Tabular fragments in the filing show percent rate changes and plan/deductible labels (e.g., Premier $2,500 Deductible); these fragments are strictly rate/premium data and do not contain authorization or prior‑authorization rules.
- Premium/deductible labels such as Premier $2,500 Deductible and Premier $5,000 Deductible appear alongside percent change entries.
- Examples of percent changes shown include values like 4.8%, 5.1%, 4.9% across age bands and plan selections.
No prior‑authorization policies in excerpt
No authorization or prior‑authorization policies or procedures are present in these document fragments; content consists solely of rate tables and premium selections for individual products.
Rate/premium tables only — no authorization procedures
The excerpt contains numeric tables of percent rate changes and premium amounts; there are no prior‑authorization procedures or provider action instructions included in these sections.
Rate filing tables — premiums and deductible selections
Contains tables of individual rate filing changes, premiums and deductible selections for regulator review; providers referencing allowed rates should use these premium and deductible tables.
- Premium selections and deductible tiers (example entries: $2,500 and $5,000 deductibles) are presented by age band and contract type.
- Percent change columns accompany proposed rates (example percent changes repeatedly shown: ~4.8%–6.1%).
Premium & percent‑change data provided — informational
Rate filing pages include premium and percentage change data for individual products; these fragments do not include any provider authorization or prior‑authorization rules.
Rate filing — informational (no clinical/authorization content)
This rate filing page displays proposed individual rate changes and premium tables (OCR text). The excerpt is informational only and does not include prior authorization, denial risk, or clinical authorization language.
Informational rate fragments — no provider actions
Informational rate/premium fragments show age‑banded premiums and percent changes; no provider actions or authorization requirements are specified in these pieces.
Rate table fragment — percent change and premium tables (no authorization)
Rate filing pages contain percentage changes and premium tables for age bands and plan/deductible selections; these fragments include no prior authorization or provider action instructions.
- Percent change examples visible in the tables: 4.8%, 5.1%, 4.9%, 6.1%.
- Deductible options presented include $2,500 and $5,000 (Premier selections).
Individual Rate Filing — premium tables (informational)
The filing provides individual rate tables listing premiums, deductible selections and proposed effective dates for products; use these tables when referencing proposed allowed rates by age band and deductible.
- Proposed/effective dates are printed in the tables (example: March 1, 2008).
- Premium tables include age‑banded rows and plan labels such as Blue Selections Premier.
Premium schedule fragments — plan/deductible labels
Premium schedule fragments include plan selection labels (for example: Premier $2,500 Deductible; Premier $3,000 Deductible for children) that providers may reference for allowed‑rate lookups; these are presentation of pricing only.
- Examples of plan labels and deductibles appear alongside premium amounts and age bands.
- Child premium rows are shown separately (e.g., Child(ren) entries).
Individual rate filing — premium tables by age and deductible
Rate filing and premium tables present proposed premiums by age band and deductible selection for individual products; these tables are part of the filing's actuarial exhibits and contain no clinical coverage rules.
- Premium amounts and percent change columns accompany each age band and deductible combination.
- Deductible options repeatedly shown include $2,500 and $5,000.
Rate table excerpt — individual & child premiums (no authorization)
Contains premium and deductible tables for individual and child coverage (rates and selections); these excerpts list monetary premiums by age band and do not include authorization or prior‑authorization procedures.
Terms, Dates, and Projection Notes
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