Oct. 11, 2017

2018 Age Curve Adjustment

Blue Cross and Blue Shield of Texas (BCBSTX) is implementing an age-curve adjustment to our individual market and metallic, fully insured small group market rating models.

This change follows recent Affordable Care Act (ACA) guidance, which amended the Federal uniform age curve with the purpose of providing a more gradual transition from child to age rating.

Background
The 2018 Notice of Benefit and Payment Parameters Final Rule updated ACA’s rating provision. Before this change, a single age band was applied to rate for members from birth through age 20.

Under the 2018 final rule, beginning on Jan. 1, 2018:

Along with the 2018 Notice of Benefit and Payment Parameters Final Rule, the Default Federal Standard Age Curve was also published, and will apply in states that do not establish their own age curves. BCBSTX rating models will continue to apply the Default Federal Standard Age Curve in our Individual and Small Group markets.

Current and 2018 Rating Factors and Rate Examples*
Age
Current Rating Factor
2018 Rating Factor
Current Small Group Rate Example
2018 Small Group Rate Example
0-14
0.635
0.765
$256.55
$309.08
15
0.635
0.833
$256.55
$336.55
16
0.635
0.859
$256.55
 $347.05
17
0.635
0.885
$256.55
 $357.56
18
0.635
0.913
$256.55
 $368.87
19
0.635
0.941
$256.55
 $380.18
20
0.635
0.970
$256.55
 $391.90
21
1.000
1.000
$404.02
 $404.02
22
1.000
1.000
 $404.02
 $404.02
23
1.000
1.000
 $404.02
 $404.02
24
1.000
1.000
 $404.02
 $404.02
25
1.004
1.004
 $405.64
 $405.64
26
1.024
1.024
 $413.72
 $413.72
*Rate examples are approximate

Implementation
The age-curve adjustment will apply to Individual market and Small Group market plans with effective dates on or after Jan. 1, 2018. For existing business, the new age curve will apply upon the 2018 renewal.

Grandfathered policies, transitional policies, and Blue Balance FundedSM ASO programs are not impacted by this rating change.

BCBSTX’s family premium calculation is not impacted by this rating change. We will continue to use the ages of only the three oldest children under the age of 21 to rate for family premiums.

Please see our answers to the most frequently asked questions. If your questions aren’t answered here, please contact your sales executive or the Small Group Account Management Team.

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