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2017 Rate Review Information

Oct. 25, 2016

The Montana Commissioner of Securities and Insurance (CSI) determined that Blue Cross and Blue Shield of Montana's (BCBSMT) 2017 rates for its individual and small group plans are "unreasonable." BCBSMT respectfully disagrees with the CSI and will move forward with offering individual and small group plans in every county in Montana for the following reasons:

  1. Premiums must cover the medical and pharmacy costs of our members, the cost of doing business, and contributions to reserves. Reserves allow BCBSMT to protect against the risk of its members' costs being higher than expected. In 2014 and 2015, BCBSMT's individual and small group premiums did not cover all of these costs. In fact, the losses in 2014 and 2015 exceeded $90 million. Further, BCBSMT's year-to-date data indicate that 2016 premiums will not cover all of these costs. Medical and drug costs are becoming more expensive, and our members are utilizing more care. BCBSMT expects that these trends will continue in 2017.
  2. After the CSI issued its initial Notice of Deficiency in August, BCBSMT twice hired an independent actuarial firm to analyze its individual and small group rate filings. The actuarial firm twice reported that BCBSMT individual and small group rates for 2017 are reasonable and justified. BCBSMT shared the independent opinion with the CSI. After reviewing the opinion, the CSI maintained its position that BCBSMT's rates are unreasonable, but the CSI did not identify any errors with the BCBSMT filing. Instead, the CSI only disagreed with the actuarial assumptions used by BCBSMT.
  3. BCBSMT compared its 2017 plans and rates to the plans and rates that other issuers will offer in Montana when this information became public in September. In some cases, BCBSMT's rates are the most affordable options available to consumers. BCBSMT believes that, overall, its rates are competitive with other issuers' rates.

BCBSMT has been committed to serving Montanans for the past 75 years. BCBSMT does not take these rate increases lightly. BCBSMT works every day to increase access to care, improve health outcomes, and control costs for Montanans. In addition, BCBSMT has communicated with state and federal government leaders about the public policy changes that are necessary to improve affordability in the individual and small group markets.


BCBSMT Letter dated September 9, 2016

BCBSMT Letter Dated September 22, 2016

BCBSMT Letter dated October 7, 2016

Final Determination Notices

Market Level Calculations

Consumer Narrative

Actuarial Memorandum