Illinois Rate and Plan Analysis

2016 Analysis of Illinois Exchange Rates
Highlights of the 2016 Get Covered Illinois Marketplace

Majority of Areas Show Increase in Choices over 2015
Number of plans increase to 480 choices in 2016 from 410 in 2015*
- 290 Individual plans and 190 Small Group plans
Three new issuers on the Individual Marketplace for a total of 10
- Aetna, Celtic, Harkin
Counties with a decrease in the number of issuers include:
- Adams, Logan, Mason, Menard, Morgan, Pike and Sangamon
Number of issuers in down-state counties did not change
Information shown does not include Grandfathered or Transitional
policies
All platinum plans in the Individual market were terminated
* Includes Multi-State Plans
OLIVER WYMAN
November 3, 2015
Highlights of the 2016 Get Covered Illinois Marketplace

Overall Average Increase in Lowest Cost Plans
Lowest silver plan average increase is 5.3%
Lowest bronze plan average increase is 11.3%
Rate Changes Vary

Rate changes in lowest silver range from -8% to 28%
Rate changes in lowest bronze range from -4% to 39%
Rate changes in lowest gold range from 3% to 34%
Competition Generates Lower Rate Increases

Rate increases in the lowest plan tend to be lower when there is a new
issuer in that spot, or where an existing carrier has expanded their
service area
OLIVER WYMAN
November 3, 2015
Issuers on Get Covered Illinois in 2016

Individual Marketplace
Aetna Health Inc.*

Celtic Insurance Company**
Coventry Health Care of Illinois, Inc.
Coventry Health & Life Insurance Company
Health Alliance Medical Plans, Inc. (HAMP)
Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC, aka Blue
Cross Blue Shield)
Humana Health Plan, Inc.
Midwest Security Life Insurance Company** (United subsidiary)
Land of Lincoln Mutual Health Insurance Company
UnitedHealthCare of the Midwest, Inc.
* Aetna Life Insurance Company was on the Exchange in 2014 but dropped off in 2015. Aetna Health Inc. (a separate legal entity) is on
the Exchange in 2016.
**New to Exchange in 2016
OLIVER WYMAN
November 3, 2015
Issuers on Get Covered Illinois in 2016

Small Group Marketplace (SHOP)
Health Alliance Medical Plan, Inc. (HAMP)
Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC, aka Blue
Cross Blue Shield)
OLIVER WYMAN
November 3, 2015
Health Plan Rating Areas 13 distinct areas

Rating areas influence the plan
options available and the premium
levels
Rating areas remain unchanged
from 2015
Rating Areas
1
2
3
4
5
6
7
8
9
10
11
12
13
OLIVER WYMAN
November 3, 2015
PLAN ANALYSIS
OLIVER WYMAN
November 3, 2015
2016 Summary of Plan Information

480 plan offerings in Illinois
Residents in all counties have a minimum of 37 plans to
choose from, down from 56 in 2015 in the Individual
Marketplace
All counties have gold, silver, bronze and catastrophic plans
available in the Individual Marketplace
Platinum is no longer offered in the Individual Marketplace (21
plans in 2015, 25 plans in 2014)
OLIVER WYMAN
November 3, 2015
Number of Issuers Offering Coverage by County

(Individual and Small Group issuers combined)
Aetna, Celtic, Harken are new entrants in the

Chicagoland area
Harken is a United subsidiaries
Illinicare offered plans in Cook county in 2015
which is owned by the same parent company
as Celtic
HCSC, Land of Lincoln and Coventry cover the
entire state
Number
of
Coventry does this through 2 legal
Issuers
entities
4
Expansion in Bloomington area
(Rating Area 8) of the Humana Health
Plan (the HMO offering)
5
6
8
Down-state remains the same with fewest issuers

offering plans
OLIVER WYMAN
November 3, 2015
Individual Market Number Plans Offered by County

More plans are offered closer to larger cities
Larger cities tend to have closed provider
network plans, in addition to a broad provider
network type of offering
Plan
Count
30-39
40-49
50-59
60-69
70-99
OLIVER WYMAN
November 3, 2015
Individual Market Change in Number of Plans from 2015

Large decrease of plans offered in Cook County
IlliniCare withdrew multiple plans that offered
the same medical benefit packages with the
only difference in coverage being the options
to have adult dental and/or adult vision. This
accounts for a reduction of 44 plans.
HCSC no longer offers its broadest
statewide PPO, which results in fewer
options in more rural areas
OLIVER WYMAN
November 3, 2015
Change
in Plan
Count
-80 to -30
-29 to -10
-9 to 0
1 to 10
10
Small Group Market Number of plans by county

HAMP, HCSC and Land of Lincoln are the only
issuers in the SHOP
Number of available products is fairly constant
throughout the state
Plan
Count
30-39
40-49
50-59
60-69
OLIVER WYMAN
November 3, 2015
11
Small Group Market Change in number of Plans from 2015

Most areas saw a modest decrease in number
of plans available
Change
in Plan
Count
-30 to -10
-9 to 0
1 to 10
11 to 20
21 to 30
OLIVER WYMAN
November 3, 2015
12
Individual Plans Offered by County: Metal Level

County
Rating Area
Gold
Silver
Bronze
Catastrophic
Adams
10
10
13
12
Alexander
13
10
13
12
Bond
11
10
13
12
Boone
13
16
17
Rating Areas
Brown
10
11
14
14
Bureau
13
18
14
Calhoun
11
10
13
12
Carroll
11
14
14
Cass
10
11
14
14
Champaign
10
15
12
Christian
10
11
14
14
Clark
10
15
12
Clay
13
10
13
12
Clinton
11
10
13
12
12
Coles
10
15
12
13
Cook
21
31
19
Crawford
13
10
13
12
Cumberland
10
15
12
Dekalb
12
15
15
Dewitt
12
15
15
OLIVER WYMAN
November 3, 2015
2
3
4
9
10
11
13

