Carrier Contact Person: Luke Hampton, ASA, Sr. Actuarial Associate Carrier Contact Phone: (503)

Transcription

1 Kaiser Foundation Health Plan of the Northwest All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest April 30, 2015 To: DEPARTMENT OF CONSUMER & BUSINESS SERVICES INSURANCE DIVISION 350 WINTER STREET NE, ROOM 440 SALEM, OR From: Kaiser Foundation Health Plan of the Northwest 500 N.E. Multnomah St., Suite 100 Portland, OR Carrier Contact Person: Luke Hampton, ASA, Sr. Actuarial Associate Carrier Contact Phone: (503) Subject: Small Group Rate Filing Description Standard Master Contract Numbers: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDSTD0116, EOSGHDHP0116, EOSGHDHPSTD0116, EOSGTRAD0116 Previous SERFF Filing Number: KFNW Approval Date: 08/15/2014 HIOS Tracking Number: HIOS Identifiers: 71287OR043, 71287OR044, 71287OR057 Dear Mr. Sink, Enclosed for your review is our Small Group Rate Filing effective January 1, 2016 through December 31, We are requesting an average increase in per member per month rates of -10.6% for these annual rates that last for a 12 month duration. These average rates do not indicate that every group s rate will increase or decrease by these amounts, as rates are affected by the ages of those covered, family coverage, and the date of policy renewal. We have estimated that small group rate changes will range between -4.6% and -21.0%, including the impact of benefit changes. We anticipate that these rates will be reasonably market-competitive as our overall rating decision has been based, in part, on maintaining and improving market competitiveness. Oregon small group membership not enrolled in transitional plans is 6,464 as of February This membership is based on a snapshot at the end of February and is expected to increase due to the 51 to 100 migration to small group. For this filing, we are reporting the financial position of the Kaiser Foundation Health Plan of the Northwest only, instead of a combined health plan and hospital report. This is consistent with our statutory reporting, medical loss ratio reporting, and our previous small group rate filings. 1

2 Kaiser Foundation Health Plan of the Northwest All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest The average annual increase for each quarter included in this filing as well as the membership associated with each quarter is show in the table below Rate Effective Date Requested Annual Rate Change From Last Effective Date Minimum Rate Change Maximum Rate Change Renewing Members January % % -4.66% 2,091 April (small group only) % % -4.62% 1,345 July (small group only) % % -5.39% 2,466 October (small group only) % % -6.56% 563 Total % % -4.62% 6,464 Experience Period Projection vs Actual In our approved rate filing effective Jan. 2014, we projected the following financial results for 2014, on a PMPM basis: - Claims costs: 85.5% - Administrative costs: 14.5% - Profit: 0% Actual results for this period, which serves as the base experience period for our current filing, were as follows: - Claims costs: 78.9% - Administrative costs: 19.9% - Profit: 1.3% These figures do not include portability losses, losses on charitable care, or premium taxes. Note that the experience projections from the previous filing are based on total Oregon small group business and the actual results are based on Oregon small group business excluding transitional plans. 2

3 Kaiser Foundation Health Plan of the Northwest All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest Plan Modifications and Discontinuations Below is a table with a list of discontinued plans along with the 2016 plan we intend to map members to. All other plans are considered modifications. HIOS ID Discontinued 2015 Plan Mapped 2016 Plan 71287OR KP OR Bronze 3500/50 KP OR Silver 3500/ OR KP OR Bronze 3500/50 w/vx & ALTC KP OR Silver 3500/40 w/vx & ALTC 71287OR KP OR Bronze 5000/60 HSA w/ VX & ALTC Kaiser Permanente Oregon Standard Bronze Plan 71287OR KP OR Silver 2000/40 2T POS KP OR Silver 2000/40 3T POS 71287OR KP OR Bronze 4500/50 2T POS KP OR Silver 2000/40 3T POS 71287OR KP OR Silver 2000/40 2T POS w/vx & ALTC KP OR Silver 2000/40 3T POS w/vx & ALTC 71287OR KP OR Bronze 4500/50 2T POS w/vx & ALTC KP OR Silver 2000/40 3T POS w/vx & ALTC 71287OR KP OR Gold 600/35 3T POS - OOA KP OR Gold 1000/35 3T POS- OOA 71287OR KP OR Gold 600/35 3T POS w/vx & ALTC - OOA KP OR Gold 1000/35 3T POS w/vx & ALTC - OOA 71287OR KP OR Bronze 4500/50 3T POS- OOA KP OR Gold 1000/35 3T POS- OOA 71287OR KP OR Bronze 4500/50 3T POS w/vx & ALTC - OOA KP OR Gold 1000/35 3T POS w/vx & ALTC - OOA 71287OR KP OR Silver 2000/40 3T POS - OOA KP OR Gold 1000/35 3T POS- OOA 71287OR KP OR Silver 2000/40 3T POS w/vx & ALTC - OOA KP OR Gold 1000/35 3T POS w/vx & ALTC - OOA 3

4 Kaiser Foundation Health Plan of the Northwest All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest Plan Description and Plan Status (Renewing vs New Plan) Plan ID Marketing Name Metal Tier Plan Status 71287OR Kaiser Permanente Oregon Standard Gold Plan Gold Renewing Plan 71287OR Kaiser Permanente Oregon Standard Silver Plan Silver Renewing Plan 71287OR Kaiser Permanente Oregon Standard Bronze Plan Bronze Renewing Plan 71287OR KP OR Platinum 0/20 Platinum Renewing Plan 71287OR KP OR Platinum 250/20 Platinum Renewing Plan 71287OR KP OR Gold 0/30 Gold Renewing Plan 71287OR KP OR Gold 500/20 Gold Renewing Plan 71287OR KP OR Gold 1000/20 Gold Renewing Plan 71287OR KP OR Silver 0/50 Silver Renewing Plan 71287OR KP OR Silver 1500/35 Silver Renewing Plan 71287OR KP OR Silver 2000/35 Silver Renewing Plan 71287OR KP OR Silver 2600/25% HSA Silver Renewing Plan 71287OR KP OR Silver 3500/40 Silver New Plan 71287OR KP OR Bronze 4500/50 Bronze Renewing Plan 71287OR KP OR Bronze 3800/50% HSA Bronze New Plan 71287OR KP OR Bronze 6600/35 Bronze New Plan 71287OR KP OR Platinum 250/10 3T POS Platinum New Plan 71287OR KP OR Platinum 250/10 3T POS - OOA Platinum New Plan 71287OR KP OR Gold 600/35 3T POS Gold Renewing Plan 71287OR KP OR Gold 1000/35 3T POS Gold New Plan 71287OR KP OR Gold 1000/35 3T POS- OOA Gold New Plan 71287OR KP OR Silver 2000/40 3T POS Silver New Plan 71287OR KP OR Platinum 0/20 w/vx Platinum New Plan 71287OR KP OR Platinum 250/20 w/vx Platinum New Plan 71287OR KP OR Gold 0/30 w/vx Gold New Plan 71287OR KP OR Gold 500/20 w/vx Gold New Plan 71287OR KP OR Gold 1000/20 w/vx Gold New Plan 71287OR KP OR Silver 0/50 w/vx Silver New Plan 71287OR KP OR Silver 1500/35 w/vx Silver New Plan 71287OR KP OR Silver 2000/35 w/vx Silver New Plan 71287OR KP OR Silver 2600/25% HSA w/vx Silver New Plan 71287OR KP OR Silver 3500/40 w/vx Silver New Plan 71287OR KP OR Bronze 4500/50 w/vx Bronze New Plan 71287OR KP OR Bronze 3800/50% HSA w/vx Bronze New Plan 71287OR KP OR Bronze 6600/35 w/vx Bronze New Plan 71287OR KP OR Platinum 250/10 3T POS w/vx Platinum New Plan 71287OR KP OR Platinum 250/10 3T POS w/vx - OOA Platinum New Plan 71287OR KP OR Gold 600/35 3T POS w/vx Gold New Plan 71287OR KP OR Gold 1000/35 3T POS w/vx Gold New Plan 71287OR KP OR Gold 1000/35 3T POS w/vx - OOA Gold New Plan 71287OR KP OR Silver 2000/40 3T POS w/vx Silver New Plan 71287OR KP OR Platinum 0/20 w/altc Platinum New Plan 71287OR KP OR Platinum 250/20 w/altc Platinum New Plan 71287OR KP OR Gold 0/30 w/altc Gold New Plan 4

5 Kaiser Foundation Health Plan of the Northwest All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest Plan ID Marketing Name Metal Tier Plan Status 71287OR KP OR Gold 500/20 w/altc Gold New Plan 71287OR KP OR Gold 1000/20 w/altc Gold New Plan 71287OR KP OR Silver 0/50 w/altc Silver New Plan 71287OR KP OR Silver 1500/35 w/altc Silver New Plan 71287OR KP OR Silver 2000/35 w/altc Silver New Plan 71287OR KP OR Silver 2600/25% HSA w/altc Silver New Plan 71287OR KP OR Silver 3500/40 w/altc Silver New Plan 71287OR KP OR Bronze 4500/50 w/altc Bronze New Plan 71287OR KP OR Bronze 3800/50% HSA w/altc Bronze New Plan 71287OR KP OR Bronze 6600/35 w/altc Bronze New Plan 71287OR KP OR Platinum 250/10 3T POS w/altc Platinum New Plan 71287OR KP OR Platinum 250/10 3T POS w/altc - OOA Platinum New Plan 71287OR KP OR Gold 600/35 3T POS w/altc Gold New Plan 71287OR KP OR Gold 1000/35 3T POS w/altc Gold New Plan 71287OR KP OR Gold 1000/35 3T POS w/altc - OOA Gold New Plan 71287OR KP OR Silver 2000/40 3T POS w/altc Silver New Plan 71287OR KP OR Platinum 0/20 w/vx & ALTC Platinum Renewing Plan 71287OR KP OR Platinum 250/20 w/vx & ALTC Platinum Renewing Plan 71287OR KP OR Gold 0/30 w/vx & ALTC Gold Renewing Plan 71287OR KP OR Gold 500/20 w/vx & ALTC Gold Renewing Plan 71287OR KP OR Gold 1000/20 w/vx & ALTC Gold Renewing Plan 71287OR KP OR Silver 0/50 w/vx & ALTC Silver Renewing Plan 71287OR KP OR Silver 1500/35 w/vx & ALTC Silver Renewing Plan 71287OR KP OR Silver 2000/35 w/vx & ALTC Silver Renewing Plan 71287OR KP OR Silver 2600/25% HSA w/vx & ALTC Silver Renewing Plan 71287OR KP OR Silver 3500/40 w/vx & ALTC Silver New Plan 71287OR KP OR Bronze 4500/50 w/vx & ALTC Bronze Renewing Plan 71287OR KP OR Bronze 3800/50% HSA w/vx & ALTC Bronze New Plan 71287OR KP OR Bronze 6600/35 w/vx & ALTC Bronze New Plan 71287OR KP OR Platinum 250/10 3T POS w/vx & ALTC Platinum New Plan 71287OR KP OR Platinum 250/10 3T POS w/vx & ALTC - OOA Platinum New Plan 71287OR KP OR Gold 600/35 3T POS w/vx & ALTC Gold Renewing Plan 71287OR KP OR Gold 1000/35 3T POS w/vx & ALTC Gold New Plan 71287OR KP OR Gold 1000/35 3T POS w/vx & ALTC - OOA Gold New Plan 71287OR KP OR Silver 2000/40 3T POS w/vx & ALTC Silver New Plan Rating Factor Changes There are no rating factor changes for Benefit or Administrative Changes No other changes are being made at this time. 5

6 Kaiser Foundation Health Plan of the Northwest All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest Kaiser Permanente Our System of Health Care Delivery As part of our public filing, we would like to provide additional context around our costs for provision of medical services, the way we practice medicine and our high standard of care. Please see the attachment to this cover letter entitled About Kaiser Permanente. This, plus the Cost Containment and Quality Improvement Efforts portion of the filing, will provide excellent information regarding how valuable premium dollars are utilized. Please let me know if you have any questions about this filing. Sincerely, Luke Hampton, ASA Actuarial Services About Kaiser Permanente Kaiser Foundation Health Plan of the Northwest is committed to helping shape the future of health care. We are recognized as one of America s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 9.0 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, please go to: Kaiser Permanente provides an integrated approach to care delivery that offers the following advantages: Quality Medical Care At Kaiser Permanente, we offer a full range of health care services and health education programs, and we are proud to have surpassed many national standards for disease management, preventive care, and health outcomes. Nationally, Kaiser Permanente surpasses all reporting commercial health plans with top marks in 12 quality measures reported in 2010 National Committee for Quality Assurance s Quality Compass data. Our high quality is partially due to our investment in medical care. Excellent Physicians Kaiser Permanente is committed to recruiting excellent physicians as part of the process of ensuring that our members receive high-quality care. 6

