BCN Will Now Begin Experience Rating for Groups 100+

Beginning with January 2014 renewals, Blue Care Network will now use experience rating for groups with 100 or more contracts enrolled.

Previously, BCN used community rating by class, which based premiums on the demographic profile of the geographic region or the total population covered on the policy.

Under community rating by class, the expenses of all participants are pooled together and then spread out equally across all participants.

Under BCN’s experience rating, it will now predict a group’s future medical costs based on its past experience, such as the actual cost of providing health care coverage to the group during a given period of time or the group’s claim history. Thus, the insurer calculates the group’s insurance premium based on its own, not the overall community’s experience.

Experience rating now gives groups more control over their health care spending because a portion of their rates are based on the company’s own demographics and claims experience and not on community or area pooled ratings.

An Experience Summary will be provided with all renewals showing claims experience used and associated factors for the renewal period. A Glossary and Benefit and Rate Schedule will also be provided.

Questions? Contact your managing or general agent.