County
Rating Area
Gold
Silver
Bronze
Catastrophic
Douglas
10
15
12
Dupage
15
19
14
Edgar
10
15
12
Edwards
13
10
13
12
Rating Areas
Effingham
13
10
13
12
Fayette
13
10
13
12
Ford
10
15
12
Franklin
13
10
13
12
Fulton
16
21
19
Gallatin
13
10
13
12
Greene
11
10
13
12
Grundy
14
21
15
Hamilton
13
10
13
12
Hancock
13
18
14
12
Hardin
13
10
13
12
13
Henderson
13
18
14
Henry
14
19
16
Iroquois
10
15
12
Jackson
13
10
13
12
Jasper
13
10
13
12
OLIVER WYMAN
November 3, 2015
2
3
4
9
10
11
14

County
Rating Area
Gold
Silver
Bronze
Catastrophic
Jefferson
13
10
13
12
Jersey
11
10
13
12
Jo Daviess
11
14
14
Johnson
13
10
13
12
Rating Areas
Kane
15
19
14
Kankakee
15
23
15
Kendall
14
21
15
Knox
15
20
17
La Salle
15
20
17
Lake
14
19
16
Lawrence
13
10
13
12
Lee
11
14
14
Livingston
12
15
15
Logan
10
10
13
12
12
Macon
10
12
15
16
13
Macoupin
11
10
13
12
Madison
12
11
15
16
Marion
13
10
13
12
Marshall
16
21
18
Mason
10
11
14
14
OLIVER WYMAN
November 3, 2015
2
3
4
9
10
11
15

County
Rating Area
Gold
Silver
Bronze
Catastrophic
Massac
13
10
13
12
Mcdonough
15
20
17
McHenry
12
16
14
Mclean
13
16
15
Rating Areas
Menard
10
10
13
12
Mercer
14
19
16
Monroe
12
11
15
16
Montgomery
11
10
13
12
Morgan
10
10
13
12
Moultrie
10
11
14
14
Ogle
12
15
15
Peoria
17
22
20
Perry
13
10
13
12
10
Piatt
10
15
12
11
Pike
10
10
13
12
Pope
13
10
13
12
Pulaski
13
10
13
12
Putnam
15
20
17
Randolph
11
10
13
12
Richland
13
10
13
12
Rock Island
14
19
16
OLIVER WYMAN
November 3, 2015
4
5
6
7
12
13
16

County
Rating Area
Gold
Silver
Bronze
Catastrophic
Saint Clair
12
11
15
16
Saline
13
10
13
12
Sangamon
10
12
15
16
Schuyler
10
11
14
14
Rating Areas
Scott
10
11
14
14
Shelby
10
12
15
16
Stark
16
21
18
Stephenson
11
14
14
Tazewell
17
22
20
Union
13
10
13
12
Vermilion
10
15
12
Wabash
13
10
13
12
Warren
13
18
14
10
Washington
11
10
13
12
11
Wayne
13
10
13
12
White
13
10
13
12
Whiteside
14
19
16
Will
18
25
17
Williamson
13
10
13
12
Winnebago
13
16
17
Woodford
16
21
18
OLIVER WYMAN
November 3, 2015
4
5
6
12
13
17
Small Group Plans Offered by County: Metal Level

County
Rating Area
Platinum
Gold
Silver
Bronze
Adams
10
13
15
11
Alexander
13
13
15
11
Bond
11
14
16
12
Boone
15
17
13
Rating Areas
Brown
10
13
15
11
Bureau
14
16
12
Calhoun
11
14
16
12
Carroll
14
16
12
Cass
10
13
15
11
Champaign
13
15
11
Christian
10
13
15
11
Clark
13
15
11
Clay
13
13
15
11
Clinton
11
14
16
12
12
Coles
13
15
11
13
Cook
18
20
11
Crawford
13
13
15
11
Cumberland
13
15
11
Dekalb
15
17
13
Dewitt
14
16
12
OLIVER WYMAN
November 3, 2015
2
3
4
5
9
10
11
18

County
Rating Area
Platinum
Gold
Silver
Bronze
Douglas
13
15
11
Dupage
16
17
10
Edgar
13
15
11
Edwards
13
13
15
11
Rating Areas
Effingham
13
13
15
11
Fayette
13
13
15
11
Ford
13
15
11
Franklin
13
13
15
11
Fulton
15
18
13
Gallatin
13
13
15
11
Greene
11
14
16
12
Grundy
15
17
13
Hamilton
13
13
15
11
Hancock
14
16
12
12
Hardin
13
13
15
11
13
Henderson
14
16
12
Henry
14
16
12
Iroquois
13
15
11
Jackson
13
13
15
11
Jasper
13
13
15
11
OLIVER WYMAN
November 3, 2015
2
3
4
5
9
10
11
19

County
Rating Area
Platinum
Gold
Silver
Bronze
Jefferson
13
13
15
11
Jersey
11
14
16
12
Jo Daviess
14
16
12
Johnson
13
13
15
11
Rating Areas
Kane
16
17
10
Kankakee
16
19
13
Kendall
15
17
13
Knox
15
18
13
La Salle
15
18
13
Lake
15
16
10
Lawrence
13
13
15
11
Lee
14
16
12
Livingston
14
16
12
Logan
10
13
15
11
12
Macon
10
13
15
11
13
Macoupin
11
14
16
12
Madison
12
14
16
12
Marion
13
13
15
11
Marshall
16
19
14
Mason
10
13
15
11
OLIVER WYMAN
November 3, 2015
2
3
4
5
9
10
11
20

County
Rating Area
Platinum
Gold
Silver
Bronze
Massac
13
13
15
11
Mcdonough
15
18
13
McHenry
13
13
Mclean
15
17
12
Rating Areas
Menard
10
13
15
11
Mercer
14
16
12
Monroe
12
14
16
12
Montgomery
11
14
16
12
Morgan
10
13
15
11
Moultrie
10
13
15
11
Ogle
15
17
13
Peoria
16
19
14
Perry
13
13
15
11
10
Piatt
13
15
11
11
Pike
10
13
15
11
12
Pope
13
13
15
11
13
Pulaski
13
13
15
11
Putnam
15
18
13
Randolph
11
14
16
12
Richland
13
13
15
11
Rock Island
14
16
12
OLIVER WYMAN
November 3, 2015
5
6
7
8
21

