NHSEHRP Methodology for Determining Reinsurance Premium Rates

NHSEHRP NEW HAMPSHIRE SMALL EMPLOYER HEALTH REINSURANCE POOL August 26, 2005 New Hampshire Insurance Department Attention: Commissioner Roger A. Sevigny 21 South Fruit Street, Suite 14 Concord, NH 03301-2430 Dear Commissioner Sevigny: On behalf of the Board of Directors of the New Hampshire Small Employer Health Reinsurance Pool, I am submitting the attached documentation (the standard health benefit plan, base reinsurance premium rates, and the rating methodology) which constitutes our understanding of the information for lhe subm.ission that is required on August 26, 2005 per the Statute, RSA 420-K: 4, 11 for the New Hampshire Small Employer Health Reinsurance Pool. Sincerely, ~emanl.,#-a;:',t;,,;,nc..H-;?"-" President, Pool Administrators Inc. NHSEHRP Methodology for Determining Reinsurance Premium Rates Develop A Standard Health Benefit Plan According to RSA 420-K: 4 (Standard Health Benefit Plan), I. The board shall: (a) Develop a standard health benefit plan which shall contain benefit and cost sharing levels that reflect the health coverages most commonly sold by small employer carriers in the state. It is the consensus of the NHSEHRP Board that the most popular benefit plans which their companies sell contain benefit and cost sharing levels that refiect the health coverages most sold by Small E;mployer Health Carriers in the state. In fact, the NHSEHRP Board is comprised of Small Employer Health Carriers whose combined market share accounted for more than 92% of the Covered Lives in the New Hampshire small group market in 2002 (Source: NH DOI Supplemental Reports Calendar Year 2002). With that understanding, Pool Administrators Inc. contacted the Board Member companies as well as Fortis Benefits Insurance Company, Fortis Insurance Company, John Alden, and Trustmark Insurance Company (Starmark) requesting a summary of benefits for each company's most commonly sold plans in the New Hampshire small group market. The number of plans so summarized ranged from one to four plans per carrier and included HMO, PPO, POS, and Indemnity plans. The Board decided that multiple Standard Health Benefit Plans for each major type of insurance program best meets the needs of the reinsurance Pool. The Board requested benefit summaries as well as PAi's array of the benefits that showed for each benefit the richest, the poorest and the roughly estimated a composite benefit from all of the plans submitted. The Board decided on the HMO/PPO/POS/lndemnity designs for the Standard Plans of reinsurance because they are comprehensive in nature. The Board also selected individual benefits that were richer rather than poorer to avoid requiring carriers lo re-adjudicate their reinsurance reimbursement requests to the lesser of the benefits of the Standard plan or the plan for which the benefits were paid. The Board approved Standard Benefit Plan Designs are shown as Exhibit A. Develop Base Reinsurance Rates Also, according to RSA 420•K: 4 (Standard Health Benefit Plan), I. The board shall: (b) Develop base reinsurance premium rates for the standard health benefit plan. The base reinsurance premium rates shall be set at levels which reasonably approximate gross premiums charged to small employers by small employer carriers for health benefit plans with benefits similar to the standard health benefit plan The base premium rates shall be subject to approval of the commissioner. Because of the very short period of time (45 days) to develop the Standard Health Benefit Plans and to develop the base reinsurance premium rates for the plans, the Board discussed alternative approaches to developing the rates and decided that instead of a formal survey, a premium worksheet approach would allow quicker turnaround by companies and would still contain the necessary support for the calculations. Also the Board decided that responses from the Board member companies would provide a reasonable approximation of the gross premium rates charged on either a simple average or on a weighted average basis since these