7 Kaiser Foundation Health Plan of the Northwest All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest Clinical Quality At Kaiser Foundation Health Plan of the Northwest, quality of care is our highest priority. We already receive high marks for quality. Our clinicians and staff, our philosophy of evidence-based medicine, our electronic medical information system, and our research center help ensure our quality of care. Access to Care Kaiser Permanente offers many options for members to obtain the care they need. We provide same-day appointments for urgent needs, 24-hour advice nurse services, self-referrals for some types of specialty care, and convenient coverage when members travel outside the local service area. Kaiser Permanente members can receive care at any of our hundreds of hospital and medical facilities across the country when traveling or temporarily outside the home Region. Most facilities include a full range of services from physician care to laboratory, x-ray, and pharmacy services. When special medical attention is needed, patients may be referred to one of our affiliated referral centers for specialty care. Sophisticated Information Systems Kaiser Permanente has the largest, most complete private health care information system in the country, allowing us to measure and improve quality at every level. All of Kaiser Permanente s 14,000 physicians have electronic access to their patient s medical records at 430 Kaiser Permanente medical office buildings, and 24 Kaiser Permanente medical centers through KP HealthConnect. Northwest Permanente physicians, affiliated clinicians, and specialists have online access to clinical practice guidelines and protocols as well as the electronic outpatient medical record. The patient's medical record includes test results and flags that remind physicians to recommend preventive screening tests. KP HealthConnect provides information to the clinician about patients at the time they are seen in the medical facility. This capability allows us to identify high-risk populations and more effectively manage patients with chronic illness or disease states. KP HealthConnect also provides the data needed to allow Kaiser Permanente to perform outcomes studies based on population-based medicine. Our Environment Kaiser Permanente's clinical environment makes it more convenient for patients to access different types of care without the need to drive from location to location. Patients can fill their prescriptions in the pharmacies located within our medical offices and borrow books or other information resources from health resource centers located at medical offices throughout the service area. The integrated environment encourages physicians to focus on the health of their patients and to share information and learn from their colleagues. It allows our practitioners to use a common medical record for each patient so that all physicians, affiliated clinicians, and pharmacists treating that patient have access to the most up-to-date information. Structure Kaiser Foundation Health Plan is a non-profit organization whose focus is not profit-driven but on improving the health of our members and contributing to the welfare of the communities we serve. Any revenues in excess of expenses are reinvested in our members care in the form of facility improvements, enhanced 7

8 Kaiser Foundation Health Plan of the Northwest All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest clinical services, and reasonable cost. The exclusive partnership between Kaiser Foundation Health Plan and the Permanente Medical Groups ensures that our organizational goals and objectives are made with the sole purpose of improving the health of our members. 8

9 SERFF Tracking #: KFNW State Tracking #: KFNW Company Tracking #: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDST... State: Oregon Filing Company: Kaiser Foundation Health Plan of the Northwest TOI/Sub-TOI: Product Name: Project Name/Number: / H16G Group Health - Major Medical/H16G.003G Small Group Only - Other Small Group Filing at a Glance Company: Product Name: State: TOI: Sub-TOI: Filing Type: Kaiser Foundation Health Plan of the Northwest Small Group Oregon H16G Group Health - Major Medical H16G.003G Small Group Only - Other Rate Date Submitted: 04/30/2015 SERFF Tr Num: SERFF Status: State Tr Num: State Status: Co Tr Num: KFNW Pending State Action KFNW Review pending EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDSTD0116, EOSGHDHP0116, EOSGHDHPSTD0116, EOSGTRAD0116 Implementation Date Requested: Author(s): Reviewer(s): Disposition Date: Disposition Status: Implementation Date: 01/01/2016 Rob Pickard, Boyd Law, Robert Martin, Kyle Moteberg, Luke Hampton, Erik Wheeler, James Chambers, David Liebert Jeff Furnish (primary), Sarah McGovern, Ethan Baldwin, Annette Boyce, Suna Oh, Michael Sink State Filing Description: Small Group -10.6% Policy Holders: PDF Pipeline for SERFF Tracking Number KFNW Generated 05/04/ :25 AM

10 SERFF Tracking #: KFNW State Tracking #: KFNW Company Tracking #: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDST... State: Oregon Filing Company: Kaiser Foundation Health Plan of the Northwest TOI/Sub-TOI: Product Name: Project Name/Number: / H16G Group Health - Major Medical/H16G.003G Small Group Only - Other Small Group General Information Project Name: Status of Filing in Domicile: Project Number: Date Approved in Domicile: Requested Filing Mode: File & Use Domicile Status Comments: Explanation for Combination/Other: Market Type: Group Submission Type: New Submission Group Market Size: Small Group Market Type: Employer Overall Rate Impact: -10.6% Filing Status Changed: 05/01/2015 State Status Changed: 05/01/2015 Deemer Date: Created By: Luke Hampton Submitted By: Luke Hampton Corresponding Filing Tracking Number: PPACA: Non-Grandfathered Immed Mkt Reforms PPACA Notes: null Exchange Intentions: Exchange and Outside Market Filing Description: 2016 Small Group Filing for ACA Products. Company and Contact Filing Contact Information Luke Hampton, Senior Actuarial Associate 500 NE Multnomah St., Ste 100, 14th Fl Portalnd, OR Filing Company Information Kaiser Foundation Health Plan of the Northwest 500 NE Multnomah St. Suite 100 Portland, OR (503) ext. [Phone] luke.w.hampton@kp.org [Phone] CoCode: Group Code: Group Name: FEIN Number: State of Domicile: Oregon Company Type: HCSC State ID Number: 126 Filing Fees Fee Required? Retaliatory? Fee Explanation: State Specific No No Have you reviewed the General Instructions attached as a separate pdf at the bottom of the General Instructions page?: Yes Did you read the instructions regarding how to enter the form number and edition date in the Forms Schedule tab?: Yes Did you realize Oregon does not respond to Status Requests thru SERFF?: Yes Please confirm that you have read the Fraud Bulletin located at: PDF Pipeline for SERFF Tracking Number KFNW Generated 05/04/ :25 AM

11 SERFF Tracking #: KFNW State Tracking #: KFNW Company Tracking #: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDST... State: Oregon Filing Company: Kaiser Foundation Health Plan of the Northwest TOI/Sub-TOI: Product Name: Project Name/Number: / H16G Group Health - Major Medical/H16G.003G Small Group Only - Other Small Group Yes For PC files: Have you attached under the Supporting Documentation tab any state specific Amendatory Endorsements that will be used to bring the submitted forms into compliance with our statutes?: Yes PDF Pipeline for SERFF Tracking Number KFNW Generated 05/04/ :25 AM

12 SERFF Tracking #: KFNW State Tracking #: KFNW Company Tracking #: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDST... State: Oregon Filing Company: Kaiser Foundation Health Plan of the Northwest TOI/Sub-TOI: Product Name: Project Name/Number: / H16G Group Health - Major Medical/H16G.003G Small Group Only - Other Small Group Rate Information Rate data applies to filing. Filing Method: Rate Change Type: Decrease Overall Percentage of Last Rate Revision: % Effective Date of Last Rate Revision: Filing Method of Last Filing: Company Rate Information Company Name: Kaiser Foundation Health Plan of the Northwest Company Rate Overall % Indicated Overall % Rate Written Premium Number of Policy Holders Affected Written Premium for Maximum % Change Minimum % Change Change: Change: Impact: Change for this Program: for this Program: this Program: (where req'd): (where req'd): Decrease % % $-651,072, ,244 $54,748, % % PDF Pipeline for SERFF Tracking Number KFNW Generated 05/04/ :25 AM

13 SERFF Tracking #: KFNW State Tracking #: KFNW Company Tracking #: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDST... State: Oregon Filing Company: Kaiser Foundation Health Plan of the Northwest TOI/Sub-TOI: Product Name: Project Name/Number: / H16G Group Health - Major Medical/H16G.003G Small Group Only - Other Small Group Rate Review Detail COMPANY: Company Name: Kaiser Foundation Health Plan of the Northwest HHS Issuer Id: PRODUCTS: Product Name HIOS Product ID HIOS Submission ID Number of Covered Lives various Trend Factors: FORMS: New Policy Forms: Affected Forms: Other Affected Forms: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDSTD0116, EOSGHDHP0116, EOSGHDHPSTD0116, EOSGTRAD0116 n/a n/a REQUESTED RATE CHANGE INFORMATION: Change Period: Annual Member Months: 97,855 Benefit Change: None Percent Change Requested: Min: Max: 1,073.0 Avg: PRIOR RATE: Total Earned Premium: 61,259, Total Incurred Claims: 49,939, Annual $: Min: Max: 1, Avg: REQUESTED RATE: Projected Earned Premium: 54,748, Projected Incurred Claims: 44,631, Annual $: Min: Max: 1, Avg: PDF Pipeline for SERFF Tracking Number KFNW Generated 05/04/ :25 AM

14 SERFF Tracking #: KFNW State Tracking #: KFNW Company Tracking #: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDST... State: Oregon Filing Company: Kaiser Foundation Health Plan of the Northwest TOI/Sub-TOI: Product Name: Project Name/Number: / H16G Group Health - Major Medical/H16G.003G Small Group Only - Other Small Group Rate/Rule Schedule Item No. Schedule Item Document Name Affected Form Numbers Status 1 Rate Tables and Factors EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDSTD0116, EOSGHDHP0116, EOSGHDHPSTD0116, EOSGTRAD0116 (Separated with commas) Rate Action Rate Action Information Attachments New Rate Tables and Factors.pdf, Rate Tables and Factors.xlsm, PDF Pipeline for SERFF Tracking Number KFNW Generated 05/04/ :25 AM

15 SERFF Tracking #: KFNW State Tracking #: KFNW Company Tracking #: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDST... State: Oregon Filing Company: Kaiser Foundation Health Plan of the Northwest TOI/Sub-TOI: Product Name: Project Name/Number: / H16G Group Health - Major Medical/H16G.003G Small Group Only - Other Small Group Attachment Rate Tables and Factors.xlsm is not a PDF document and cannot be reproduced here. PDF Pipeline for SERFF Tracking Number KFNW Generated 05/04/ :25 AM

16 Kaiser Foundation Health Plan of the Northwest Oregon Small Group Medical Small Group Rate Tables and Factors Table of Contents Exhibits Exhibit A Exhibit B Exhibit C Exhibit D Exhibit E Content Geographic Average Rates by Plan and Family Type Rating Factors Rating Example Rate Sheets Area Factors

