Rate increase justification for Affordable Care Act (ACA) products
Each year, health plans review the cost of care and make adjustments to monthly premiums. The following considerations are used to determine rate increases for Security Health Plan of Wisconsin, Inc., individual and small group products. Here are some key reasons rates may change:
- Utilization and cost of medical and pharmacy services
- Required taxes and fees for the plan under the ACA
- Expected payments and changes under the Federal Risk Adjustment Program
- Impact of regulatory changes
- The demographics and retention of our members
- The Wisconsin Healthcare Stability Plan reinsurance program
- Overall changes to plan offerings
A subscriber’s actual rate increase could vary depending on the benefit plan.