companies represented more than 92% of the small group market in 2002 (the latest year available for PAI to use for the weighted average calculation). The Board approved a Premium Worksheet (Exhibit B) that starts with Base PMPM rates used for the third quarter 2005 rate development and filing for medical and Rx, adjusts them for the approved standard designs for each product and trends the rates forward to January 1, 2006 effective dates. The rationale for this approach is the fact that SB 125 will cause all small group carriers to substantially change their rating schemes and these changes are not known yet. The Board also agreed to re·examine the rates so developed when more is known in November 2006. Therefore, for each of the Standard Benefit Plans, the development methodology was as follows: 1. Base PMPM rates used were for the third quarter, 2005 rate development and filing. Average values were assumed for all the rating factors used at that time. 2. Equivalent benefit adjustment factors for each of the plans were made to adjust the rates for the standard benefit plan design of HMO, POS, PPO and Indemnity plans. 3. The adjusted benefit cost for each of the standard plans was calculated. 4. Trend factors were applied to the first quarter, 2006, 5. The adjusted benefit cost for each of the plans was calculated, 6. Load factors were applied to consider administration and reserves, etc, 2 Develop Base Reinsurance Rates /continued) 7. Per Member per Month Premium cost for 2006 was calculated. 8. A Per Subscriber per Month conversion factor was applied to the PMPM cost. 9. The Per Subscriber per Month Premium cost was calculated. It is common practice for the NAIC model pools to set the base reinsurance rates using the market average which could be the simple average or a weighted average based on covered lives or premium in the New Hampshire Small Employer Health Insurance market. In order to allow the Board to consider all the options, averages were presented following each method of calculation. The Board chose the weighted average Covered Lives approach since it gave greater weight to the more commonly sold premium rates and this meets the requirement that the base rates are "set at levels which reasonably approximate gross premiums charged to small employers". 3 Establish a Methodology for Determining Premium Rates to be Charged by the Pool Also, RSA 420-K: 4 requires that the Board (c) /:stablish a methodology for determining premium rates to be charged by the pool to reinsure small employer groups and individuals. The methodology shall include a system for classification of small employers that reflects the types of case characteristics commonly used by small employer carriers in establishing premium rates. Milliman has developed individual and group unisex rate tables for each of the four Standard Health Benefit Plans that reflect the age of the person being reinsured. Attachment I contains the monthly reinsurance premium rates for effective dates of reinsurance during the first quarter of 2006. Exhibit D provides documentation of how Milliman developed the rate tables. Finally, there is an effective date adjustment factor for each quarter in 2006, so that reinsurance ceding during the year considers the trend in the rates, 4 Establish a Methodology for Determining Premium Rates to be charged by the Pool (continued) The Plan of Operation is currently being developed by the Board of Directors but it will not be completed in time to use its text for the methodology. The following are the highlights of the instructions that will be contained in the Plan of Operation, Article XII, Reinsurance that will document the methodology for determining premium rates for reinsuring small employers and individuals. These instructions will specify that "Pool reinsurance premiums shall be established at the following percentages of the base reinsurance premium rate established by the pool for that classification of small employers with similar case characteristics: (a) An entire small employer group consisting of 2 or more employees may be