17 Kaiser Foundation Health Plan of the Northwest Small Group Rate Tables and Factors Geographic Average Rates by Plan Q1 Normalized Avg Min & Max Q1 Rate Q2 Rate Q3 Rate Q4 Rate Metallic Level Name Base Rate Plan Relativity Non-EHB Admin Demo Factor Q1 Rate Q2 Rate Q3 Rate Q4 Rate Increase Increase Increase Increase KP OR Gold 0/ Gold Kaiser Permanente Oregon Standard Gold Plan % -8.6% -9.1% -9.5% KP OR Gold 0/ Silver Kaiser Permanente Oregon Standard Silver Plan % -8.6% -9.0% -9.5% KP OR Silver 0/Bronze Kaiser Permanente Oregon Standard Bronze Plan % -11.8% -12.2% -12.7% KP OR Silver 0/Platinum KP OR Platinum 0/ % -10.7% -11.1% -11.5% KP OR Gold 50 Platinum KP OR Platinum 250/ % -10.0% -10.5% -11.0% KP OR Gold 50 Gold KP OR Gold 0/ % -10.5% -11.1% -11.6% KP OR Gold 10 Gold KP OR Gold 500/ % -10.1% -10.5% -10.9% KP OR Gold 10 Gold KP OR Gold 1000/ % -9.6% -10.2% -10.6% KP OR Silver 15Silver KP OR Silver 0/ % -9.1% -9.4% -9.9% KP OR Silver 15Silver KP OR Silver 1500/ % -12.5% -12.7% -13.2% KP OR Silver 20Silver KP OR Silver 2000/ % -12.0% -12.4% -12.9% KP OR Silver 20Silver KP OR Silver 2600/25% HSA % -18.7% -19.3% -19.5% KP OR Bronze Silver KP OR Silver 3500/ na na na na KP OR Bronze Bronze KP OR Bronze 4500/ % -13.8% -14.1% -14.6% KP OR Silver 17Bronze KP OR Bronze 3800/50% HSA na na na na KP OR Silver 17Bronze KP OR Bronze 6600/ na na na na KP OR PlatinumPlatinum KP OR Platinum 250/10 3T POS na na na na KP OR PlantinuPlatinum KP OR Platinum 250/10 3T POS - OOA na na na na KP OR PlatinumGold KP OR Gold 600/35 3T POS % -10.5% -10.8% -11.2% KP OR PlantinuGold KP OR Gold 1000/35 3T POS na na na na KP OR Bronze Gold KP OR Gold 1000/35 3T POS- OOA na na na na KP OR Bronze Gold KP OR Silver 2000/40 3T POS na na na na KP OR Gold ST Platinum KP OR Platinum 0/20 w/vx na na na na KP OR Silver STPlatinum KP OR Platinum 250/20 w/vx na na na na KP OR Bronze Gold KP OR Gold 0/30 w/vx na na na na KP OR Bronze Gold KP OR Gold 500/20 w/vx na na na na KP OR SILVER Gold KP OR Gold 1000/20 w/vx na na na na KP OR Gold 60 Silver KP OR Silver 0/50 w/vx na na na na KP OR BRONZESilver KP OR Silver 1500/35 w/vx na na na na KP OR SILVER Silver KP OR Silver 2000/35 w/vx na na na na KP OR Gold 60 Silver KP OR Silver 2600/25% HSA w/vx na na na na KP OR BRONZESilver KP OR Silver 3500/40 w/vx na na na na KP OR GOLD 6 Bronze KP OR Bronze 4500/50 w/vx na na na na KP OR GOLD 6 Bronze KP OR Bronze 3800/50% HSA w/vx na na na na KP OR BRONZEBronze KP OR Bronze 6600/35 w/vx na na na na KP OR BRONZEPlatinum KP OR Platinum 250/10 3T POS w/vx na na na na KP OR SILVER Platinum KP OR Platinum 250/10 3T POS w/vx - OOA na na na na KP OR SILVER Gold KP OR Gold 600/35 3T POS w/vx na na na na Gold KP OR Gold 1000/35 3T POS w/vx na na na na Gold KP OR Gold 1000/35 3T POS w/vx - OOA na na na na Gold KP OR Silver 2000/40 3T POS w/vx na na na na Platinum KP OR Platinum 0/20 w/altc na na na na Platinum KP OR Platinum 250/20 w/altc na na na na Gold KP OR Gold 0/30 w/altc na na na na Gold KP OR Gold 500/20 w/altc na na na na Gold KP OR Gold 1000/20 w/altc na na na na Silver KP OR Silver 0/50 w/altc na na na na Silver KP OR Silver 1500/35 w/altc na na na na Silver KP OR Silver 2000/35 w/altc na na na na Silver KP OR Silver 2600/25% HSA w/altc na na na na Silver KP OR Silver 3500/40 w/altc na na na na Bronze KP OR Bronze 4500/50 w/altc na na na na Bronze KP OR Bronze 3800/50% HSA w/altc na na na na Bronze KP OR Bronze 6600/35 w/altc na na na na Platinum KP OR Platinum 250/10 3T POS w/altc na na na na Platinum KP OR Platinum 250/10 3T POS w/altc - OOA na na na na Gold KP OR Gold 600/35 3T POS w/altc na na na na Gold KP OR Gold 1000/35 3T POS w/altc na na na na Gold KP OR Gold 1000/35 3T POS w/altc - OOA na na na na Gold KP OR Silver 2000/40 3T POS w/altc na na na na Platinum KP OR Platinum 0/20 w/vx & ALTC % -10.2% -10.7% -11.2% Platinum KP OR Platinum 250/20 w/vx & ALTC % -9.7% -10.2% -10.5% Gold KP OR Gold 0/30 w/vx & ALTC % -10.2% -10.6% -11.1% Gold KP OR Gold 500/20 w/vx & ALTC % -9.7% -10.1% -10.6% Gold KP OR Gold 1000/20 w/vx & ALTC % -9.4% -9.6% -10.2% Silver KP OR Silver 0/50 w/vx & ALTC % -8.7% -9.2% -9.4% Silver KP OR Silver 1500/35 w/vx & ALTC % -11.9% -12.4% -13.0% Silver KP OR Silver 2000/35 w/vx & ALTC % -11.6% -12.1% -12.5% Silver KP OR Silver 2600/25% HSA w/vx & ALTC % -18.4% -18.8% -19.2% Silver KP OR Silver 3500/40 w/vx & ALTC na na na na Bronze KP OR Bronze 4500/50 w/vx & ALTC % -13.4% -13.7% -14.2% Bronze KP OR Bronze 3800/50% HSA w/vx & ALTC na na na na Bronze KP OR Bronze 6600/35 w/vx & ALTC na na na na Platinum KP OR Platinum 250/10 3T POS w/vx & ALTC na na na na Platinum KP OR Platinum 250/10 3T POS w/vx & ALTC - OOA na na na na Gold KP OR Gold 600/35 3T POS w/vx & ALTC % -9.9% -10.4% -10.9% Gold KP OR Gold 1000/35 3T POS w/vx & ALTC na na na na Gold KP OR Gold 1000/35 3T POS w/vx & ALTC - OOA na na na na Gold KP OR Silver 2000/40 3T POS w/vx & ALTC na na na na Sources of the normalized base rate, NON EHB factor, and Plan Relativity can be found in the actuarial Memorandum.

18 2016 Rating Factors & Gradient 2015 Rating Factors & Gradient Age and Smoker Factors Quarterly Gradient Age and Smoker Factors Quarterly Gradient Age Age Related Trend 3.0% Age Age Related Trend 5.0% 20 and Under and Under Q1 Q2 Q3 Q Q1 Q2 Q3 Q Area Factor Area Factor An area factor of 1 is used for all areas An area factor of 1 is used for all areas Tiers Factor Tiers Factor Employee Employee Emp + Spouse Emp + Spouse Emp + Child(ren) Emp + Child(ren) Family Family

19 Example of Rate Calculation Index Rate (1) Plan Relativity KP OR Silver 3500/ (2) Group Census Age Demo Factors Member Member Member Member Member (3) Admin % 1.27 (4) EHB % 1.00 (5) Rate by Mem Member 1 =(1)x(2)x(3)x(4)x(5) Member 2 =(1)x(2)x(3)x(4)x(5) Member 3 =(1)x(2)x(3)x(4)x(5) Member 4 =(1)x(2)x(3)x(4)x(5) Member 5 =(1)x(2)x(3)x(4)x(5) (6) Group PMPM Rate Sum Mem Rate/ # of Mem (7) Note The group PMPM rate represents the per member premium liability for the group.

20 Oregon Small Group Exchange Q1 Rates HIOS ID 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Silver Bronze Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Kaiser Permanente Kaiser Permanente Kaiser Permanente Oregon Standard Gold Oregon Standard Oregon Standard KP OR Platinum KP OR Silver KP OR Bronze KP OR Bronze KP OR Bronze KP OR Platinum KP OR Platinum KP OR Gold 600/35 Age Plan Silver Plan Bronze Plan KP OR Platinum 0/20 250/20 KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/ /25% HSA KP OR Silver 3500/ / /50% HSA 6600/35 250/10 3T POS 250/10 3T POS - OOA 3T POS 20 and Under $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $911.00

21 Oregon Small Group Exchange Q1 Rates 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Gold Gold Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Gold KP OR Platinum KP OR Gold 1000/35 KP OR Gold 1000/35 KP OR Silver 2000/40 KP OR Platinum 0/20 KP OR Platinum KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/35 KP OR Silver KP OR Silver 3500/40 KP OR Bronze KP OR Bronze KP OR Bronze KP OR Platinum 250/10 3T POS w/vx - KP OR Gold 600/35 3T KP OR Gold 1000/35 3T POS 3T POS- OOA 3T POS w/vx 250/20 w/vx w/vx w/vx w/vx w/vx w/vx w/vx 2600/25% HSA w/vx w/vx 4500/50 w/vx 3800/50% HSA w/vx 6600/35 w/vx 250/10 3T POS w/vx OOA POS w/vx 3T POS w/vx $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $907.00

22 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Gold Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Gold Gold KP OR Silver KP OR Bronze KP OR Platinum KP OR Platinum KP OR Gold 1000/35 KP OR Gold 1000/35 KP OR Silver 2000/40 KP OR Platinum 0/20 KP OR Platinum KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/ /25% HSA KP OR Silver 3500/40 KP OR Bronze 3800/50% HSA KP OR Bronze 250/10 3T POS 250/10 3T POS KP OR Gold 600/35 3T KP OR Gold 1000/35 3T POS w/altc - 3T POS w/vx - OOA 3T POS w/vx w/altc 250/20 w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc 4500/50 w/altc w/altc 6600/35 w/altc w/altc w/altc - OOA POS w/altc 3T POS w/altc OOA $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1,276.00

23 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Gold Gold Gold KP OR Silver KP OR Bronze KP OR Bronze KP OR Bronze KP OR Platinum KP OR Platinum KP OR Gold 1000/35 KP OR Gold 1000/35 KP OR Silver 2000/40 KP OR Silver 2000/40 KP OR Platinum 0/20 KP OR Platinum KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/ /25% HSA w/vx KP OR Silver 3500/ /50 w/vx & 3800/50% HSA w/vx 6600/35 w/vx & 250/10 3T POS w/vx 250/10 3T POS w/vx KP OR Gold 600/35 3T 3T POS w/vx & 3T POS w/vx & 3T POS w/vx & 3T POS w/altc w/vx & ALTC 250/20 w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC & ALTC w/vx & ALTC ALTC & ALTC ALTC & ALTC & ALTC - OOA POS w/vx & ALTC ALTC ALTC - OOA ALTC $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $823.00

24 Oregon Small Group Exchange Q2 Rates HIOS ID 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Silver Bronze Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Kaiser Permanente Kaiser Permanente Kaiser Permanente Oregon Standard Gold Oregon Standard Oregon Standard KP OR Platinum KP OR Silver KP OR Bronze KP OR Bronze KP OR Bronze KP OR Platinum KP OR Platinum KP OR Gold 600/35 3T Age Plan Silver Plan Bronze Plan KP OR Platinum 0/20 250/20 KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/ /25% HSA KP OR Silver 3500/ / /50% HSA 6600/35 250/10 3T POS 250/10 3T POS - OOA POS 20 and Under $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $918.00

25 Oregon Small Group Exchange Q2 Rates 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Gold Gold Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Gold KP OR Platinum KP OR Gold 1000/35 KP OR Gold 1000/35 KP OR Silver 2000/40 KP OR Platinum 0/20 KP OR Platinum KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/35 KP OR Silver KP OR Silver 3500/40 KP OR Bronze KP OR Bronze KP OR Bronze KP OR Platinum 250/10 3T POS w/vx - KP OR Gold 600/35 3T KP OR Gold 1000/35 3T POS 3T POS- OOA 3T POS w/vx 250/20 w/vx w/vx w/vx w/vx w/vx w/vx w/vx 2600/25% HSA w/vx w/vx 4500/50 w/vx 3800/50% HSA w/vx 6600/35 w/vx 250/10 3T POS w/vx OOA POS w/vx 3T POS w/vx $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $913.00

26 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Gold Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Gold Gold KP OR Silver KP OR Bronze KP OR Platinum KP OR Platinum KP OR Gold 1000/35 KP OR Gold 1000/35 KP OR Silver 2000/40 KP OR Platinum 0/20 KP OR Platinum KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/ /25% HSA KP OR Silver 3500/40 KP OR Bronze 4500/ /50% HSA KP OR Bronze 6600/35 250/10 3T POS 250/10 3T POS KP OR Gold 600/35 3T KP OR Gold 1000/35 3T POS w/altc - 3T POS w/vx - OOA 3T POS w/vx w/altc 250/20 w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc - OOA POS w/altc 3T POS w/altc OOA $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1,286.00

27 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Gold Gold Gold KP OR Silver KP OR Bronze KP OR Platinum KP OR Platinum KP OR Gold 1000/35 KP OR Silver 2000/40 KP OR Platinum 0/20 KP OR Platinum KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/ /25% HSA w/vx KP OR Silver 3500/40 KP OR Bronze 4500/ /50% HSA w/vx KP OR Bronze 6600/35 250/10 3T POS w/vx 250/10 3T POS w/vx KP OR Gold 600/35 3T KP OR Gold 1000/35 3T POS w/vx & ALTC KP OR Silver 2000/40 3T POS w/altc w/vx & ALTC 250/20 w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC & ALTC w/vx & ALTC w/vx & ALTC & ALTC w/vx & ALTC & ALTC & ALTC - OOA POS w/vx & ALTC 3T POS w/vx & ALTC - OOA 3T POS w/vx & ALTC $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $829.00