County
Rating Area
Platinum
Gold
Silver
Bronze
Saint Clair
12
14
16
12
Saline
13
13
15
11
Sangamon
10
13
15
11
Schuyler
10
13
15
11
Rating Areas
Scott
10
13
15
11
Shelby
10
13
15
11
Stark
16
19
14
Stephenson
14
16
12
Tazewell
16
19
14
Union
13
13
15
11
Vermilion
13
15
11
Wabash
13
13
15
11
Warren
14
16
12
10
Washington
11
14
16
12
11
Wayne
13
13
15
11
12
White
13
13
15
11
13
Whiteside
14
16
12
Will
19
21
15
Williamson
13
13
15
11
Winnebago
15
17
13
Woodford
16
19
14
OLIVER WYMAN
November 3, 2015
5
6
7
8
22
RATE INFORMATION
OLIVER WYMAN
November 3, 2015
23
Individual Market Rate Change of Lowest Silver

Rate changes in the majority of counties are in
the 5% to 10% range
However, a wide range in rate changes
Rating Area 1 (Cook county) has an 8%
decrease (entrance of new issuer Celtic)
Rating Area 5 has 28% increase
Number of Issuers offering the lowest cost
silver continues to increase (see next slide)
Issuers finding niche areas
2014 state dominated by HCSC
RateChange
10%to5%
2015 4 issuers offered lowest cost
5%to10%
10%to15%
silver plans
15%to20%
20%to25%
2016 6 issuers offering lowest cost
25%to30%
silver plans
OLIVER WYMAN
November 3, 2015
24
Individual Market Change in Lowest Cost Silver Issuer

JoDaviess
Boone
2015 Lowest Cost Silver Issuer

Stephenson Winnebago
Rockford
Carroll
2016 Lowest Cost Silver Issuer
Lake
McHenry
Ogle
Kane
DeKalb
Chicago
DuPage Cook
Lee
Whiteside
Kendall
Will
RockIsland
Bureau
Henry
LaSalle
Grundy
Mercer
Putnam
Henderson
Stark
Kankakee
Marshall
Knox
Livingston
Warren
Peoria
Hancock McDonough
Woodford
Bloomington
Tazewell
Fulton
Mason
DeWitt
Logan
Champaign
Vermilion
Piatt
Menard
Cass
Brown
Ford
McLean
Schuyler
Adams
Iroquois
Springfield Macon
Pike
Scott
Douglas
Sangamon
Springfield
Morgan
Edgar
Moultrie
Christian
Coles
Shelby
Cumberland
Macoupin Montgomery
Calhoun
Jersey
Effingham
Fayette
Jasper
Crawford
Bond
Madison
Clay
RichlandLawrence
Marion
St.Clair
Wayne
Washington
Monroe
Randolph
Edwards
Clinton
Jefferson
Perry
Hamilton
White
Franklin
Gallatin
Williamson Saline
Jackson
Alexander
Union
OLIVER WYMAN
Clark
Wabash
Greene
Issuer
HAMP
Land of Lincoln
HCSC
Coventry
United
Celtic
Johnson Pope
Pulaski
Hardin
Massac
November 3, 2015
25
The Average Rate Increase Across All Rating Areas in Lowest

Silver Plans is 5.3%
Rating Area
2015 Issuer
Rating Area 1
Land of Lincoln
Rating Area 2
HCSC
Rating Area 3
HCSC
Rating Area 4
HCSC
Rating Area 5
HCSC
Rating Area 6
HCSC
Rating Area 7
Coventry Health Care
Rating Area 8
Health Alliance Medical Plans, Inc.
Rating Area 9
Rating Area 10
Rating Area 11
Land of Lincoln
Rating Area 12
Coventry Health & Life
Rating Area 13
Land of Lincoln
Weighted Average Increase
2015 21 Year-Old
Non-Tobacco Rate
$166.17
$179.84
$170.00
$169.58
$192.48
$163.35
$176.74
$202.92
$202.92
$203.71
$198.93
$185.29
$226.66
2016 Issuer
Celtic
HCSC
HCSC
Land of Lincoln
United
HCSC
Land of Lincoln
Land of Lincoln
2016 21 Year-Old
Non-Tobacco Rate
2016 Rate
Increase
$152.42
$212.23
$205.30
$198.90
$246.54
$205.94
$200.96
$233.84
$219.95
$228.23
$228.79
$198.03
$245.55
8%
18%
21%
17%
28%
26%
14%
15%
8%
12%
15%
7%
8%
5.3%
Notes:
1. Lowest across the rating area. May not be available in all counties in the rating area.
2. Weights used for average increase calculation are based on ASPE enrollment report http://aspe.hhs.gov/basic-report/2015-plan-selections-zip-code-health-insurance-marketplace
OLIVER WYMAN
November 3, 2015
26
Individual Market Rate Change of Second Lowest Silver

Rate changes in the majority of counties are in
the 15% to 20% range
Number of Issuers at the Second Lowest
Silver increased from 2015 to 2016 (see next
slide)
HCSC has smaller number of counties
where they are the second lowest silver
(Rating Area 8)
Aetna, Celtic and United Healthcare are
new to being the second lowest silver
Rate
Change
10%to5%
5%to10%
10%to15%
15%to20%
OLIVER WYMAN
November 3, 2015
27
Individual Market Change in Second Lowest Cost Silver