reinsured for a rate that is 150 percent of the applicable base reinsurance premium rate for the group established pursuant to RSA 420-K4, II and (b) An eligible employee or dependent may be reinsured for a rate that is 500 percent of the applicable base reinsurance premium rate for the individual established pursuant to RSA 420-K: 4, II." Please note that the rate tables for whole group and individual reinsurance already reflect the 150% and 500% rate adjustments described in this section of the Law. The following are the instructions that explain how the rates are computed for each group or individual being ceded. The steps include the following: 1. Determine the type of benefit plan (HMO, POS, PPO, Indemnity). Determine which Standard Plan Design comes closest to matching the benefit plan that has been sold to the group. Select the Plan Design which will be used for reinsurance. 2. Determine whether to cede the whole group or one or more individuals. Determine whether to use Whole Group or Individual Reinsurance Rate Tables. If the whole group is to be ceded then it shall include every Eligible Employee and every Eligible Dependent of each Eligible Employee in calculating the premium required. If individual is used then any Eligible Employee and any Eligible Dependent of an Eligible Employee may be ceded using the Individual Reinsurance Rate Tables. 5 Establish a Methodology for Determining Premium Rates to be charged by the Pool (continued) 3. Determine the age of the life/lives to be ceded. The age of the ceded risk(s) shall be determined as of the effective date of insurance for the group, regardless of whether Whole Group Reinsurance or Individual Reinsurance is used. 4. Look up the appropriate rate in the rate table for each person being ceded 5. Adjust the rates for effective date of the reinsurance. Based on the insurance effective date for the group, apply the effective date adjustment factor for the applicable quarter to determine the reinsurance rate for each risk being rein sured. 6. Sum the rates across all the lives. 7. Apply industry adjustment if applicable. 8. Apply case size adjustment if applicable. The industry and case size adjustments should be 1.0 for the initial submission. Because the Board does not yet know exactly how carriers will reflect these risk characteristics in their rating and because other state pools do not adjust for these variables in the reinsurance rates. The Board will request revisions to the factors as appropriate when final marketplace rates become known. This constitutes our understanding of the information for the submission that is required on August 26, 2005 per the Statute, RSA 420-K: 4, II. The standard health benefit plan, base reinsurance premium rates, and the rating methodology shall be submitted to the commissioner for approval within 45 days after the appointment of the board and shall subsequently be revised as necessary and appropriate. 6 Board Approved Standard Health Benefit Plan Designs HMO Version HMO Plan Benefits Proposed by the NH Reinsurance Board Deductible Individual None Familv None Out of Pocket Maximums Individual None Familv None Coinsurance None Lifetime Maximum None Emergency Room $50 co-pay per visit Hosoital Services Inpatient Covered in fu 11 Outpatient, other than emergency room Covered in full Physician Office Services PCP Office Visit $10 oo-oav oer visit Specialist Office Visit $10 co-Pav per visit Preventative Care Covered in full Phvsician Hospital Visits Covered in full Suroerv and Asst. Suraeon Fees Covered in full Laboratorv and X-Rav Covered in full Clinical Trials Not Covered Diabetes Covered in full Diabetic Suoolies Under RX Nonprescription l:nteral Formulas Not Covered Mammoaraohv Covered in Full Pap Smi!lar Covered in Full Exhibit A 7 Routine Preventive Test Covered in Full Prescription Drug - Retail Generic $5 co-pay Preferred Brand $10 co-oav Non- Preferred Brand $25 co-oav Prescription Drug - Mail Order - per month Generic $5 co-oav Preferred Brand $10 co-oav Non- Preferred Brand $25 co-pay Maternitv Excenses Pre/Post Natal Office Visits