28 Oregon Small Group Exchange Q3 Rates HIOS ID 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Silver Bronze Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Kaiser Permanente Kaiser Permanente Kaiser Permanente Oregon Standard Gold Oregon Standard Oregon Standard KP OR Platinum KP OR Silver KP OR Bronze KP OR Bronze KP OR Bronze KP OR Platinum KP OR Platinum KP OR Gold 600/35 3T Age Plan Silver Plan Bronze Plan KP OR Platinum 0/20 250/20 KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/ /25% HSA KP OR Silver 3500/ / /50% HSA 6600/35 250/10 3T POS 250/10 3T POS - OOA POS 20 and Under $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $925.00

29 Oregon Small Group Exchange Q3 Rates 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Gold Gold Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Gold KP OR Platinum KP OR Gold 1000/35 KP OR Gold 1000/35 KP OR Silver 2000/40 KP OR Platinum 0/20 KP OR Platinum KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/35 KP OR Silver KP OR Silver 3500/40 KP OR Bronze KP OR Bronze KP OR Bronze KP OR Platinum 250/10 3T POS w/vx - KP OR Gold 600/35 3T KP OR Gold 1000/35 3T POS 3T POS- OOA 3T POS w/vx 250/20 w/vx w/vx w/vx w/vx w/vx w/vx w/vx 2600/25% HSA w/vx w/vx 4500/50 w/vx 3800/50% HSA w/vx 6600/35 w/vx 250/10 3T POS w/vx OOA POS w/vx 3T POS w/vx $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $920.00

30 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Gold Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Gold Gold KP OR Silver KP OR Bronze KP OR Platinum KP OR Platinum KP OR Gold 1000/35 KP OR Gold 1000/35 KP OR Silver 2000/40 KP OR Platinum 0/20 KP OR Platinum KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/ /25% HSA KP OR Silver 3500/40 KP OR Bronze 4500/ /50% HSA KP OR Bronze 6600/35 250/10 3T POS 250/10 3T POS KP OR Gold 600/35 3T KP OR Gold 1000/35 3T POS w/altc - 3T POS w/vx - OOA 3T POS w/vx w/altc 250/20 w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc - OOA POS w/altc 3T POS w/altc OOA $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1,295.00

31 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Gold Gold Gold KP OR Silver KP OR Bronze KP OR Platinum KP OR Platinum KP OR Gold 1000/35 KP OR Silver 2000/40 KP OR Platinum 0/20 KP OR Platinum KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/ /25% HSA w/vx KP OR Silver 3500/40 KP OR Bronze 4500/ /50% HSA w/vx KP OR Bronze 6600/35 250/10 3T POS w/vx 250/10 3T POS w/vx KP OR Gold 600/35 3T KP OR Gold 1000/35 3T POS w/vx & ALTC KP OR Silver 2000/40 3T POS w/altc w/vx & ALTC 250/20 w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC & ALTC w/vx & ALTC w/vx & ALTC & ALTC w/vx & ALTC & ALTC & ALTC - OOA POS w/vx & ALTC 3T POS w/vx & ALTC - OOA 3T POS w/vx & ALTC $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $835.00

32 Oregon Small Group Exchange Q4 Rates HIOS ID 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Silver Bronze Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Kaiser Permanente Kaiser Permanente Kaiser Permanente Oregon Standard Gold Oregon Standard Oregon Standard KP OR Platinum KP OR Silver KP OR Bronze KP OR Bronze KP OR Bronze KP OR Platinum KP OR Platinum KP OR Gold 600/35 3T Age Plan Silver Plan Bronze Plan KP OR Platinum 0/20 250/20 KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/ /25% HSA KP OR Silver 3500/ / /50% HSA 6600/35 250/10 3T POS 250/10 3T POS - OOA POS 20 and Under $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $932.00

33 Oregon Small Group Exchange Q4 Rates 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Gold Gold Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Gold KP OR Platinum KP OR Gold 1000/35 KP OR Gold 1000/35 KP OR Silver 2000/40 KP OR Platinum 0/20 KP OR Platinum KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/35 KP OR Silver KP OR Silver 3500/40 KP OR Bronze KP OR Bronze KP OR Bronze KP OR Platinum 250/10 3T POS w/vx - KP OR Gold 600/35 3T KP OR Gold 1000/35 3T POS 3T POS- OOA 3T POS w/vx 250/20 w/vx w/vx w/vx w/vx w/vx w/vx w/vx 2600/25% HSA w/vx w/vx 4500/50 w/vx 3800/50% HSA w/vx 6600/35 w/vx 250/10 3T POS w/vx OOA POS w/vx 3T POS w/vx $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $927.00

34 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Gold Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Gold Gold KP OR Silver KP OR Bronze KP OR Platinum KP OR Platinum KP OR Gold 1000/35 KP OR Gold 1000/35 KP OR Silver 2000/40 KP OR Platinum 0/20 KP OR Platinum KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/ /25% HSA KP OR Silver 3500/40 KP OR Bronze 4500/ /50% HSA KP OR Bronze 6600/35 250/10 3T POS 250/10 3T POS KP OR Gold 600/35 3T KP OR Gold 1000/35 3T POS w/altc - 3T POS w/vx - OOA 3T POS w/vx w/altc 250/20 w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc w/altc - OOA POS w/altc 3T POS w/altc OOA $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1,305.00

35 71287OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR OR Gold Platinum Platinum Gold Gold Gold Silver Silver Silver Silver Silver Bronze Bronze Bronze Platinum Platinum Gold Gold Gold Gold KP OR Silver KP OR Bronze KP OR Platinum KP OR Platinum KP OR Gold 1000/35 KP OR Silver 2000/40 KP OR Platinum 0/20 KP OR Platinum KP OR Gold 0/30 KP OR Gold 500/20 KP OR Gold 1000/20 KP OR Silver 0/50 KP OR Silver 1500/35 KP OR Silver 2000/ /25% HSA w/vx KP OR Silver 3500/40 KP OR Bronze 4500/ /50% HSA w/vx KP OR Bronze 6600/35 250/10 3T POS w/vx 250/10 3T POS w/vx KP OR Gold 600/35 3T KP OR Gold 1000/35 3T POS w/vx & ALTC KP OR Silver 2000/40 3T POS w/altc w/vx & ALTC 250/20 w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC w/vx & ALTC & ALTC w/vx & ALTC w/vx & ALTC & ALTC w/vx & ALTC & ALTC & ALTC - OOA POS w/vx & ALTC 3T POS w/vx & ALTC - OOA 3T POS w/vx & ALTC $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $1, $ $ $1, $842.00

36 Kaiser Foundation Health Plan of the Northwest Oregon Small Group Medical Small Group Rate Tables and Factors POS Area Factors Note: All members who live in our service area are given an area factor of Oregon All Areas

37 SERFF Tracking #: KFNW State Tracking #: KFNW Company Tracking #: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDST... State: Oregon Filing Company: Kaiser Foundation Health Plan of the Northwest TOI/Sub-TOI: Product Name: Project Name/Number: / H16G Group Health - Major Medical/H16G.003G Small Group Only - Other Small Group Supporting Document Schedules Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Individual and Small Group Health Benefit Plan Rate Filings Product Standard.pdf 3894 Certification of Compliance Certification of Compliance.pdf HBP - Draft notice to policyholder 302SBG OR SBG Renewal letter_final.pdf HBP - Actuarial Memorandum - SG and Individual OR 2016 Small Group Actuarial Memorandum.pdf OR 2016 Small Group Actuarial Memorandum Exhibits.pdf OR 2016 Small Group Actuarial Memorandum Exhibits.xlsx HBP -Exhibit 1: Development of Rate Change Development of Rate Change.pdf HBP - Exhibit 2: Covered Benefit or Plan Design Changes Covered Benefits or Plan Design Changes.pdf PDF Pipeline for SERFF Tracking Number KFNW Generated 05/04/ :25 AM

38 SERFF Tracking #: KFNW State Tracking #: KFNW Company Tracking #: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDST... State: Oregon Filing Company: Kaiser Foundation Health Plan of the Northwest TOI/Sub-TOI: Product Name: Project Name/Number: / Item Status: Status Date: H16G Group Health - Major Medical/H16G.003G Small Group Only - Other Small Group Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: HBP- Exhibit 3:Average Annual Rate Change Summary of Rate Increases.pdf HBP - Exhibit 4: Trend Information and Projection Trend Information and Projection.pdf HBP - Exhibit 5: Statement of Administrative Expenses and Premium Statement of Administrative Expense.pdf HBP - Exhibit 6: Plan Relativities Plan Relativities.pdf HBP - Appendix I: Insurer's Financial Position: Insurer's Financial Position.pdf HBP - Appendix II: Cost Containment and Quality Improvement Efforts Cost Containment and Quality Improvement Efforts.pdf PDF Pipeline for SERFF Tracking Number KFNW Generated 05/04/ :25 AM

39 SERFF Tracking #: KFNW State Tracking #: KFNW Company Tracking #: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDST... State: Oregon Filing Company: Kaiser Foundation Health Plan of the Northwest TOI/Sub-TOI: Product Name: Project Name/Number: / H16G Group Health - Major Medical/H16G.003G Small Group Only - Other Small Group Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Satisfied - Item: Comments: Attachment(s): Item Status: Status Date: Standard Review Questions STANDARD REVIEW QUESTIONS.pdf Unified Rate Review Template Part I Unified Rate Review Data Template.pdf Part I Unified Rate Review Data Template.xlsm 2016 Proposed Small Group Standard Rates 2016 Proposed Small Group Standard Plan Rates.pdf PDF Pipeline for SERFF Tracking Number KFNW Generated 05/04/ :25 AM

40 SERFF Tracking #: KFNW State Tracking #: KFNW Company Tracking #: EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDST... State: Oregon Filing Company: Kaiser Foundation Health Plan of the Northwest TOI/Sub-TOI: Product Name: Project Name/Number: / H16G Group Health - Major Medical/H16G.003G Small Group Only - Other Small Group Attachment OR 2016 Small Group Actuarial Memorandum Exhibits.xlsx is not a PDF document and cannot be reproduced here. Attachment Part I Unified Rate Review Data Template.xlsm is not a PDF document and cannot be reproduced here. PDF Pipeline for SERFF Tracking Number KFNW Generated 05/04/ :25 AM

41 Department of Consumer & Business Services Oregon Insurance Division 5 P.O. Box Winter St. NE Salem, OR Phone (503) Standards for Filing Individual and Small Group Health Benefit Plan Rates This checklist must be submitted with your filing in compliance with OAR (2). These standards are summaries, and review of the entire statute or rule may be necessary. Complete each item to confirm that diligent consideration has been given to each and is certified by the signature on the certification of compliance form. Not applicable can be used only if the item does not apply to the rates being filed. Not including required information may cause this filing to be considered incomplete and returned without review. These standards are subject to change as HHS releases more information. Insurer Name: Date: TOI (type of insurance): H15I Individual Health - Hospital/Surgical/Medical Expense H16G Group Health Major Medical H16I Individual Health Major Medical Sub-TOI: H15I.001- Hospital/Surgical/Medical Expense H16G.001A Any size group PPO H16G.001B Any size group POS H16G.001C Any size group Other H16G.003A Small Group only - PPO H16G.003B Small Group only PPO Basic H16G.003D Small Group only POS H16G.003E Small Group only POS Basic H16G.003G Small Group only Other H16I.005A Individual PPO H16I.005B Individual POS H16I.005C Individual Other Product Type: HMO PPO EPO POS HSA HDHP FFS Other (12/14 INS) 1

42 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # SUBMISSION PACKAGE REQUIREMENTS OAR ORS OAR (2) Required forms are located on SERFF or on our Web site: Paper filings: These items must be submitted with your filing for it to be accepted as complete: NAIC transmittal form Two self addressed stamped envelopes, one in which Insurance Division can return the approved filing Complete copy of the filing on a CD, with each document as a separate PDF If SERFF is not functioning, filing must be submitted by the deadline by one of the following methods: dcbs.ratesforms@state.or.us CD rom (postmarked by due date) Paper filing (postmarked by due date) The filing must be entered into SERFF at the earliest availability OAR (2)(m) Third party filer s letter of authorization Yes N/A Confirm Yes N/A OAR (2)(l) OAR (2) Certification of compliance form signed and dated by an authorized person Product standards (this document) for rates with boxes checked. Confirm Confirm GRANDFATHERED STATUS OAR (2) ORS Grandfathered Plans 45 CFR (A)(B) Part 147 REVIEW REQUESTED ORS (1), OAR (3), ORS , OAR (1) (12/14 INS) 2 Naming convention of all electronic files consistent with the Product Standard Category (left column) attached to the appropriate section in SERFF (Grandfathered and Transitional plans only) Draft letter to consumer advising them of the rate change will be provided before the rate review is complete. Effective for plan years on or after 1/1/2014, filings for Grandfathered status health plans must be pooled separately from Non- Grandfathered status health plans. Each filing must stand alone. The following are submitted in this filing for review (select one): 1. New rate filing 2. Rate change 3. Continued use of existing rates The annual geographic average rate (GAR) filing is satisfied through the inclusion of GARs in the Rate Tables and Factors exhibit. Confirm Yes N/A Confirm Yes No

