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  #31  
Old 07-01-2015, 03:25 PM
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Quote:
Originally Posted by exponentialpi View Post
Looking at the list S&P put out earlier this year, listed below, it appears a few might have adverse results. Ones to watch would be Nevada Health Co-Op and Colorado HealthOP.

The one shocker is Health Republic of NY that was not on the list. They will need to come up with over $22 million, if I did the math right, in surplus to pay for risk adjustment.
It would be $22M if they booked $0 at 12/31 for RI and RA.
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  #32  
Old 07-01-2015, 05:06 PM
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It would be $22M if they booked $0 at 12/31 for RI and RA.
True. I was looking at RA in both markets exceeds RI by 22 million. They have to get the cash from someplace.
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  #33  
Old 07-02-2015, 11:32 AM
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Anyone know if it is possible to get your hands on some of the underlying EDGE data? I'm primarily looking for members by HIOS id. Knowing how many enrollees are hitting reinsurance threshold would be nice too.
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  #34  
Old 07-02-2015, 11:39 AM
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For RA, has anyone been able to replicate the "Rating Area Transfer PMPM"? I would've figured it would be:

State Average Premium*(PLRS*IDF*GCF/Product for All Plans with Risk - AV*IDF*GCF*ARF/Product for All Plans without Risk)

It seems I'm either misunderstanding the formula or screwing something up.
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  #35  
Old 07-04-2015, 12:43 AM
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Quote:
Originally Posted by Sloop John B View Post
For RA, has anyone been able to replicate the "Rating Area Transfer PMPM"? I would've figured it would be:

State Average Premium*(PLRS*IDF*GCF/Product for All Plans with Risk - AV*IDF*GCF*ARF/Product for All Plans without Risk)

It seems I'm either misunderstanding the formula or screwing something up.
The "Product for All Plans..." factors are the composite for your own plans, not the market averages.
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  #36  
Old 07-06-2015, 01:12 AM
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Originally Posted by sixt8 berd View Post
It would be $22M if they booked $0 at 12/31 for RI and RA.
As it happens, their financials booked $0 for RA and $61M for RI as of 12/31.
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  #37  
Old 07-14-2015, 07:49 PM
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Quote:
Originally Posted by cincinnatikid View Post
The "Product for All Plans..." factors are the composite for your own plans, not the market averages.
Are you sure about this? I'm able to replicate exactly the Rating Area Transfer PMPM.

Sloop, maybe you're using your own State Average Premium instead of the market's?
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  #38  
Old 07-14-2015, 09:43 PM
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Are you sure about this? I'm able to replicate exactly the Rating Area Transfer PMPM.

Sloop, maybe you're using your own State Average Premium instead of the market's?
Yeah I was able to replicate it, forgot to report back to this thread.
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  #39  
Old 07-15-2015, 11:13 AM
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Is anyone getting inquiries on 2016 rate filings concerning the 2014 risk adjustment results?
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  #40  
Old 07-15-2015, 11:52 AM
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Quote:
Originally Posted by piginthecity View Post
Are you sure about this? I'm able to replicate exactly the Rating Area Transfer PMPM.

Sloop, maybe you're using your own State Average Premium instead of the market's?
You are correct, these are the state average denominators. I was also remiss in not updating this thread after figuring out my own errors.
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