Covered In full Deliverv Chari:ies Covered in full Newborn Hosoital Bill Covered In full Newborn Pediatrician $1 o co-pay per visit Rehabilitation Therapies Physical Theraov $10 co-pay per visit Occmiational Theranv $10 co-Pav per visit Cardiac Therapv Covered in full Soeech Theranv $1 O co-oav oer vis it Home Health Care Covered in full Mental Health Mirror NH state mandate Inpatient Mirror NH state mandate Outoatient Substance Abuse Inpatient Mirror NH state mandate Outoatient Mirror NH state mandate Ambulance Covered in full Chiropractic Treatment $10 co-pay per visit Allergy Care $10 co-Dav Der visit Allergy Injections - $1 O co-pay per visit 8 $100 deductible with max annual benefit of $3,500 Durable Medical Equipment (DMEl Prosthetics Appliances and Orthotlcs Included in $100 DME deductible Date: 8/19/2005 9 Exhibit A Board Approved Standard Health Benefit Plan Designs POS Version POS Proposed by the NH Reinsurance Board Plan Benefits IN Network (matches HMO) Out of Network POS Benefits Deductible Individual None $150 Family None $450 Out of Pocket Ma)dmums Individual None $900 Non-Network (includes deductible and coinsurance) Family None $2700 Non-Network (includes deductible and coinsurance Coinsurance None 80% Annual Maximum Benefit None $1,000,000 Lifetime Maximum None $2,000,000 Emergency Room $50 co-pay per visit Subject to deductible and coinsurance Hospital Services Subject to deductible and coinsurance Inpatient Covered in full Subject to deductible and co- Insurance Outpatient. other than emergency room Covered In full Subject to deductible and coinsurance Physician Office Services PCP Office Visit $ 10 copay per visit Subject to deductible and coinsurance Specialist Office Visit $1 0 copay per visit Subject to deductible and coinsurance Preventative Care Covered in fu 11 Subject to deductible and coinsurance 10 Physician Hospital Visits Covered in full Subject to deductible and coinsurance Surgery and Asst Surgeon Fees Covered in full Subject to deductible and coinsurance Laboratory and X-Ray Covered in full Subject to deductible and ooinsurance Mammography Covered in full Subject to deductible and coinsurance Pap Smear Covered in full Subject to deductible and coinsurance Routine Preventive Test Covered in full subject to deductible and coinsurance Prescription Drug - Retail Generic $5 co-pay $5 co-pay Preferred Brand $10 co-pay $10 co-pay Non- Preferred Brand $25 co-pay $25 co-pay Prescription Drug - Mail Order - monthly Generic $5 co-pay $5 co-pay Preferred Brand $10 co-pay $10 co-pay Non- Preferred Brand $25 co-pay $25 co-pay Matern lty Expenses Pre/Post Natal Office Visits Covered in full Subject to deductible and coinsurance Delivery Charges Covered in full Subject to deductible and coinsurance Newborn Hospital Bill Covered In full Subject to deductible and coinsurance Newborn Pediatrician $10 co-pay Subject to deductible and coinsurance Rehabilitation Therapies Physical Therapy $10 co-pay Subject to deductible and coinsurance Occupational Therapy $10 co-pay Deductible and co-insurance l 1 Cardiac Therapy No charge Speech Therapy $10 co-pay Subject to deductible and co- Insurance Home Health Care Covered in full Subject to deductible and coinsurance Mental Health Inpatient Mirror NH State Mandate Mirror NH State Mandate subject to deductible and coinsurance Outpatient Mirror NH State Mandate Mirror NH State Mandate subject to deductible and coinsurance Substance Abuse Inpatient Mirror NH State Mandate Mirror NH State Mandate subject to deductible and coinsurance Outpatient Mirror NH State Mandate Mirror NH State Mandate subject to deductible and coinsurance Ambulance Covered in full Subject to deductible and coinsurance Date: 8/19/2005 12 Exhibit A Board Approved Standard Health Benefit Plan Designs PPO Version PPO Proposed by the NH Reinsurance Board Plan Benefits IN Network (matches HMO) Out of Network PPO Benefits Deductible Individual None $200 Family None $600 Out of Pocket Maximums Individual None $800 Non-Network (includes deductible and coinsurance) Family None $2400 Non-Network (includes deductible and