43 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # FORM NUMBERS ORS A list of policy form numbers to be listed on the Rate/Rule Schedule tab in SERFF. HEALTHCARE REFORM ELEMENTS PPACA Public Law CFR Title 45 Single Risk Pool CFR 45 (A)(B) Part 156 sub part Grandfathered Plans CFR 45 (A)(B) Part 147 sub part Age Banding CFR 45 (A)(B) Part 147 sub part (a)(1)(iii). Per Member Rating CFR 45 (A)(B) Part 147 sub part (c)(1). Composite Rating CFR 45 (A)(B) Part 147 sub part (c)(3). Tobacco Factors Composite Rating CFR 45 (A)(B) Part 147 sub part (a)(iv) (12/14 INS) Alignment of Individual Market All ACA compliant products issued on or after January 1, 2014 may only provide coverage through December 31 of that year. Rates and benefits for the same plan offered in and out of the Exchange must be identical Single Pool Rating: All associations (except student health plans available through a bona fide association) must be included in the base experience Grandfathered plans: Grandfathered plans are not subject to any of the new rating and benefit provisions effective in to 1 Age Banding Rating Restrictions: Age factors will be standardized statewide and will be restricted to a 3 to 1 ratio The federal age factors will be used for small group and individual ACA compliant plans and individual Transitional plans List bill (Individual ACA compliant filings): All individual rates will be priced per member, with a maximum of 3 children under 21 Composite rating (Small Group ACA compliant filings): Per-member build-up of rates is required to determine group aggregate premium based on census at time of quote Standardized tier factors must be used for allocation of group aggregate to group members; changes from current tier factors must be revenue neutral Standardized tier factors: Employee Only: 1.0; Employee + Spouse: 2.0; Employee + Child = 1.85; Family: 2.85 (note that children include all dependent children ages 0 to 25) Tobacco Rating Factors (Individual ACA compliant plans): Tobacco factors may not exceed 1.5 The age band ratio for smokers may not exceed 3 to 1. Children under 18 may not be charged a tobacco load. Confirm Yes N/A

44 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # HEALTHCARE REFORM ELEMENTS Medical Loss Ratio CFR 45 (A)(B) Part 158 sub part B Federal MLR: Rates may not be set such that the anticipated federal MLR is under 80%. When determining reasonability of rates, Oregon does not recognize federal credibility standards in calculation of the Federal MLR Yes N/A Confirm HEALTHCARE REFORM ELEMENTS HEALTHCARE REFORM ELEMENTS The 3 Rs FEDERAL REGULATIONS Insurer Fee CFR 45 (A)(B) Part 156 sub part B (De minimis) CFR 45 (A)(B) Part 156 sub part (a) (Actuarial Value) CFR 45 (A)(B) Part 156 sub part (a) FEDERAL REGULATIONS Public Law (Federal Reinsurance) CFR 45 (A)(B) Part 153 sub part (C) (State Reinsurance) CFR 45 (A)(B) Part 153 sub part (C) Fees and Assessments (General): Fees must reflect an average total cost over the plan year Insurer s Fee: This fee is not considered a deduction for tax purposes The unique tax implications should be added to margin, since they do not reflect explicit costs associated with the health benefit plans Actuarial Value (AV) Calculator: All metal tier plans, both inside and outside the exchange must meet the de minimis range (within 2%) for one of the 4 metal tiers: bronze, silver, gold, platinum Catastrophic plans do not have an AV requirement Actuarial value is determined based on Essential Health Benefits only Where appropriate, the AV calculator should determine the objective differences between plans Where the AV calculator is not appropriate, methodology must be consistent across all plans The AV calculator is not required for determining pricing relativities Reinsurance (Federal and State Supplemental): Use parameters and assessments provided by federal and state regulators Claims adjustments on individual filings must be consistent with average market risk Embedded pediatric dental qualifies for reinsurance Stand alone dental does not qualify for reinsurance Reinsurance payments in the base period experience are inappropriate adjustments for projecting future claims Yes N/A Confirm Yes N/A Confirm (12/14 INS) 4

45 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # FILING DESCRIPTION (Federal Risk Adjustment) CFR 45 (A)(B) Part 153 sub part(s) (D) (Risk Corridor) CFR 45 (A)(B) Part 153 sub part(s) (F) OAR (2)(a) Risk Adjustment Carrier projected claims must be adjusted to reflect average experience for the market Risk adjustment payments in the base period experience are appropriate adjustments for projecting future claims Risk Corridor: Health benefit plans should not be priced to anticipate an impact of the risk corridor program Any findings regarding risk corridor payments will result in adjustments to the approved rates, consistent with the company s business plan. The document labeled FILING DESCRIPTION is submitted in the form of a cover letter summarizing the reasons for rate change and includes: Filing Information: Description of the benefit plan(s) Prior Filing Information: Most recent prior SERFF filing number(s) and approval date(s) Current HIOS Submission Tracking ID Comparison of actual and expected results, including the following: o Projected claims, admin and profit percentages from the prior filing with the rating period that most closely matches the experience period of this filing (Rate Filing Summary, to percentages) o Actual claims, admin, and profit percentages from this filing (Rate Filing Summary, from percentages Quantify primary differences between actual and expected results. Confirm Yes N/A (12/14 INS) 5

46 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # FILING DESCRIPTION OAR (2)(a) Rate Change Summary: Type of rate change request: annual, quarterly, other (explain) Identify the intended duration of rate change request (typically 12 months) Effective dates of all rate change requests, if not annual Confirm average rate change, minimum and maximum rate impact (do not include any impact from demographic shifts) Briefly list key changes in the filing: o Rating factors o New and discontinued plans o Significant benefit changes Filing Impact: Identify the total members, subscribers, and groups affected by this rate filing and source of the counts, typically a snapshot of the most recent enrollment (e.g. members effective July 1,2013) Identify how membership is projected to change between the experience period and rating period, as appropriate: o Anticipated membership on the effective date of the filing o Estimated average membership for the filing period o Projected membership for the end of the rating period, if the proposed premium rate is approved as filed Yes N/A (12/14 INS) 6

47 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # RATE TABLES AND FACTORS OAR (2)(b) (12/14 INS) 7 A document labeled RATE TABLES AND FACTORS that includes: Introduction: Indicate whether the rate changes are the same for all policies If the rate change is not uniform for all policies, clear explanation of how the rate changes apply to different policies o Identify the rate factors that are changing o Refer to table demonstrating a meaningful distribution of rate changes(exhibit 4) Clear instructions, including a calculation, so that any member or group can determine the rates for each benefit plan, each age bracket, each geographic area, each rate tier, and all other variables used to determine rates Cross-reference supporting exhibits: Benefit changes (Exhibit 2), Plan Relativities(Exhibit 6) Identify any rating factors that are not used to develop rates Rate Tables: Rate tables containing, at a minimum, the base rates for each available plan Geographic Average Rate (GAR) table containing family type, geographic area, and average of highest and lowest rates resulting from the application of other rating factors (Small Group only) Rates may vary quarterly based on trend Rate Factors: Tables for all factors not already included in the rate tables: o Age o Tobacco o Family/Rating Tier o Geographic Area The following factors are no longer allowed for plans issued on or after 2014 o Contribution o Participation o Wellness program participation o Duration of in-force coverage o Experience adjustments Identify each rate factor that is changing as a result of this filing o Include the previous rate factors o Calculate the rate impact for each change Yes N/A

48 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # ACTUARIAL MEMORANDUM OAR (2)(c) This is the primary supporting document for the filing and should satisfy both state and federal memorandum requirements. All other supporting documentation should be provided as Exhibits to accompany the memorandum. A document labeled ACTUARIAL MEMORANDUM that includes: Company s Identifying Information: Company Legal Name State: Oregon HIOS Issuer ID Market: Individual or Small Group Effective Date Company Contact Information: Name and contact information of the filer Name and contact information for secondary contact Introduction: Identify the benefit plans impacted by the rate change request Overview of the filing o Identify the base rate increase, as calculated in the Development of Rate Change exhibit. (Exhibit 1) o Quantify the impact of all rate factor changes and whether those changes are revenue neutral, as identified in the Rate Table and Factors exhibit o Quantify any impacts of the changes to the benefit plan, as described in the Covered Benefit Design Changes (Exhibit 2) o Demonstrate the calculation of the average annual rate change (Exhibit 3) Fill out and include Summary of Filed Rating Assumptions (see template) in Actuarial Memorandum. Yes N/A (12/14 INS) 8

49 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # ACTUARIAL MEMORANDUM OAR (2)(c) Discussion: Description of any changes in rating methodology, supported by sufficient detail to permit the division to evaluate the effect on rates Discussion of all assumptions and calculations pertinent to the proposed rate o (Small Group only) If rates vary more frequently than annually, provided information to justify such variation in rates o Provide justification and need for assumptions, identifying relevant sources if the assumption is data driven o Tie together the administrative costs presented in the Development of Rate Change (Exhibit 1) and Statement of Administrative Expenses (Exhibit 5) o Consideration of credibility of calculations and data Demonstrate how projected claims on Exhibit 1 tie to the Index Rate shown on the URRT. Demonstrate starting with the Index rate how the rates for each plan are calculated utilizing network/area, pricing relativity, age factors and admin only. Demonstrate that the anticipated Risk Corridor payments/receipts are zero. We expect use of HHS guidance or generally accepted actuarial principles Mandates: Identify all mandated state and federal changes to the filing including, but not limited to: o New benefits (EHB), including effective dates and pricing methodology o New fees, including implementation and justification o 3 R s : Reinsurance, Risk Adjustment, Risk Corridor o Exchange impacts: fees, reallocation impacts o Impact of cost sharing subsidies on plan pricing o Impact of market changes: Transitional and Small Group Expansion o Guaranteed issue Yes N/A (12/14 INS) 9

50 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # ACTUARIAL MEMORANDUM DEVELOPMENT OF RATE CHANGE OR BASE RATE (Exhibit 1) OAR (2)(c) OAR (2)(d) Certification: Identify that the filing is consistent with the company s internal business plans Confirm all calculations are based on generally accepted actuarial rating principles for rating blocks of business Signature of and date that a qualified actuary reviewed the rate filing Contact information of peer review actuary (Per ASOP #8, definition 2.2, the peer review actuary is also a filing actuary, but Oregon is not requesting a signature from that actuary) Please refer to provided template. A document labeled DEVELOPMENT OF RATE CHANGE OR BASE RATE including : Detailed calculation of how the proposed rate or rate change was determined: o Base period data appropriate for risk pool o All adjustments from base period claims to projected claims o Addition of all expenses and margin to costs o All adjustments from base period premiums to current premiums o Calculation of final required premium and rate increase o Loss ratio demonstrations o Federal MLR calculation Sufficient detail to allow division to review and determine reasonability and actuarial soundness of assumptions, calculations, and estimates o Distinguish between data, assumptions, and calculations o Provide calculated aggregate and PMPM values o Provide all formulas Cross-reference supporting exhibits: Trend (Exhibit 4), Admin (Exhibit 5) Confirm Confirm (12/14 INS) 10

51 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # COVERED BENEFIT OR PLAN DESIGN CHANGES (Exhibit 2) SUMMARY OF RATE INCREASES (Exhibit 3) OAR (2)(e) OAR (2)(f) (12/14 INS) 11 A document labeled COVERED BENEFIT OR PLAN DESIGN CHANGES that: Explains benefit and administrative changes with rating impact, including: o Covered benefit level changes o Member cost-sharing changes o Elimination of plans o Implementation of new plan designs o Provider network changes o New utilization or prior authorization programs o Changes to eligibility requirements o Changes to exclusions o Any other change in the plan offerings that impacts costs or coverage provided o Complete description of plan changes made due to federal healthcare reform including the total premium percentage increase attributed to these changes and a specific breakdown that shows the benefit change and percentage of rate increase for each benefit o Percentage rating impact for each item, as well as the total impact o Members impacted by change Please refer to provided template A document labeled SUMMARY OF RATE INCREASES including: Table showing the following for all effective dates (quarterly for small group, for example): o Effective date o Membership count o Requested average annual rate change o Minimum annual rate impact o Maximum annual rate impact o Rate change from prior effective date (if not annual) If applicable, a table showing a meaningful distribution of rate increases across the entire pool. Estimate the contributing factors to the rate increase: trend, rating changes, margin changes, benefit changes, other Yes N/A Yes N/A