Issuer nd
nd
Lowest Cost Silver Issuer
JoDaviess
Boone
2015 2
Rockford
Carroll
2016 2
Lowest Cost Silver Issuer
Lake
McHenry
Ogle
Kane
DeKalb
Chicago
DuPage Cook
Lee
Whiteside
Kendall
Will
RockIsland
Bureau
Henry
LaSalle
Grundy
Mercer
Putnam
Henderson
Stark
Kankakee
Marshall
Knox
Livingston
Warren
Peoria
Hancock McDonough
Woodford
Bloomington
Tazewell
Fulton
Mason
DeWitt
Logan
Champaign
Vermilion
Piatt
Menard
Cass
Brown
Ford
McLean
Schuyler
Adams
Iroquois
Springfield Macon
Pike
Scott
Douglas
Sangamon
Springfield
Morgan
Edgar
Moultrie
Christian
Coles
Shelby
Cumberland
Macoupin Montgomery
Calhoun
Jersey
Effingham
Fayette
Jasper
Crawford
Bond
Madison
Clay
RichlandLawrence
Marion
St.Clair
Wayne
Washington
Monroe
Randolph
Edwards
Clinton
Jefferson
Perry
Hamilton
White
Franklin
Gallatin
Williamson Saline
Jackson
Alexander
Union
OLIVER WYMAN
Clark
Wabash
Greene
Issuer
HAMP
Land of Lincoln
HCSC
Coventry
United
Celtic
Aetna
Johnson Pope
Pulaski
Hardin
Massac
November 3, 2015
28
Individual Market Rate Change of Lowest Bronze

Rate changes in the majority of counties are in the
15% to 20% range
Similar to the silver plans, there are more issuers
at the lowest bronze level (see next slide)
2014 lowest bronze dominated by HCSC and
Coventry
2015 there are 4 issuers, with HAMP
dominating the most counties
2016 there are 8 issuers, with HCSC and
HAMP having the most counties
RateChange
5%to0%
- Celtic is lowest in Cook
5%to10%
10%to15%
- Land of Lincoln only lowest in one
15%to20%
20%to25%
county (Lake)
25%to30%
30%to35%
35%to40%
OLIVER WYMAN
November 3, 2015
29
Individual Market Change in Lowest Cost Bronze Issuer

2016 Lowest Cost Bronze Issuer
JoDaviess
Boone
2015 Lowest Cost Bronze Issuer

Rockford
Carroll
Lake
McHenry
Ogle
Kane
DeKalb
Chicago
DuPage Cook
Lee
Whiteside
Kendall
Will
RockIsland
Bureau
Henry
LaSalle
Grundy
Mercer
Putnam
Henderson
Stark
Kankakee
Marshall
Knox
Peoria
Hancock McDonough
Woodford
Mason
HCSC
DeWitt
Logan
Champaign
Vermilion
Coventry
Piatt
Menard
United
Springfield Macon
Pike
Scott
Douglas
Sangamon
Springfield
Morgan
Edgar
Moultrie
Christian
Coles
Shelby
Cumberland
Macoupin Montgomery
Calhoun
Jersey
Effingham
Fayette
Jasper
Humana HP
Aetna
Crawford
Bond
Madison
Clay
RichlandLawrence
Marion
St.Clair
Wayne
Washington
Monroe
Randolph
Edwards
Clinton
Jefferson
Perry
Hamilton
White
Franklin
Gallatin
Williamson Saline
Jackson
Alexander
Union
OLIVER WYMAN
Clark
Celtic
Wabash
Greene
HAMP
Land of Lincoln
Ford
McLean
Cass
Brown
Iroquois
Bloomington
Tazewell
Fulton
Schuyler
Adams
Issuer
Livingston
Warren
Johnson Pope
Pulaski
Hardin
Massac
November 3, 2015
30
An 11.3% Average Rate Increase Across All Rating Areas in

Lowest Bronze Plans
Rating Area
2015 Issuer
Rating Area 1
HCSC
Rating Area 2
HCSC
Rating Area 3
HCSC
Rating Area 4
HCSC
Rating Area 5
HCSC
Rating Area 6
HCSC
Rating Area 7
Rating Area 8
Rating Area 9
Rating Area 10
Rating Area 11
Land of Lincoln
Rating Area 12
Rating Area 13
Weighted Average Increase
2015 21 Year-Old
Non-Tobacco Rate
$132.82
$141.77
$134.01
$133.68
$152.45
$128.77
$137.61
$159.28
$159.28
$158.60
$161.18
$144.27
$179.82
2016 Issuer
Celtic
Land of Lincoln
HCSC
HCSC
United
HCSC
HCSC
2016 21 Year-Old
Non-Tobacco Rate
2016 Rate
Increase
$128.03
$164.77
$176.97
$177.65
$195.38
$179.57
$159.25
$189.87
$189.87
$175.90
$202.51
$155.40
$214.37
4%
16%
32%
33%
28%
39%
16%
19%
19%
11%
26%
8%
19%
11.3%
Notes:
1. Lowest across the rating area. May not be available in all counties in the rating area.
2. Weights used for average increase calculation are based on ASPE enrollment report http://aspe.hhs.gov/basic-report/2015-plan-selections-zip-code-health-insurance-marketplace
OLIVER WYMAN
November 3, 2015
31
Individual Market Rate Change of Lowest Gold

Majority of counties were in the 15% to 20% range
Similar to others, there are more carriers at the
lowest gold level (see next slide)
2014 state dominated by HCSC and Coventry
2015 state dominated by Land of Lincoln
2016 more evenly distributed between the
issuers
Number of carriers increased from 3 in 2014 and
2015 to 6 in 2016
RateChange
0%to5%
5%to10%
10%to15%
15%to20%
20%to25%
25%to30%
30%to35%
OLIVER WYMAN
November 3, 2015
32
Individual Market Change in Lowest Cost Gold Issuers

JoDaviess
Rockford
Carroll
Boone
2015 Lowest Cost Gold Issuers
2016 Lowest Cost Gold Issuers
Lake
McHenry
Ogle
Kane
DeKalb
Whiteside
Chicago
DuPage Cook
Lee
Kendall
RockIsland
Will
Bureau
Henry
LaSalle
Grundy
Mercer
Putnam
Henderson
Stark
Kankakee
Marshall
Knox
Livingston
Warren
Peoria
Hancock McDonough
Woodford
Bloomington
Tazewell
Fulton
Mason
DeWitt
Logan
Champaign
Vermilion
Piatt
Menard
Cass
Brown
Ford
McLean
Schuyler
Adams
Iroquois
Springfield Macon
Pike
Scott
Douglas
Sangamon
Springfield
Morgan
Edgar
Christian
Moultrie
Coles
Shelby
Cumberland
Macoupin Montgomery
Calhoun
Jersey
Effingham
Fayette
Jasper
Clay
RichlandLawrence
Marion
St.Clair
Wayne
Washington
Randolph
Edwards
Clinton
Jefferson
Perry
Hamilton
White
Franklin
Gallatin
Williamson Saline
Jackson
Al exa nder
Union
OLIVER WYMAN
Crawford
Bond
Madison
Monroe
Clark
Wabash
Greene
Issuer
HAMP
Land of Lincoln
HCSC
Coventry
United
Celtic
Johnson Pope
Hardin
Pulaski Massac
November 3, 2015
33
SUBSIDY INFORMATION
OLIVER WYMAN
November 3, 2015
34
Background Information on Subsidies