coinsurance Coinsurance None 80% Annual Maximum Benefit None $1,000,000 Lifetime Maximum None $2,000,000 Emergency Room $50 co-pay per visit Subject to deductible and coinsurance Hospital Services Subject to deductible and coinsurance Inpatient Covered in full Su bjeot to deductible and coinsurance Outpatient, other than emergency room Covered in fu 11 Subject to deductible and coinsurance Physician Office Services PCP Office Visit $ 10 copay per visit Subject to deductible and coinsurance Specialist Office Visit $10 copay per visit Subject to deductible and co• insurance 13 Preventative Care Covered In full Subject to deductible and co" insurance Physicien Hospital Visits Covered in fu 11 Subject to deductible and coinsurance Surgery and Asst. Surgeon Fees Covered In full Subject to deductible and coinsurance Laboratory and X-Ray Covered in full Subject to deductible and coinsurance Mammography Covered in full Subject to deductible and coinsurance Pap Smear Covered in full Subject to deductible and coinsurance Routine Preventive Test Covered in full subject to deductible and coinsurance Prescription Drug • Retail Generic $5 co-pay $5 co"pay Preferred Brand $10 co-pay $10 co-pay Non- Preferred Brand $25 co-pay $25 co-pay Prescription Drug • Mail Order - monthly Generic $5 co-pay $5 co-pay Preferred Brand $10 co-pay $10 co-pay Non- Preferred Brand $25 co-pay $25 co-pay Matern lty Expenses Pre/Post Natal Office Visits Covered in full Subject to deductible and coinsurance Delivery Charges Covered in full Subject to deductible and coinsurance Newborn Hospital Bill Covered in full Subject to deductible and coinsurance Newborn Pediatrician $10 co-pay Subject to deductible and co- Insurance Rehabilitation Therapies Physical Therapy $10 co-pay Subject to deductible and coinsurance 14 Occupational Therapy $10 co•pay Deductible and co-insurance Cardiac Therapy No charge Speech Therapy $10 co-pay Subject to deductible and co- Insurance Home Health Care Covered in full Subject to deductible and co• insurance Mental Health Inpatient Mirror NH State Mandate Mirror NH State Mandate subject to deductible and coinsurance Outpatient Mirror NH State Mandate Mirror NH State Mandate subject to deductible and coinsurance Substance Abuse Inpatient Mirror NH State Mandate Mirror NH State Mandate subject to deductible and coinsurance Outpatient Mirror NH State Mandate Mirror NH State Mandate subject to deductible and coinsurance Ambulance Covered in full Subject to deductible and coinsurance 15 Board Approved Standard Health Benefit Plan Designs Indemnity Version Indemnity Plan Benefits Indemnity Deductible Individual $250 Family $500 Out of Pocket Maximums Individual $650 Non-Network (includes deductible and coinsurance) Family $1700 Non-Network (includes deductible and coinsurance) Coinsurance 80% Annual Maximum Benefit $1,000,000 Lifetime Maximum $2,000,000 Emergency Room Subject to deductible and coinsurance Hospital Services Subject to deductible and coinsurance Inpatient Subject to deductible and coinsurance Outpatient, other than emergency room Subject to deductible and coinsurance Physician Office Services PCP Office Visit Subject to deductible and coinsurance Specialist Office Visit Subject to deductible and coinsurance Exhibit A 16 Preventative Care Subject to deductible a.nd coinsurance Physician Hospital Visits Subject to deductible and co- Insurance Surgery and Asst. Surgeon Fees Subject to deductible and coinsurance Laboratory and X-Ray Subject to deductible and co- Insurance Mammography Subject to deductible and coinsurance Pap Smear Subject to deductible and coinsurance Routine Preventive Te.st subject to deductible and coinsurance Prescription Drug - Retail Generic $5 co-pay Preferred Brand $10 co-pay Non• Preferred Brand $25 co-pay Prescription Drug - Mail Order - monthly Generic $5 co-pay Preferred Brand $10 co-pay Non- Preferred Brand $25 co-pay Maternity Expenses Pre/Post Natal Office Visits Subject to deductible and coinsurance Delivery Charges Subject to deductible and coinsurance Newborn Hospital Bill Subject to deductible and