Rate Justification

2025 Rate Increase Justification for Affordable Care Act (ACA) products

Considerations for 2025 rate changes for Blue Cross and Blue Shield of Louisiana and HMO Louisiana, Inc., individual and small group products include: 

• Expected medical trend in both utilization and cost of services
• Expected changes in the average morbidity (Individual Blue Cross products only)
• Expected demographic shifts (Individual HMOLA products only)
• Expected selling, general, and administrative expenses, margin, and taxes and fees, including those that are applicable for 2025 under the ACA
• Expected payments and charges under the Federal Risk Adjustment Program
• Continued absence of federal funding for the cost-sharing reductions, applicable to Individual Silver metal level plans
• Changes in cost-sharing levels
• Expected utilization, cost of services, and changes in delivery system characteristics for provider networks (HMOLA products only)
• Movement of members to 2025 plans from 2024 plans that are being terminated in 2025 (Individual Blue Cross and Individual HMOLA products)

A subscriber’s actual rate increase could vary depending on the benefit plan.

2024 Rate Increase Justification for Affordable Care Act (ACA) products

Considerations for 2024 rate changes for Blue Cross and Blue Shield of Louisiana and HMO Louisiana, Inc., individual and small group products include: 

• Expected medical trend in both utilization and cost of services
• Expected changes in the average morbidity (Individual Louisiana Blue products only)
• Expected demographic shifts (Individual HMOLA products only)
• Expected selling, general, and administrative expenses, margin, and taxes and fees, including those that are applicable for 2024 under the ACA
• Expected payments and charges under the Federal Risk Adjustment Program
• Continued absence of federal funding for the cost-sharing reductions, applicable to Individual Silver metal level plans
• Changes in cost-sharing levels
• Expected utilization, cost of services, and changes in delivery system characteristics for provider networks (HMOLA products only)
• Movement of members to 2024 plans from 2023 plans that are being terminated in 2024 (Individual HMOLA and Small Group products)

A subscriber’s actual rate increase could vary depending on the benefit plan.

2023 Rate Change Justification for Affordable Care Act (ACA) products

Considerations for 2023 rate changes for Blue Cross and Blue Shield of Louisiana and HMO Louisiana, Inc., individual and small group products include: 

• Expected medical trend in both utilization and cost of services
• Expected changes in the average morbidity (Individual products only)
• Expected selling, general, and administrative expenses, margin, and taxes and fees, including those that are applicable for 2023 under the ACA
• Expected payments and charges under the Federal Risk Adjustment Program
• Continued absence of federal funding for the cost-sharing reductions, applicable to Individual Silver metal level plans
• Changes in cost-sharing levels
• Expected utilization, cost of services, and changes in delivery system characteristics for provider networks
• Movement of members to 2023 plans from 2022 plans that are being terminated in 2023 (Small Group products only)

A subscriber’s actual rate increase could vary depending on the benefit plan.