Advanced premium tax subsidies (subsidies) are available to residents of
Illinois, who are eligible and enroll in a qualified health plan through the
GetCovered Illinois Marketplace
Subsidies are calculated using the second lowest silver plan available to
that member and vary by a members income status and family status.
-
Members can apply their subsidies to the other QHP plans, but typically
the lowest cost silver plan or bronze level plans in order to reduce the
premium required.
Examples of the calculations are shown in later slides.
OLIVER WYMAN
November 3, 2015
35
Summary of Subsidy Information in Illinois

Net premiums for the lowest cost silver or bronze plans can vary significantly by
geography because of the rate differential in the plans and the competition of
carriers
For example: Using the information for a single 30 year old male earning
$23,000 (see next slide for more details):
- The rate differential in 2016 between the lowest and 2nd lowest plans in
Chicago has been very low ($173 and $175) as such the net premiums to the
consumers are within $2 of each other ($117 and $119)
- On the other hand, the rate differential between the lowest and 2nd lowest
plans in Peoria is greater ($255 and $228) the result is that the net cost for
the lowest silver plan is under $100 ($92) while the 2nd lowest is greater ($119)
Net premiums can vary significantly from year to year due to competition of carriers
and variance from the 2nd lowest silver.
For example (see next slide): The net premiums for lowest bronze plan in Peoria
changed from $44 per month in 2014 to $68 in 2015 back down to $44 in 2016
OLIVER WYMAN
November 3, 2015
36
Subsidies and tax credits may lower costs further for many individuals and families:
Example 1: Single 30-year old, with household income of $23,000
Based on household income, the individual may qualify for premium subsidies to limit net cost for a 2nd
lowest cost silver plan to ~$119 per month
2016
In Chicago
2nd Lowest Cost Silver Plan
Lowest Cost Silver Plan
Lowest Cost Bronze Plan
Premium
$175
$173
$145
2015
$56
$56
$56
$119
$117
$89
$191
$189
$151
2016
In Peoria
Premium
$255
$228
$181
2014
Subsidy Net Cost Premium Subsidy Net Cost Premium Subsidy Net Cost
$72
$72
$72
$119
$116
$79
$188
$187
$136
2015
$67
$67
$67
$121
$120
$69
2014
$136
$136
$136
$119
$92
$44
$207
$201
$156
$88
$88
$88
$119
$113
$68
$222
$191
$144
$101
$101
$101
$121
$91
$44
Individuals and families with income between 138 percent and 400 percent of the federal poverty level may
receive subsidies on a sliding scale if they obtain coverage through the marketplace
1: Values may appear to not tie exactly due to rounding
OLIVER WYMAN
Example 2: A couple, both aged 55, with household income of $40,000
2016
In Chicago
Premium
$689
$680
$571
2015
$415
$415
$415
$274
$265
$156
$752
$741
$592
2016
In Peoria
Premium
$1,004
$896
$710
2014
$477
$477
$477
$275
$265
$116
$739
$734
$533
2015
$463
$463
$463
$276
$271
$70
2014
$730
$730
$710
$274
$166
$0
$813
$788
$614
$538
$538
$538
$275
$250
$76
$871
$752
$568
$595
$595
$568
$276
$157
$0
OLIVER WYMAN
Example 3: Family of 4, parents aged 40 with 2 children, with household income of $60,000
2016
In Chicago
Premium
$591
$583
$490
2015
$186
$186
$186
$405
$397
$304
$645
$636
$508
2016
In Peoria
Premium
$861
$769
$609
2014
$237
$237
$237
$408
$399
$271
$634
$629
$457
2015
$224
$224
$224
$410
$406
$234
2014
$456
$456
$456
$405
$313
$153
$698
$676
$526
$290
$290
$290
$408
$387
$237
$747
$645
$487
$337
$337
$337
$410
$308
$150
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COVERAGE BY ISSUER
OLIVER WYMAN
November 3, 2015
40
Coventry
Unchanged Service Area from 2015
Rockford
Carroll
Coventry Health Care of Illinois, Inc.

JoDaviess
Lake
McHenry
Rockford
Carroll
Ogle
DeKalb
Kane
Kane
DeKalb
DuPage Cook
DuPage Cook
Lee
Kendall
Kendall
Will
Will
RockIsland
Bureau
Henry
LaSalle
Grundy
Grundy
Mercer
Putnam
Henderson
Stark
Knox
Livingston
Livingston
Peoria
Woodford
Iroquois
Iroquois
Bloomington
Tazewell
Fulton
Ford
Ford
McLean
McLean
Mason
Schuyler
DeWitt
Logan
Champaign
Mason
Vermilion
DeWitt
Logan
Piatt
Menard
Cass
Brown
Kankakee
Kankakee
Marshall
Warren
Hancock McDonough
Adams
Adams
Brown
Scott
Vermilion
Macon
Douglas
Sangamon
Springfield
Morgan
Douglas
Springfield
Morgan
Edgar
Moultrie
Christian
Champaign
Piatt
Menard
Cass
Springfield Macon
Pike
Lake
McHenry
Ogle
Chicago
Lee
Whiteside
Boone
JoDaviess
Boone
Coventry Health & Life Insurance Company
Edgar
Moultrie
Christian
Coles
Coles
Shelby
Effingham
Fayette
Greene
Jasper
St.Clair
Wayne
Washington
Monroe
Edwards
Clinton
Jefferson
Perry
Hamilton
Clay
Clinton
St.Clair
Randolph
Gallatin
Williamson Saline
Jefferson
Perry
Hamilton
Johnson Pope
Pulaski
Massac
Gallatin
Williamson Saline
Jackson
Hardin
Union
PPOIndividual
NoCoverage
November 3, 2015
White
Franklin
Alexander
Alexander
Union
Wayne
Washington
Monroe
White
Crawford
RichlandLawrence
Marion
Franklin
Jackson
Jasper
Clark
Bond
Richland Lawrence
Marion
Randolph
Effingham
Fayette
Crawford
Madison
Clay
Cumberland
Macoupin Montgomery
Calhoun
Jersey
Bond
Madison
OLIVER WYMAN
Clark
Wabash
Calhoun
Jersey
Edwards
Cumberland
Macoupin Montgomery
Wabash
Greene
Johnson Pope
Pulaski
Hardin
Massac
41
JoDaviess
Boone
2015 Service Area