coinsurance Newborn Pediatrician Subject to deductible and coinsurance Rehabilitation Therapies 17 Physical Therapy Subject to deductible and co- Insurance Occupational Therapy Deductible and co-insurance Cardiac Therapy Speech Therapy Subject to deductible and coinsurance Home Health Care Subject to deductible and coinsurance Mental Health Inpatient Mirror NH State Mandate subject to deductible and coinsurance Outpatient Mirror NH State Mandate subject to deductible and coinsurance Substanc11 Abuse Inpatient Mirror NH State Mandate subject to deductible and coinsurance Outpatient Mirror NH State Mandate subject to deductible and coinsurance Ambulance Subject to deductible and coinsurance Date: 8/19/2005 l8 Benefit Type: HMO POS PPO Indemnity PMPM Base Medical & Rx Cost $350.00 $450.00 $450.00 $500.00 2 Benefit Adjustment to Statewide Average Plan (To be developed and applied by each carrier) 1.000 1.000 1.000 1.000 3 Statewide PMPM Medkal Cost (#1 x #2) $350.00 $450.00 $450.00 $500.00 4 Trend Factor (to ht Qtr. '06) (To be developed and applied by each carrier) 1.000 l.000 1.000 1.000 5 Statewide PMPM Medical Cost for 1st Qtr. '06 (#3 x #4) $350.00 $450.00 $450.00 $500.00 6 Loads (Admin, Reserve, etc.) (Assumption; Please sol,ve for a MLR of 80 %.) 0.800 0.800 0.800 0.800 7 PMPM Premium cost for '06 (#5 / #6) $437.50 $562.50 $562.50 $625.00 8 Conversion Factor 1.000 1.000 1.000 l.000 9 PSPM Premium cost for '06 (#7 x #8) $437.50 $562.50 $562.50 $625.00 Exhibit 8 The Board approved version of the Premium Worksheet NOTE: THE DOLLAR AMOUNTS SHOWN ARE FOR ILLUSTRATIVE PURPOSES ONLY Carr.ier Prerni.urn Development Survey 19 Exhibit C Summary of Per Subscriber Average Insurance Rates and Reinsurance Rates 25-Aug-05 HMO POS PPO IND I. Survey Rates # of responses 3 2 4 1 Arithmetic Mean $404,87 $466,94 $475.30 $551.74 Weighted Average $426.94 $491.24 $504.20 $551.74 II. Group Reinsurance Rates Arithmetic Mean $313.98 $366.31 $389.27 $485.81 Weighted Average $331.09 $385.38 $412.94 $485.81 11. Individual Reinsurance Rates Arithmetic Mean $1,046.59 $1,221.04 $1,297.56 $1,619.36 Weighted Average $1,103.65 $1,284.59 $1,376.47 $1,619.36 % > $5,000 51.7% 52.3% 54.6% 58.7% Group Load Individual 150% 150% 150% 150% Load 500% 500% 500% 500% 20 Exhibit D Description of Reinsurance Rate Development The reinsurance rates presented in Attachment 1 were developed as follows: Step 1: The reinsurance rates are based on the weighted average Covered Lives. To determine the percentage of those rates that relates to claims in excess of $ 5,000, Milliman used its Health Cost Guidelines. This was done as follows: a) For each of the four standard benefit plans (HMO, POS, PPO, Indemnity), Milliman computed per member per month (pmpm) medical costs using Milliman's Health Cost Guidelines, the firm's healthcare utilization and cost database and rating tool. The pmpm costs recognized the standard benefit plan designs and typical utilization rates and provider reimbursement levels. The cost was computed for an average member (i.e. demographic factor of 1.0) using Milliman's standard labor population demographics. !:l.L Then, based on the assumptions underlying the development of these pmpm costs, Milliman created a claim probability distribution for each standard benefit plan. This distribution shows the percentage of a typical population of covered lives that have benefit amounts at various levels, ranging from those persons with no claims during the year to those with very high claim amounts. Using that distribution, Milliman computed the average pmpm cost for the claims in excess of $5,000 of benefits under each standard benefit plan. The ratio of the costs in excess of $5,000 to the total pmpm cost is as follows: Plan % of Total Cost HMO 51.7% POS 52.3% PPO 54.6% Indemnity 58.7% Step 2: The starting weighted average rates developed by the NHSEHRP Board for each of the four standard benefit plans were multiplied by the percentages in step 2 and then multiplied by 150% (for group reinsurance) or 500% (for individual reinsurance) to produce the starting reinsurance rate