52 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # TREND INFORMATION AND PROJECTION (Exhibit 4) OAR (2)(g) (12/14 INS) 12 A document labeled TREND INFORMATION AND PROJECTION that includes: Presentation of all significant variables of trend by these categories, if used. o Utilization trend o Cost trends by major service category, with a distribution of claims Hospital Physician Pharmacy Other o Deductible leveraging, if not reflected in the Plan Relativity exhibit o Technology/intensity o Other factors (please specify) Cost trends should be supported by known contractual increases in hospital and professional agreements. Support needs to be quantitative and specific. Quantify savings from the reduction of bad debt due to ACA coverage expansion. Show where this savings is reflected in the trend and/or rate development. Mathematical development of the pricing trend used in the Development of Rate Change Historical monthly average allowed claim costs for at least the immediately preceding three years when applicable o This information based on allocated costs if the insurer s structure doesn t include claims cost o Both un-normalized and normalized monthly average claim costs for same period. Claims should be normalized for applicable premium rating factors o Explanation of normalization method used and discussion of impact on trend Notes: Carriers may not include a trend margin, or fluctuation factor in the development of trend. Effective 1/1/2015, underwriting wear-off no longer applies to individual health plans. Yes N/A

53 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # STATEMENT OF ADMINISTRATIVE EXPENSES (Exhibit 5) PLAN RELATIVITIES (Exhibit 6) OAR (2)(h) OAR (2)(i) Please refer to provided template (12/14 INS) 13 A document labeled STATEMENT OF ADMINISTRATIVE EXPENSES including: A chart illustrating a breakdown of the insurer s administrative expenses including: o 5 years of historical data tying to financials o Projected expenses for the filing effective date A detailed breakdown of fees and taxes Target margin for the projected period Total retention for the base period and projected period Reports retention on a percentage of premium basis broken down by operating expenses, commissions, state assessments and tax, and profit Reports retention on a per member per month (PMPM) basis Identify fixed or variable expenses (or a combination of both) Reflect actual assessment of fees (Reinsurance assessment, ACA insurer fee, Exchange fees, other). The cost charge to the premium must cover the cost for that period, and not a projection of expected future fees. A description in plain language of the contributing costs of premium retention o Explanation of the basis for any proposed premium rate increase or decrease related to changes in the administrative expenses o Explanation of how administrative expenses for the filed line of business are allocated o Includes a description of retention retention means the amount to be retained by the insurer to cover all of the insurer s non-claim costs including expected profit or contribution to surplus for a nonprofit entity Please refer to provided template. A document labeled PLAN RELATIVITIES that: Explains the presentation of rates for each benefit plan Explains the methodology used to develop the benefit plan relativities Confirm Confirm

54 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # PLAN RELATIVITIES (Exhibit 6) INSURER S FINANCIAL POSITION (Appendix I) OAR (2)(i) OAR (2)(j) CCIIO has provided an Actuarial Value (AV) calculator to be used to determine the metal tier/level of benefits for each plan. If the AV calculator was not used to determine the metal level for any plan, a supporting exhibit must be included explaining the methodology used to develop the AV. Most, but not all benefit differences, are expected to be priced based on the AV calculator. If the plan relativities differ from the AV (for example, network differences), identify the factors resulting in the difference. Demonstrates the comparison and reasonableness of benefits and costs between plans If a plan includes benefit substitutions that are over 1% of total claims, then data must provide data supporting the calculation. Compares plan relativities to the last filing, when relativities change, including deductible leveraging This exhibit should be identical between the plan filing and the rate filing. The plan name, issuer plan identification number (HIOS plan ID), metal level or catastrophic plan, List of Geographic areas that plan will be offered (1-7) whether the plan will be sold: o inside the Exchange only, (in) o outside the Exchange only. (out) o both inside and outside the Exchange, or (both) Whether or not pediatric dental is embedded (yes/no) A document labeled INSURER S FINANCIAL POSITION that includes: Information about the company s financial position including but not limited to profitability, surplus, reserves, and investment earnings Discussion of whether the proposed change in the premium rate is necessary to maintain the company s solvency or to maintain rate stability and prevent excessive rate increases for the line of business in the future Yes N/A (12/14 INS) 14

55 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # INSURER S FINANCIAL POSITION (Appendix I) COST CONTAINMENT AND QUALITY IMPROVEMENT EFFORTS (Appendix II) STANDARD REVIEW QUESTIONS (Appendix III) OAR (2)(j) OAR (2)(k) Although public documents filed with the department as part of the annual statement or other requisite filings may be referenced in this item, information about the company s profitability, surplus, reserves, and investment earnings must still be included in the Insurer s Financial Position document; if such references are made, include copies of the supporting documents with this filing Specifically provide the following pages from the Annual Statement: o Assets, Liabilities, and Revenue (pages 2-4) o Supplemental Healthcare Exhibit (Part 1, both for business in the State of Oregon and the grant total pages) The last 5 years of RBC and a statement regarding the need for surplus A document labeled COST CONTAINMENT AND QUALITY IMPROVEMENT EFFORTS that: Identifies new health care cost containment efforts and quality improvement efforts since the last rate filing for the same category of health benefit plan, with estimated savings for the projection period Describes significant changes to existing health care cost containment initiatives and quality improvement efforts, with estimated savings for the projection period, savings realized over the prior experience period, and a description of how the company is measuring the impact of its initiatives Includes information about whether the cost containment initiatives reduce costs by eliminating waste, improving efficiency, by improving health outcomes through incentives, or by elimination or reduction of covered services or reduction in the fees paid to providers for services Please refer to provided template. A document labeled STANDARD REVIEW QUESTIONS that answers the questions provided in the template. Yes N/A Confirm Confirm (12/14 INS) 15

56 GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS Category Reference Description of review standards requirements Answers Page # COST AND QUALITY METRICS OREGON HEALTH POLICY BOARD Fill out the following information on the provided template. Confirm CFR 45 (A)(B) Part 158 sub part ORS (5)(f) HIOS URRT SUBMISSION CFR Part CFR Part Provide, for public review, the following metrics, as recommended by the Oregon Health Policy Board: Recommendation to Governor Kitzhaber Utilization per 1,000 members and per member per month costs for o Inpatient Admissions/Days o Outpatient Visits o Emergency Department Visits o Primary Care Visits o Specialty Care Visits o Rx Scripts o Other Claims Quality metrics for CY2013, as reported to the following entities o NCQA: Breast Cancer Screening Comprehensive Diabetes Care: Hemoglobin A1c (HbA1c) Testing o CCO Metrics: Follow-Up After Hospitalization for Mental Illness* Developmental Screening in the First Three Years of Life* CAHPS: Access to Care* All ACA Compliant plans (even off exchange only plans) must be submitted on HIOS when this rate filing is submitted via SERFF. The filing tracking number should be the Rate Filing SERFF Tracking number. The URRT must be updated after the rate filing is approved. Yes N/A Confirm (12/14 INS) 16

57 Department of Consumer & Business Services Oregon Insurance Division Winter St. NE, Rm. 440 Salem, Oregon Phone (503) CERTIFICATE OF COMPLIANCE I, the undersigned authorized filer, hereby certify that the filing submitted complies with the applicable Oregon laws, Oregon Administrative Rules, Oregon Insurance Bulletins and applicable filing requirements and product standards set forth on the Insurance Division s web site and that the filing is not false or misleading in any material respect. I further certify that I am authorized to sign and submit this certificate on behalf of the Company identified below (hereinafter Company). I, the undersigned authorized officer, a duly authorized officer of Company, certify that the undersigned authorized filer is authorized to certify on behalf of Company that this filing complies with the Oregon laws, Oregon Administrative Rules, Oregon Insurance Bulletins and applicable filing requirements and product standards set forth on the Insurance Division s web site and that the filing is not false or misleading in any material respect. I understand that the Oregon Insurance Division will rely on this certificate and, should it be determined that this filing is materially false or misleading, appropriate corrective and disciplinary action including monetary penalties, as authorized by law, will be taken by the Oregon Insurance Division against the Company. Kaiser Foundation Health Plan of the Northwest Name of Company EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDSTD0116, EOSGHDHP0116, EOSGHDHPSTD0116, EOSGTRAD0116 Signature of authorized filer Luke Hampton Print name of authorized filer Sr. Actuarial Associate Title (816) Direct telephone number of authorized filer Toll free or collect phone number Signature of authorized officer and title William R Ely Print name of authorized officer and title Company s filing number or the primary form number for the filing 4/30/2015 Date 500 NE Multnomah St., Suite 100 Address of Company or authorized filer Portland, OR City State ZIP luke.w.hampton@kp.org address of authorized filer (503) Fax number of authorized filer 4/30/2015 Date 4/30/2015 Date

58 Kaiser Foundation Health Plan of the Northwest All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest <Month day, year> <First Name><Last Name> <Group Address 1> <Group Address 2> <City>, <State> <Zip Code> RE: NOTICE OF RENEWAL Group Name: <Group Name> Group Number: <Group Number> Thank you for choosing Kaiser Permanente. The annual renewal of <Group Name>'s contract for benefits with Kaiser Foundation Health Plan of the Northwest (KFHPNW) is <Renewal Date>. For the past 70 years, we ve helped employers like you manage costs, invest in employee health, and build for the future. By partnering with us, you get what other health plans simply can t offer: award-winning coordinated care, a choice of top docs, and unmatched member satisfaction that deliver superior value to you and your employees. KFHPNW has Highest Member Satisfaction among Commercial Health Plans in the Northwest Region, Two Years in a Row, according to the J.D. Power 2014 and 2015 U.S. Member Health Plan Study SM.* KFHPNW is No. 1 in quality and performance among commercial health plans in Oregon and Washington (and No. 5 in the nation), according to the National Committee for Quality Assurance's Private Health Insurance Plan Rankings for Kaiser Permanente primary care doctors and specialists made Portland Monthly s Top Docs & Nurses 2015" more than any other health care organization. This packet includes renewal rates for medical plans designed in accordance with the Affordable Care Act. The enclosure Plan Updates highlights important changes for the new plan. Please read it carefully. Please also review the Renewal Instructions document. Should you choose a plan other than the plan(s) you are automatically renewed on to, the enclosed Renewal Decision Form must be returned and is due no later than the 15th of the month prior to the anniversary date. Thank you for your business. We look forward to helping you and your employees continue to thrive. Please know that I am available to assist you with any questions about this renewal. Sincerely, <AM Signature> <AM Name> <Title> <AM Phone> <AM > *Kaiser Foundation Health Plan of the Northwest received the highest numerical score among commercial health plans in the Northwest region (OR, WA) in the proprietary J.D. Power 2014 and 2015 U.S. Member Health Plan Study SM. Study based on 31,543 total member responses, measuring eight plans in the northwest region (excludes Medicare and Medicaid). Proprietary study results are based on experiences and perceptions of members surveyed November-December Your experiences may vary. Visit jdpower.com. NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA s Healthcare Effectiveness Data and Information Set (HEDIS ) is the most widely used performance measurement tool in health care. Kaiser Permanente Building 500 NE Multnomah St., Suite 100 Portland, OR SBG-15/ Kaiser Foundation Health Plan of the Northwest

59 Kaiser Foundation Health Plan of the Northwest State of Oregon 2016 Small Group Rate Filing HIOS Issuer ID HIOS Product ID 71287OR043, 71287OR044 Form Numbers EOSG3TPOSDED0116, EOSGDED0116, EOSGDEDSTD0116, EOSGHDHP0116, EOSGHDHPSTD0116, EOSGTRAD0116 Actuarial Memorandum I, Luke Hampton, Sr. Actuarial Associate for Kaiser Foundation Health Plan of the Northwest (KFHP) am a member of the American Academy of Actuaries. I meet the qualification standards for certifying Regulatory Filings for Rates and Financial Projections for Health Plans. This Actuarial Certification applies to the attached filing for an approval of premium rates for Small Groups sold on and off the exchange. This actuarial memorandum documents the assumptions and sources of data pertaining to the development of KFHP premium rates for all quarters of This rate filing is to be effective beginning 1/1/2016. This rate filing applies to forms that are open to new sales. KFHP offers traditional HMO copayment plans covering medical and pharmacy claims expenses. KFHP also offers Point of Service (POS), Deductible and High Deductible plans, some of which are HSA qualified. A list of plans that are impacted by this filing can be found in exhibit 7 and the average annual rate change can be seen in exhibit 11. I am the primary contact for submission of this filing. My telephone number is and my address is luke.w.hampton@kp.org. The secondary contact is Robert Pickard. His address is robert.s.pickard@kp.org and his phone number is Part I Unified Rate Review Template Benefit Categories: The benefit categories in Section II of Worksheet I are mapped based on type of service and place of treatment codes. For example: Benefit Category Inpatient Hospital Outpatient Hospital Professional Other Medical Capitation Prescription Drug Services Inpatient Facility, Inpatient Visits (Rounding), Inpatient Surgery - Non Maternity, Maternity Outpatient Facility, Emergency/Urgent Care, Hospital Outpatient Other Professional, Outpatient Surgery Diagnostic Services, Office Visits, Cardiovascular, Chemotherapy/Pharmacy, Dialysis, PT/OT/ST Other Services None Pharmacy