Rockford
Carroll
2016 Service Area

Lake
McHenry
Ogle
Kane
DeKalb
Chicago
DuPage Cook
Lee
Whiteside
Kendall
Will
RockIsland
Bureau
Henry
LaSalle
Grundy
Mercer
Putnam
Henderson
Stark
Kankakee
Marshall
Knox
Livingston
Warren
Peoria
Hancock McDonough
Woodford
Bloomington
Tazewell
Fulton
Mason
DeWitt
Logan
Champaign
Vermilion
Piatt
Menard
Cass
Brown
Ford
McLean
Schuyler
Adams
Iroquois
Springfield Macon
Pike
Scott
Douglas
Sangamon
Springfield
Morgan
Edgar
Moultrie
Christian
Coles
Shelby
Cumberland
Macoupin Montgomery
Calhoun
Jersey
Effingham
Fayette
Jasper
Crawford
Bond
Madison
Clay
RichlandLawrence
Marion
St.Clair
Wayne
Washington
Monroe
Randolph
Edwards
Clinton
Jefferson
Perry
Hamilton
White
Franklin
Gallatin
Williamson Saline
Jackson
Alexander
Union
OLIVER WYMAN
Clark
Wabash
Greene
Johnson Pope
Pulaski
Massac
Hardin
HMO/POS/PPO
NoCoverage
November 3, 2015
42
Health Care Services Corporation, a Mutual Legal Reserve Company

HCSC has made significant changes to their network
Removed Broad PPO from Individual market
Broad PPO remains in Small Group market
Additional HMO is added, partner product with Advocate Health
Service area of existing HMO is expanded
OLIVER WYMAN
November 3, 2015
43

Individual
JoDaviess
Boone
2015 Service Area

Rockford
Carroll
2016 Service Area

Lake
McHenry
Ogle
DeKalb
Kane
Chicago
DuPage Cook
Lee
Whiteside
Kendall
Will
RockIsland
Bureau
Henry
LaSalle
Grundy
Mercer
Putnam
Henderson
Stark
Kankakee
Marshall
Knox
Livingston
Warren
Peoria
Mason
DeWitt
Logan
Champaign
Vermilion
Piatt
Menard
Cass
Brown
Ford
McLean
Schuyler
Adams
Iroquois
Bloomington
Tazewell
Fulton
Hancock McDonough
Woodford
Springfield Macon
Pike
Scott
Douglas
Sangamon
Springfield
Morgan
Edgar
Moultrie
Christian
Coles
Shelby
Cumberland
Macoupin Montgomery
Calhoun
Jersey
Effingham
Fayette
Jasper
Clay
Richland Lawrence
Marion
St.Clair
Wayne
Washington
Monroe
Jefferson
Perry
Hamilton
White
Franklin
Gallatin
Williamson Saline
Jackson
Union
Alexander
Randolph
Edwards
Clinton
OLIVER WYMAN
Crawford
Bond
Madison
HMO
NarrowPPO
HMOandNarrowPPO
StatewidePPOCoverageOnly
Clark
Wabash
Greene
Johnson Pope
Pulaski
Massac
Hardin
PrecisionHMO
Precision&BlueCareDirectHMO
NarrowPPOOnly
November 3, 2015
44

Small Group
JoDaviess
Boone
2015 Service Area

Rockford
Carroll
2016 Service Area

Lake
McHenry
Ogle
DeKalb
Kane
Chicago
DuPage Cook
Lee
Whiteside
Kendall
Will
RockIsland
Bureau
Henry
LaSalle
Grundy
Mercer
Putnam
Henderson
Stark
Kankakee
Marshall
Knox
Livingston
Warren
Peoria
Mason
DeWitt
Logan
Champaign
Vermilion
Piatt
Menard
Cass
Brown
Ford
McLean
Schuyler
Adams
Iroquois
Bloomington
Tazewell
Fulton
Hancock McDonough
Woodford
Springfield Macon
Pike
Scott
Douglas
Sangamon
Springfield
Morgan
Edgar
Moultrie
Christian
Coles
Shelby
Cumberland
Macoupin Montgomery
Calhoun
Jersey
Effingham
Fayette
Jasper
Clay
Richland Lawrence
Marion
St.Clair
Wayne
Washington
Monroe
Jefferson
Perry
Hamilton
White
Franklin
Gallatin
Williamson Saline
Jackson
Union
Alexander
Randolph
Edwards
Clinton
OLIVER WYMAN
Crawford
Bond
Madison
HMO
NarrowPPO
HMOandNarrowPPO
StatewidePPOCoverageOnly
Clark
Wabash
Greene
Johnson Pope
Pulaski
Massac
Hardin
PrecisionHMO
Precision&BlueCareDirectHMO
StatewidePPOsOnly
November 3, 2015
45
Humana Health Plan, Inc.

