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Maine.gov > PFR Home > Administrative & Enforcement Actions > INS 08-1000 : Hearing Decision

 

 

Decision and Order, Maine Bureau of Insurance Docket No. INS-08-1000

Attachment A

Experiencce Period: 1/1/07 - 12/31/07
Projections Period: 1/1/08 - 12/31/08

    Scheduled Non-Scheduled Ambulatory Accident DOV ER Chemo Air Ambulance Mental Health BVS Total
1 Incurred Claims with Completion in Experience Period 589,167 7,030,967 1,368,596 399,950 332,739 220,863          
2 Claims Trend 1.10 1.175 1.11 0.96 1.03 1.04          
3 Claims Trended to Projection Period (= 1 * 2) 648,083 8,261,386 1,519,142 383,952 342,721 229,698          
4 Member Months in Experience Period 11,509 91,357 87,269 89,197 48,905 52,868          
5 Member Months in Projection Period 7,286 114,424 87,269 89,197 48,905 52,868          
6 Projected Claims Prior to Adjustments (= (3 / 4) * 5) 410,261 10,347,327 1,519,142 383,952 342,721 229,698          
7 Claim Adjustment for Changes in Benefits 1.00 1.00 1.00 1.00 1.00 1.00          
8 Claim Adjustment for Changes in Age 1.00 1.00 1.00 1.00 1.00 1.00          
9 Projected Claims Prior to Pharmacy Rebate Credit (= 6 * 7 * 8) 410,261 10,347,327 1,519,142 383,952 342,721 229,698          
                         
10 Administrative Expense % 11.00% 11.00% 11.00% 11.00% 11.00% 11.00%          
11 Cost Containment Expenses as % of Claims 2.70% 2.70% 2.70% 2.70% 2.70% 2.70%          
12 Commission % 14.20% 14.20% 14.20% 14.20% 14.20% 14.20%          
13 Pre-tax Targeted Profit and Risk % 3.00% 3.00% 3.00% 3.00% 3.00% 3.00%          
14 Premium Tax % 2.25% 2.25% 2.25% 2.25% 2.25% 2.25%          
15 Investment Income % -0.65% -0.65% -0.65% -0.65% -0.65% -0.65%          
16 Savings Offset Payment as % of Premium 0.73% 0.73% 0.73% 0.73% 0.73% 0.73%          
17 Projected Required Premium (= [9 + (11 * 9)] / [1.00 - (10 + 12 + 13 + 14 + 15 + 16)] 606,503 15,296,826 2,245,802 567,610 506,657 339,570          
                         
18 Earned Premium in Experience Period including Application Fees 1,283,658 11,128,737 2,143,571 906,295 635,272 421,410          
19 Premium Adjustment to Reflect Changes in Rates During Base Period 1.00 1.00 1.00 1.00 1.00 1.00          
20 Premium in Experience Period Adjusted to Current Rate Level (= 18 * 19) 1,283,658 11,128,737 2,143,571 906,295 635,272 421,410          
21 Projected Premium (= (20 / 4) * 5) 812,603 13,938,665 2,143,571 906,295 635,272 421,410          
                         
22 Annualized Premium in Force (Exhibit 1 of Filing) 1,039,782 13,443,326 2,643,714 1,086,678 818,495 554,778 59,663 131,984 18,462 4,026 19,800,908
                         
23 Required Premium Increase (= (17 / 21) - 1.00) -25.4% 9.7% 4.8% -37.4% -20.2% -19.4% 1.8% -50.0% 9.7% 0.0% 2.2%
                         
24 Loss ratio 68.4% 68.4% 68.4% 68.4% 68.4% 68.4% 68.4%        

 


 

 

 

Last Updated: January 16, 2014