60 Morbidity and Other Adjustments: The Other Adjustment in Section II Worksheet I contains an adjustment to include the cost of essential health benefits not included in the base experience. Paid to Allowed Ratio: The projected 2016 paid to allowed ratio is calculated as the average benefit relativity (effective plan design adjustment). The average benefit relativity accounts for the projected member distribution across the available plans. The development of the benefit relativities is discussed under the AV Pricing Values section later in this document. The same methodology is used to calculate the 2014 experience period paid to allowed ratio. Projected Incurred Claims The projected incurred claims in worksheet 1 of the URRT is within 0.5% of the projected incurred claims in exhibit 1. We believe this is an acceptable difference given rounding and the two different methodologies used to develop the projected incurred claims. Membership Projections: The total membership projection included across the plans in Section II of Worksheet two is developed based on KFHP s current membership and assumes half of the members in the 51 to 100 pool will move to small group. It is assumed that the 51 to 100 population that moves to the small group market will enroll across plans with the same distribution as the current small group population. An assumption is made in Worksheet 2 as to the distribution of members by product. Terminated Plans: The list of terminated plans that are included in the column Terminated Plans in Worksheet II of the URRT are listed in Exhibit 3. Proposed Rate Increases We are proposing an average rate increase of -10.6%. Note that not all groups will receive a rate increase of exactly -10.6% as changes in group s demographics and benefits impact a group s change in rates. Exhibit 1 reflects this rate change. Experience Period Claims Base period data: The Revenue Requirement for 2016 for the renewing ACA plans is developed by accumulating medical and administrative expenses for essential health benefits (EHB) for non-grandfathered business in the Small Group line of business incurred in the period January 2014 through December 2014 and paid through January 2015, including incurred but not reported estimates. Net cost data from internal cost systems (i.e., the cost for medical services delivered within our integrated delivery system), fee for service claims, and prescription drug claims are aggregated to determine paid claims. For the experience period, allowed claims are calculated based on paid claims divided by the paid to allowed ratio as discussed in the Paid to Allowed Ratio section in this document. Detail on the experience period data can be seen in exhibit 4.

61 Incurred but not Reported Estimates: Incurred but not reported expense was estimated using completion factors developed based on an analysis of actual claims lag for the Oregon small group portfolio for internal and external claims incurred from Jan to Dec and paid thru January Index Rate The development of the index rate is summarized in Exhibit 2. The following factors have been considered in the development and are documented below. Additional EHBs These are EHB that are not included in the experience period data. More detail on these can be found in exhibit 8. Utilization adjustment: Allowed claims are grossed up for anticipated changes in the average utilization of services due to average cost sharing requirements in the base period. Member cost sharing results in lower utilization and, thus, lower allowed costs, than would otherwise occur in a zero cost share environment. Age Normalization: Base period claims experience is normalized for age for the non-grandfathered population. An average age factor was derived by applying 2014 member months to the CMS age factors. Members that are excluded from the rate calculation due to the 3 child limit are not included in the age normalization. The allowed claims are then divided by this factor to adjust to a 21 year-old level since the 21 year-old factor is The development of the average age factor is shown in Exhibit 5. Trend: The future trend numbers are based on actuarial judgment considering a mixture of expected industry trends, future fixed costs, and expected internalization of services (i.e., movement of medical care delivery from contracted external providers to our integrated delivery system). As an integrated health care provider, a large portion of KFHP's expenses are the fixed costs associated with providing medical care through our facilities. Therefore, the projected cost that is included in our total revenue requirement is largely based on budgeting. For traditional carriers, projected claims trends are developed to project expected costs. However, given KFHP's fixed cost structure, KFHP's projected claims trends stem from the development of projected budgeted costs. For 2014 to 2016, our projected total annual internal medical expense trend for Small Group is 3.0%. Change in Morbidity: The index rate is adjusted to reflect the risk adjustment payments anticipated in the rating period based on the expected risk profile relative to the market. This adjustment has been based on a study of risk score profiles for the Oregon small group market that was performed by a national actuarial firm. The index rate has been adjusted to reflect the change in morbidity that the merger of the 51 to 100 population will cause. The difference in allowed claims after normalization for differences in demographic were used. Detail can be found in exhibit 6.

62 Plan Factor Development The rates for specific plans are calculated by multiplying plan factors times the index rate. The plan factors use industry standard data in a model from a national actuarial consulting firm, calibrated to KFHP Experience to calculate the impact of the various cost share and plan elements for EHBs, including the impact on utilization of benefit differences.. The reference plan used as the basis for the AV pricing values is a $0 cost share plan valued using the same industry standard factors described above. Exhibit 10 indicates the portion of the AV Pricing Value (allowable modifiers) that is attributable to each of the allowable modifiers to the Index Rate. The modifiers include adjustments for non-ehbs and administrative expenses. Also, the Cost-Sharing Design adjustment (shown in more detail in Exhibit 7) reflects both member cost shares (Effective Plan Design) and the resulting dampening of expected utilization (Utilization Adjustment) due to these cost shares. In the case of POS plans the allowable modifiers also reflects the impact of network differences between the various tiers, and non-pos factors include a small adjustment to lower their expected cost from the overall average network level KFHP will not be rating for tobacco usage for Small Group. Age Factors The age factor table used to develop age specific rates is the standard table provided by CMS. Non-EHB An adjustment has been made to the base period allowed amount to remove the Non-EHB benefits from the Index Rate. This multiplier was calculated by summing the allowed amount for Non-EHB benefits in the base period and dividing by total allowed. The cost of additional non-ehb benefits are included as well based on specific benefits for each plan. Specifically, as a general pattern, KFHP 2016 small group plans are developed with four different types of non-ehb packages: a version without any non-ehbs, a version with vision benefits, a version with alternative care benefits, or a version with both vision and alternative care benefits. Detail on the non EHBs can be found in exhibit 8. Administrative Expense Retention includes broker commissions, administrative expenses and capital contribution. Commissions are paid to Brokers of Record. The capital contribution is an amount to maintain and expand medical center facilities where members receive the majority of health care in the integrated delivery system. In other health care delivery models, capital contributions are included in fee for service payments whereas for KFHP, these are funded through premium rates. Exhibit 9 contains a buildup of retention. Rate Factors There are no changes to the rating factors. Quarterly Rate Factors Quarterly rate factors have been applied to develop base rates for 2 nd, 3 rd and 4 th quarter 2016 effective dates. These adjustments are based on an annual trend of 3.0%. KFHP reserves the right to amend this filing with new quarterly factors based on emerging experience and other subsequent events.

63 Profit and Risk Margin We are projecting a capital contribution of 3.0%. This meets our long term objectives for capital contribution from the small group line of business and is consistent with our internal business plan. Taxes and Fees Administrative expense has been adjusted to reflect the PCORI tax and insurer tax that will apply in The amount is shown as a percentage in Exhibit 9. Summary Rate Calculation Exhibit 2 shows the development of the Index Rate from the experience period Medical Cost Data. The final 2016 rates by plan and age are developed by applying plan factors, non-ehb benefit costs and admin expense to the index rate to get a plan specific PMPMs. The plan specific PMPMs are multiplied by the age slope to generate age specific rates. Exhibit 10 show how plan specific rate are derived from the index rate in exhibit 2. Projected Loss Ratio We anticipate an MLR based on federally prescribed methodology to be at least 80.4%, based on a target admin percentage of 19.6%, which includes a 3.0% capital contribution margin, Exhibit 12 shows our projected MLR based on the federal methodology. Projected Risk Corridor Calculation5 Based on a target admin percentage of 19.6% we do not expect to trigger a risk corridor payment or credit. Exhibit 13 shows our projected risk corridor calculation. Credibility This block of business is considered 100% credible. Mandates State and Federal Changes There are no mandated federal or state changes included in this filing. AV Metal Values The AV Metal Values were developed based on the CMS Actuarial Value calculator, with an adjustment for four plans, as described in 45 CFR Part 156, The KP OR Platinum 0/20, KP OR Platinum 0/20 w/vx, KP OR Platinum 0/20 w ALTC and KP OR Platinum 0/20 w VX & ALTC are unique benefit designs because the outpatient facility cost is a dollar copay, which the AV Calculator does not accept. To calculate the impact on the actuarial value of the plan for this benefit we used the alternate method described in (b)(2). Using a national average allowed amount for outpatient facility costs, we compared the copay amount to the allowed amount to calculate the implied coinsurance percentage. This coinsurance should only be applied to the outpatient facility cost and not the outpatient professional cost, which should be covered at 100%. Warning Alerts. There is a warning alert in row 54 and 56 on sheet 2 of the URRT due to $0.00 being entered for the plan adjusted index rate for the terminated plans as prescribed in the instructions. Entering $0.00 for the plan adjusted index rate while there is membership associated with the terminated plans lowers the average PMPM in row 54 which in turn lowers the total premium in row 56.

64 Exhibit Table of Contents: The following exhibits are included in this filing: Exhibit 1 Development of Rate Change Exhibit 2 Index Rate Development Exhibit 3 Terminated Plans Exhibit 4 Historical Experience Exhibit 5 Average Age Factor Exhibit 6 Change in Morbidity Exhibit 7 Allowable Modifiers Exhibit 8 Additional EHB & Non EHB Exhibit 9 Buildup of Administrative Expense Exhibit 10 Plan Adjusted Index Rate Development Exhibit 11 Summary of Filed Rating Assumptions Exhibit 12 Minimum Loss Ratio Exhibit 13 Projected Risk Corridor Calculation Certification This filing is in conformity with all applicable Actuarial Standards of Practice, including ASOP No. 8. To the best of my knowledge, the rating methodologies of KFHP Foundation Health Plan of the Northwest and the development of the Index Rate comply with the applicable State and Federal Statutes and Regulations (45 CFR (d)(1). The percent of total premium that represents essential health benefits included in Worksheet 2, Sections III and IV were calculated in accordance with actuarial standards of practice. The index rate and only the allowable modifiers as described in 45 CFR (d) (1) and 45 CFR (d) (2) were used to generate plan level rates. The rating methodologies produce premiums that are reasonable in relation to benefits being provided and the populations being covered and are based on sound and commonly accepted actuarial principles and are neither excessive nor deficient. The federal AV Calculator was used to determine the AV Metal Values shown in Worksheet 2 of the Part I Unified Rate Review Template for all plans. The development of the Federal actuarial value is based on the acceptable alternative method outlined in (b)(2) for those benefits that deviate substantially from the parameters of the AV Calculator and have a material impact on the AV. Luke Hampton, ASA, MAAA Sr. Actuarial Associate Kaiser Foundation Health Plan of the Northwest 4/30/2015 Peer Review Actuary Robert Pickard, FSA, MAAA robert.s.pickard@kp.org Actuarial Manager Kaiser Foundation Health Plan of the Northwest 4/30/2015

65 DEVELOPMENT OF RATE CHANGE Company Name: Market: Effective Date: Kaiser Foundation Health Plan of the Northwest Market: Small Group Exhibit 1 Exhibit 1 Development of Rate Change Experience Period (from Jan 2014 to Dec 2014) Rating Period (from Jan 2016 to Dec 2016) Experience: Total PMPM % of Revenue ( A ) Experience Period Member Months 97,855 na na Data ( B ) Expected Member Months in the Rating Period 137,244 na na Data ( C ) Experience Period Premium $38,475,934 $ % Data ( D ) Experience Period Completed Incurred Claims $30,349,993 $ % Data ( E ) Adjustments (Explain) -$331, $ % Data ( F ) Adjusted Incurred Claims $30,018,828 $ % Data Experience Period Medical Loss Ratio 78.9% na na Calculation Claims development: Total PMPM % of Revenue Adjusted Incurred Claims ( F ) $30,018,828 $ % Data ( G ) Benefit Adjustments $247,441 $ % Assumption ( H ) Plan Adjustments $464, $ % ( I ) Network Adjustments $ % ( J ) Morbidity Adjustments -$1,973, $ % Assumption ( K ) Average Market Risk Adjustment $ % ( L ) Pricing Trend $ % ( M ) Months of Trend 24 na na Calculation ( N ) Trend Factor na na Assumption ( O ) Reinsurance Recoveries: State $ % ( P ) Reinsurance Recoveries: Federal $ % ( Q ) Projected Incurred Claims $30,508,429 $ % Calculation Admin Development Total PMPM % of Revenue ( R ) Administrative Expenses $7,671, % Assumption ( S ) Commissions $1,802, % Assumption ( T ) Taxes and Fees $824, % Data ( U ) Total Administrative Costs 2 $10,297, % Premium development Total PMPM % of Revenue ( V ) Experience Period Premium ( C ) $38,475,934 $ Calculation ( W ) Adjustments for Approved Rate Changes $43,362,378 $ Calculation ( X ) Adjusted Earned Premium 3 $54,729,181 $ Calculation Proposed Base Rate Development: Total PMPM % of Revenue ( Y ) Projected Incurred Claims $42,788,808 $ % Calculation ( U ) Total Administrative Costs $10,297, % Calculation ( Z ) Margin / Profit $1,642, % Calculation ( AA ) Required Revenue $54,729,181 $ % Calculation ( AB ) Requested Base Rate $54,729,181 $ % Calculation ( AC ) Requested Q1 Rate Increase -$6,087,601 -$ % Calculation Target Medical Loss Ratio 78.18% Calculation Federal MLR Calculation 80.43% Calculation