for calendar year 2006 for each standard benefit plan. Those rates are presented below: Plan Group Reinsurance I Individual Reinsurance 21 HMO $331.09 $1,103.65 POS $385,38 $1,284.59 PPO $412.94 $1,376.47 Indemnity $485.81 $1,619.36 Step 3: Using Milllman's Health Cost Guidelines, unisex demographic rating adjustment factors were computed for five year age bands. These factors reflect the expected medical costs for the standard PPO benefit plan for claims in excess of $5,000 per reinsured life. The same factors apply to all four standard benefit plans as, based on sample calculations, the demographic slope does not vary among plans by a meaningful amount. Milliman adjusted the weighted average rates developed by the NHSEHRP Board from a rate per average subscriber to an average rate per member, so that the rates would be denominated to match the demographic factors in step 4. Milliman used demographic factors for employees based on the standard labor population in the Milliman Health Cost Guidelines. Step 5: The 2006 monthly reinsurance rate tables shown in Attachment 1 were computed using the following formula: Rate= Base reinsurance rate for standard benefit plan (step 3) / adjustment factor to convert to pmpm ( step 5) * demographic factor (step 4) Step 6: The rate tables in Attachment 1 represent the rates for coverage during calendar year 2006. Because reinsurance may become effective throughout the year, it is necessary to apply trend factors to the rates for other effective dates. Milliman computed quarterly trend factors for effective dates during each quarter of 2006. The assumed underlying basic medical cost trend rate was 12%. This is a Milliman assumption based on industry analyses of expected changes in the costs of medical costs for first dollar benefits. This trend rate was then adjusted to reflect the fact that the benefits being provided are subject to a fixed deductible of $5,000 of benefits. Since the deductible remains fixed while the cost of care increases, the trend in the 22 reinsurance claims is leveraged. The effective annual trend rate for the $5,000 deductible plan becomes 17.0%. The quarterly trend adjustments are as follows: Effective Dates Trend Factor 1q 2006 1.0000 2q 2006 1.0400 3q 2006 1.0817 4q 2006 1.1250 Step 7: Case size is one of the allowable rating characteristics that small employers can use to rate groups in New Hampshire. Because the actual case size factors that will be used are not yet known and the fact that other reinsurance pools do not adjust the reinsurance rates for case size, the case size adjustment factor has been set at 1.00 for the reinsurance rates. Step 8: Industry is also an allowable rating characteristic in New Hampshire. For the same reasons that are presented for case size, the industry adjustment factor has been set at 1.00 for the reinsurance rates. 23 Attachment 1 New Hampshire Small Employer Reinsurance Pool 2006 Monthly Reinsurance Rates Group Reinsurance HMO PO$ PPO Indemnity <25 $ 177.96 $ 207.14 $ 221.96 $ 261.12 25-29 $ 217.96 $ 253.70 $ 271.84 $ 319.81 30-34 $ 223.77 $ 260.46 $ 279.09 $ 328.33 35-39 $ 235.36 $ 273.94 $ 293.54 $ 345.34 40-44 $ 267.67 $ 311.55 $ 333.84 $ 392.74 45-49 $ 338.28 $ 393.74 $ 421.90 $ 496.35 50-54 $ 450.98 $ 524.91 $ 562.46 $ 661.71 55-59 $ 595.74 $ 693.42 $ 743.01 $ 874.12 60-64 $ 753.96 $ 877.57 $ 940.34 $1,106.27 65+ $ 907.07 $ 1,055.78 $ 1,131.29 $ 1,330.92 65+ Med. $ 317.47 $ 369.52 $ 395.95 $ 465.82 Child $ 101.13 $ 117.70 $ 126.12 $ 148.38 Individual Reinsurance HMO POS PPO Indemnity <25 $ 593.21 $ 690.47 $ 739.86 $ 870.41 25-29 $ 726.54 $ 845.65 $ 906.14 $1,066.04 30-34 $ 745.90 $ 868.19 $ 930.29 $1,094.45 35.39 $ 784.53 $ 913.15 $ 978.46 $1,151.12 40-44 $ 892.23 $ 1,038.51 $ 1,112.79 $1,309.15 45-49 $ 1,127.59 $ 1,312.45 $ 1,406.33 $1,654.49 50-54 $ 1,503.26 $ 1,749.71 $ 1,874.86 $2,205.69 55-59 $ 1,985.82 $ 2,311.38 $ 2,476.71 $2,913.74 60-64 $ 2,513.21 $ 2,925.24 $ 3,134.47 $3,687.58 65+ $ 3,023.56 $ 3,519.26 $ 3,770.98 $4,436.40 65+ Med. $ 1,058.25 $ 1,231.74 $ 1,319.84 $1,552.74 Child $ 337.08 $ 392.35 $ 420.41 $ 494.60 24