Expanded Service Area in 2016
2015 Service Area
2016 Service Area
HMOIndividual
NoCoverage
OLIVER WYMAN
November 3, 2015
46

Additional Narrow Network Options in 2016
Narrow network or branded product options added in 2016
Lowest silver plans
- Competitive in Rating Area 4 and McHenry county which have narrow
network
- Competitive Down-State with broad PPO network
Second lowest silver plans competitive in areas with their narrow
network products
Lowest bronze plans only competitive in Lake county (with narrow
network)
Lowest gold plans mixed results
OLIVER WYMAN
November 3, 2015
47

Additional Narrow Network Options in 2016
JoDaviess
Boone
2015 Service Area

Rockford
Carroll
2016 Service Area

Lake
McHenry
Ogle
Kane
DeKalb
Chicago
DuPage Cook
Lee
Whiteside
Kendall
Will
RockIsland
Bureau
Henry
LaSalle
Grundy
Mercer
Putnam
Henderson
Stark
Kankakee
Marshall
Knox
Livingston
Warren
Peoria
Hancock McDonough
Woodford
Bloomington
Tazewell
Fulton
Mason
DeWitt
Logan
Champaign
Vermilion
Piatt
Menard
Cass
Brown
Ford
McLean
Schuyler
Adams
Iroquois
Springfield Macon
Pike
Scott
Douglas
Sangamon
Springfield
Morgan
Edgar
Moultrie
Christian
Coles
Shelby
Cumberland
Macoupin Montgomery
Calhoun
Jersey
Effingham
Fayette
Jasper
Crawford
Bond
Madison
Clay
RichlandLawrence
Marion
St.Clair
Wayne
Washington
Monroe
Randolph
Edwards
Clinton
Jefferson
Perry
Hamilton
White
Franklin
Gallatin
Williamson Saline
Jackson
Alexander
Union
OLIVER WYMAN
Clark
Wabash
Greene
Johnson Pope
Pulaski
Massac
Hardin
NarrowPPOAvailable
PPOStatewideCoverageOnly
November 3, 2015
48
UnitedHealthcare of the Midwest, Inc.

Expanded Service Area in 2016
2015 Service Area
2016 Service Area
HMOIndividual
NoCoverage
OLIVER WYMAN
November 3, 2015
49
New entrant in 2016
JoDaviess
Boone
Celtic Insurance Company
Rockford
Carroll
Ogle
Kane
DeKalb
IlliniCare exited exchange, owned by same parent

company
Lake
McHenry
Chicago
DuPage Cook
Lee
Whiteside
Kendall
Will
RockIsland
Bureau
Henry
LaSalle
Grundy
Mercer
Putnam
Henderson
Stark
Kankakee
Marshall
Knox
Livingston
Warren
Peoria
Mason
DeWitt
Logan
Champaign
Vermilion
Piatt
Menard
Cass
Brown
Ford
McLean
Schuyler
Adams
Iroquois
Bloomington
Tazewell
Fulton
Hancock McDonough
Woodford
Springfield Macon
Pike
Douglas
Sangamon
Springfield
Morgan
Scott
Edgar
Moultrie
Christian
Coles
Shelby
Cumberland
Macoupin Montgomery
Calhoun
Jersey
Effingham
Fayette
Jasper
Clay
RichlandLawrence
Marion
St.Clair
Wayne
Washington
Monroe
Randolph
Jefferson
Perry
Hamilton
White
Franklin
Gallatin
Williamson Saline
Jackson
Alexander
Union
November 3, 2015
Edwards
Clinton
OLIVER WYMAN
Crawford
Bond
Madison
HMOIndividual
NoCoverage
Clark
Wabash
Greene
Johnson Pope
Pulaski
Hardin
Massac
50
Aetna Insurance Company

New entrant in 2016
Offered plans on-exchange in 2014
Temporarily exited exchange in 2015
HMOIndividual
NoCoverage
OLIVER WYMAN
November 3, 2015
51
New entrant in 2016
JoDaviess
Boone
Harken Health Insurance Company (Midwest Security Life)
Rockford
Carroll
Ogle
Kane
DeKalb
Offers 7 plans in Cook County
Lake
McHenry
Chicago
DuPage Cook
Lee
Whiteside
Kendall
Will
RockIsland
Bureau
Henry
LaSalle
Grundy
Mercer
Putnam
Henderson
Stark
Kankakee
Marshall
Knox
Livingston
Warren
Peoria
Mason
DeWitt
Logan
Champaign
Vermilion
Piatt
Menard
Cass
Brown
Ford
McLean
Schuyler
Adams
Iroquois
Bloomington
Tazewell
Fulton
Hancock McDonough
Woodford
Springfield Macon
Pike
Douglas
Sangamon
Springfield
Morgan
Scott
Edgar
Moultrie
Christian
Coles
Shelby
Cumberland
Macoupin Montgomery
Calhoun
Jersey
Effingham
Fayette
Jasper
Clay
RichlandLawrence
Marion
St.Clair
Wayne
Washington
Monroe
Randolph
Jefferson
Perry
Hamilton
White
Franklin
Gallatin
Williamson Saline
Jackson
Alexander
Union
November 3, 2015
Edwards
Clinton
OLIVER WYMAN
Crawford
Bond
Madison
PPOIndividual
NoCoverage
Clark
Wabash
Greene
Johnson Pope
Pulaski
Hardin
Massac
52
SAMPLE RATES
OLIVER WYMAN
November 3, 2015
53
Sample of Rates Submitted: Non-smoker

Non-Tobacco Rates
Plan
Lowest Cost
Bronze Plans
Lowest Cost
Silver Plans
2nd Lowest cost

Silver Plans
OLIVER WYMAN
Rating Area
Age 25
Age 40
Age 55
Rating Area 1
$129
$164
$286
Rating Area 2
$165
$211
$367
Rating Area 3
$178
$226
$395
Rating Area 4
$178
$227
$396
Rating Area 5
$196
$250
$436
Rating Area 6
$180
$229
$400
Rating Area 7
$160
$204
$355
Rating Area 8
$191
$243
$423
Rating Area 9
$191
$243
$423
Rating Area 10
$177
$225
$392
Rating Area 11
$203
$259
$452
Rating Area 12
$156
$199
$347
Rating Area 13
$215
$274
$478
Rating Area 1
$153
$195
$340
Rating Area 2
$213
$271
$473
Rating Area 3
$206
$262
$458
Rating Area 4
$200
$254
$444
Rating Area 5
$248
$315
$550
Rating Area 6
$207
$263
$459
Rating Area 7
$202
$257
$448
Rating Area 8
$235
$299
$521
Rating Area 9
$221
$281
$490
Rating Area 10
$229
$292
$509
Rating Area 11
$230
$292
$510
Rating Area 12
$199
$253
$442
Rating Area 13
$247
$314
$548
Rating Area 1
$155
$198
$345
Rating Area 2
$215
$274
$478
Rating Area 3
$217
$276
$481
Rating Area 4
$201
$255
$446
Rating Area 5
$248
$316
$552
Rating Area 6
$215
$274
$478
Rating Area 7
$226
$288
$502
Rating Area 8
$235
$299
$522
Rating Area 9
$230
$293
$511
Rating Area 10
$233
$296
$516
Rating Area 11
$257
$328
$572
Rating Area 12
$216
$275
$480
Rating Area 13
$265
$337
$589
November 3, 2015
54
APPENDIX
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November 3, 2015
55
Definitions of Member Costs
OLIVER WYMAN
November 3, 2015
56
Definitions
Small Group Plan Health insurance plan for businesses with 2-50
employees. Illinois has chosen not to expand the definition to 99
employees.
Indemnity Plan type of medical plan that reimburses the patient and/or
provider as expenses are incurred.
Metal Levels (Platinum, Gold, Silver, Bronze) Tiers or levels of health
plans designed to make it easier for shoppers to compare options. More
than one plan may be available in each level. The premiums typically
increase from bronze to platinum metal levels, while the out-of-pocket costs
for enrollees decrease from bronze to platinum metal levels.
OLIVER WYMAN
November 3, 2015
57
Average Plan Value by Metal Level
100%
90%
80%
Estimated
Policyholder
Responsibility
70%
60%
50%
Estimated Insurer
Responsibility
40%
30%
20%
10%
0%
Bronze
Lowest
Premiums
OLIVER WYMAN
Silver
Gold
Platinum
Highest
Premiums
Exchange Health Plan Requirements

Meet network sufficiency standards
Remove the lifetime limit on benefits
Not allowed to discriminate or discourage consumers with existing health
problems
Expanded coverage options for young adults
Spend at least 80 cents of every premium dollar on care
Provide essential health benefits
OLIVER WYMAN
November 3, 2015
59
Essential Health Benefits

Ambulatory patient services
Emergency services
Hospitalization
Maternity and newborn care
Mental health and substance use disorder services, including behavioral
health treatment
Prescription drugs
Rehabilitative and habilitative services and devices
Lab services
Preventive and wellness services and chronic disease management and
Pediatric services, including oral and vision care
OLIVER WYMAN
November 3, 2015
60
Types of Products Offered

HMO A health care system that assumes both the financial risks
associated with providing comprehensive medical services (insurance and
service risk) and the responsibility for health care delivery in a particular
geographic area to HMO members, usually in return for a fixed, prepaid
fee. Financial risk may be shared with the providers participating in the
HMO.
PPO Preferred Provider Organizations An indemnity plan where

coverage is provided to participants through a network of selected health
care providers (such as hospitals and physicians). The enrollees may go
outside the network, but would incur larger costs in the form of higher
deductibles, higher coinsurance rates, or nondiscounted charges from the
providers.
OLIVER WYMAN
November 3, 2015
61

Illinois Rate and Plan Analysis

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Illinois Rate and Plan Analysis

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2016 Analysis of Illinois Exchange Rates

Highlights of the 2016 Get Covered Illinois Marketplace

Highlights of the 2016 Get Covered Illinois Marketplace

Rate Changes Vary

Competition Generates Lower Rate Increases

Issuers on Get Covered Illinois in 2016

Aetna Health Inc.*

Issuers on Get Covered Illinois in 2016

Health Plan Rating Areas 13 distinct areas

2016 Summary of Plan Information

Number of Issuers Offering Coverage by County

Aetna, Celtic, Harken are new entrants in the

Down-state remains the same with fewest issuers

Individual Market Number Plans Offered by County

Individual Market Change in Number of Plans from 2015

Small Group Market Number of plans by county

Small Group Market Change in number of Plans from 2015

Individual Plans Offered by County: Metal Level

Individual Plans Offered by County: Metal Level

Individual Plans Offered by County: Metal Level

Individual Plans Offered by County: Metal Level

Individual Plans Offered by County: Metal Level

Small Group Plans Offered by County: Metal Level

Small Group Plans Offered by County: Metal Level

Small Group Plans Offered by County: Metal Level

Small Group Plans Offered by County: Metal Level

Small Group Plans Offered by County: Metal Level

Individual Market Rate Change of Lowest Silver

Individual Market Change in Lowest Cost Silver Issuer

2015 Lowest Cost Silver Issuer

2016 Lowest Cost Silver Issuer

The Average Rate Increase Across All Rating Areas in Lowest

Individual Market Rate Change of Second Lowest Silver

Individual Market Change in Second Lowest Cost Silver

Lowest Cost Silver Issuer

Individual Market Rate Change of Lowest Bronze

Individual Market Change in Lowest Cost Bronze Issuer

2015 Lowest Cost Bronze Issuer

An 11.3% Average Rate Increase Across All Rating Areas in

Individual Market Rate Change of Lowest Gold

Individual Market Change in Lowest Cost Gold Issuers

2015 Lowest Cost Gold Issuers

2016 Lowest Cost Gold Issuers

Background Information on Subsidies

Examples of the calculations are shown in later slides.

Summary of Subsidy Information in Illinois

Coventry Health Care of Illinois, Inc.

Coventry Health & Life Insurance Company

Health Alliance Medical Plans, Inc.

2015 Service Area

2016 Service Area

Health Care Services Corporation, a Mutual Legal Reserve Company

Health Care Services Corporation, a Mutual Legal Reserve Company

2015 Service Area

2016 Service Area

Health Care Services Corporation, a Mutual Legal Reserve Company

2015 Service Area

2016 Service Area

Humana Health Plan, Inc.

2016 Service Area

Land of Lincoln Mutual Health Insurance Company

Land of Lincoln Mutual Health Insurance Company

2015 Service Area

2016 Service Area