66 Kaiser Foundation Health Plan of the Northwest Market: Small Group Exhibit 2 Index Rate Development - Summary Projected Index Rate Development 1 Base Period Allowed $ Data 2 Non-EHB Claims Adjustment Data 3 Experience Period Index Rate $ Calculation 4 Additional EHB Assumption 5 Annualized Trend 3.0% Assumption 6 Months of Trend 24 Data 7 Trend Factor Calculation 8 Change in Morbidity Assumption 9 Gradient Calculation 10 Change in Util Calculation 11 Projected Period Index Rate - Base Data $ Calculation Base Rate Development - Reference Plan Adjustments to the Projected Index Rate 12 Risk Adjustment Assumption 13 Reinsurance/Risk Adj Fee Assumption 14 Supp Reins Fee Assumption 14 Exchange Fee Assumption 14 Market Adjusted Index Rate $ Calculation 14 Util Impact Assumption 15 Base Rate for Reference Plan $ Calculation Normalized Base Rate 1 Base Rate for Reference Plan $ Calculation 2 Tobacco Normalization Assumption 3 Demographic Normalization Assumption 4 Area Normalization Assumption 5 Normalized Base Rate $ Calculation

67 Kaiser Foundation Health Plan of the Northwest Market: Small Group Terminated Plan Listing Exhibit 3 HIOS ID Discontinued 2015 Plan Mapped 2016 Plan 71287OR KP OR Bronze 3500/50 KP OR Silver 3500/ OR KP OR Bronze 3500/50 w/vx & ALTC KP OR Silver 3500/40 w/vx & ALTC 71287OR KP OR Bronze 5000/60 HSA w/ VX & ALTC Kaiser Permanente Oregon Standard Bronze Plan 71287OR KP OR Silver 2000/40 2T POS KP OR Silver 2000/40 3T POS 71287OR KP OR Bronze 4500/50 2T POS KP OR Silver 2000/40 3T POS 71287OR KP OR Silver 2000/40 2T POS w/vx & ALTC KP OR Silver 2000/40 3T POS w/vx & ALTC 71287OR KP OR Bronze 4500/50 2T POS w/vx & ALTC KP OR Silver 2000/40 3T POS w/vx & ALTC 71287OR KP OR Gold 600/35 3T POS - OOA KP OR Gold 1000/35 3T POS- OOA 71287OR KP OR Gold 600/35 3T POS w/vx & ALTC - OOA KP OR Gold 1000/35 3T POS w/vx & ALTC - OOA 71287OR KP OR Bronze 4500/50 3T POS- OOA KP OR Gold 1000/35 3T POS- OOA 71287OR KP OR Bronze 4500/50 3T POS w/vx & ALTC - OOA KP OR Gold 1000/35 3T POS w/vx & ALTC - OOA 71287OR KP OR Silver 2000/40 3T POS - OOA KP OR Gold 1000/35 3T POS- OOA 71287OR KP OR Silver 2000/40 3T POS w/vx & ALTC - OOA KP OR Gold 1000/35 3T POS w/vx & ALTC - OOA

68 Kaiser Foundation Health Plan of the Northwest Market: Small Group Historical Experience Exhibit 4 Small Group 51 to 100 Entire Pool Member Months 97, , ,446 Average Members 8,155 9,299 17,454 Premium $ $ $ Paid and Incurred* $ $ $ IBNR $6.70 $7.01 $6.86 Completed Allowed Claims $ $ $ Relation to Base Pop Paid Claims $ $ $ Administrative Expense $78.12 $62.97 $70.05 G/L $4.92 $26.86 $16.61 Gross Loss Ratio 78.88% 76.80% 77.78%

69 Kaiser Foundation Health Plan of the Northwest Market: Small Group Exhibit 5 Average Age Factor Age Bracket Demo Distribution of Members Age Bracket Demo % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % % Total % Distribution of Members Age Adj Factor = 1/avg demo factor Note The members excluded in the rate calculation due to the 3 child limit have have been excluded from the average age adjustment. This is the reason the sum of the distribution of members is not 100%.

70 Kaiser Foundation Health Plan of the Northwest Market: Small Group Change in Morbidity Calculation Exhibit 6 1) SG Member Months for ,855 2) SG Allowed Experience for 2014 $ ) Avg Demo Factor ) SG Demo Adj Exp $ ) 51 to 100 Member Months for ,591 6) 51 to 100 Allowed Experience for 2014 $ ) Avg Demo Factor ) 51 to 100 Demo Adj Exp $ ) % of 51 to 100 Moving into SG 50.0% 10) Combined Member Months for ,651 11) Combined Allowed Experience for 2014 $ ) Impact of 51 to 100 (= line 11 / line 4) ) SG Morbidity to SG Total Market ) Change in morbidity Factor (=Line 12 / Line 13) 0.934

71 Kaiser Foundation Health Plan of the Northwest Market: Small Group Exhibit 7 Allowable Modifiers Allowable Modifiers (A) (B) (D) (E) (F) 2016 Utilization Effective Plan Cost Sharing Federal AV Projected Plans Name Adjustment Design Design 1 Value Membership 1 Kaiser Permanente Oregon Standard Gold Plan Kaiser Permanente Oregon Standard Silver Plan Kaiser Permanente Oregon Standard Bronze Plan KP OR Platinum 0/ KP OR Platinum 250/ KP OR Gold 0/ ,037 7 KP OR Gold 500/ KP OR Gold 1000/ KP OR Silver 0/ KP OR Silver 1500/ KP OR Silver 2000/ KP OR Silver 2600/25% HSA KP OR Silver 3500/ KP OR Bronze 4500/ KP OR Bronze 3800/50% HSA KP OR Bronze 6600/ KP OR Platinum 250/10 3T POS KP OR Platinum 250/10 3T POS - OOA KP OR Gold 600/35 3T POS KP OR Gold 1000/35 3T POS KP OR Gold 1000/35 3T POS- OOA KP OR Silver 2000/40 3T POS KP OR Platinum 0/20 w/vx KP OR Platinum 250/20 w/vx KP OR Gold 0/30 w/vx KP OR Gold 500/20 w/vx KP OR Gold 1000/20 w/vx KP OR Silver 0/50 w/vx KP OR Silver 1500/35 w/vx KP OR Silver 2000/35 w/vx KP OR Silver 2600/25% HSA w/vx KP OR Silver 3500/40 w/vx KP OR Bronze 4500/50 w/vx KP OR Bronze 3800/50% HSA w/vx KP OR Bronze 6600/35 w/vx KP OR Platinum 250/10 3T POS w/vx KP OR Platinum 250/10 3T POS w/vx - OOA KP OR Gold 600/35 3T POS w/vx KP OR Gold 1000/35 3T POS w/vx KP OR Gold 1000/35 3T POS w/vx - OOA KP OR Silver 2000/40 3T POS w/vx KP OR Platinum 0/20 w/altc KP OR Platinum 250/20 w/altc KP OR Gold 0/30 w/altc KP OR Gold 500/20 w/altc KP OR Gold 1000/20 w/altc KP OR Silver 0/50 w/altc KP OR Silver 1500/35 w/altc KP OR Silver 2000/35 w/altc KP OR Silver 2600/25% HSA w/altc KP OR Silver 3500/40 w/altc KP OR Bronze 4500/50 w/altc KP OR Bronze 3800/50% HSA w/altc KP OR Bronze 6600/35 w/altc KP OR Platinum 250/10 3T POS w/altc KP OR Platinum 250/10 3T POS w/altc - OOA KP OR Gold 600/35 3T POS w/altc KP OR Gold 1000/35 3T POS w/altc KP OR Gold 1000/35 3T POS w/altc - OOA KP OR Silver 2000/40 3T POS w/altc KP OR Platinum 0/20 w/vx & ALTC KP OR Platinum 250/20 w/vx & ALTC KP OR Gold 0/30 w/vx & ALTC KP OR Gold 500/20 w/vx & ALTC KP OR Gold 1000/20 w/vx & ALTC KP OR Silver 0/50 w/vx & ALTC KP OR Silver 1500/35 w/vx & ALTC KP OR Silver 2000/35 w/vx & ALTC KP OR Silver 2600/25% HSA w/vx & ALTC KP OR Silver 3500/40 w/vx & ALTC KP OR Bronze 4500/50 w/vx & ALTC KP OR Bronze 3800/50% HSA w/vx & ALTC KP OR Bronze 6600/35 w/vx & ALTC KP OR Platinum 250/10 3T POS w/vx & ALTC KP OR Platinum 250/10 3T POS w/vx & ALTC - OOA KP OR Gold 600/35 3T POS w/vx & ALTC KP OR Gold 1000/35 3T POS w/vx & ALTC KP OR Gold 1000/35 3T POS w/vx & ALTC - OOA KP OR Silver 2000/40 3T POS w/vx & ALTC Average Value Cost Sharing Design = Product(Effective Plan Design, Utilization Adjustment)

72 Kaiser Foundation Health Plan of the Northwest Market: Small Group Additional EHB & Non EHB Exhibit 8 EHB's not included in Experience Period Pediatric vision $0.91 Pediatric hearing aid $0.19 Total $ Plans in Exp Period 40% Experience Period Index Rate Total Non EHB Adjustment Adult Vision Exam $3.26 Vision Hardwear $3.74 Chiropractic Treatment $0.54 Alt Care Rider $5.14 Base Rate Medical Plan $ Vision Alt Care Vision and AltCare 1.033

73 Kaiser Foundation Health Plan of the Northwest Market: Small Group Exhibit 9 Buildup of Administrative Expense % (1) Base Period Admin $ Fees Reinsurance Fee $5.25 OR Supplemental Reinsurance $4.00 Insurer Fee $2.80 Risk adj user Fee $0.08 Pcori $0.17 Commissions $13.13 Net Admin $52.69 (2) Trend 3.0% (3) Months of Trend 24 (4) Trend Factor (5) Trended Admin $55.90 (5) = (1) x (4) (5) Commissions $13.13 (6) Insurer Tax (.86%) 0.86% (7) PCORI $0.17 (8) Margin 3.00% a. Base Rate - Reference Plan $ b. Avg Cost-Sharing Adjustment 74.5% (9) c. Network Adjustment 100.0% d. Non EHB Adj 101.5% e. Avg Plan Specific Rate net of retention $ (9)e = (9)a x (9)b x (9)c x (9)d (10) Admin Load 26.9% (10) = (1+ ((5)+(7))/(9E))/(1-(6)-(8)-(9))-1

74 Kaiser Foundation Health Plan of the Northwest Market: Small Group Exhibit 10 Plan Adjusted Index Rate Development Allowable Modifiers (A) (B) (C) (D) (E) (F) (G) (H) (G) (H) Market Adjusted Index Calibrated Market Rate (100% Age Curve Plan Adjusted Provider Adjusted Index Plan Paid Provider Impact of Non- Cost Sharing Plan Adjusted Calibration Area Curve Index Rate Plan Metal Level Name Network Rate Basis) Network EHB Design 1 Admin Index Rate (Average Age) Calibration (Base Rate) 1 Gold Kaiser Permanente Oregon Standard Gold Plan HMO Silver Kaiser Permanente Oregon Standard Silver Plan HMO Bronze Kaiser Permanente Oregon Standard Bronze Plan HMO Platinum KP OR Platinum 0/20 HMO Platinum KP OR Platinum 250/20 HMO Gold KP OR Gold 0/30 HMO Gold KP OR Gold 500/20 HMO Gold KP OR Gold 1000/20 HMO Silver KP OR Silver 0/50 HMO Silver KP OR Silver 1500/35 HMO Silver KP OR Silver 2000/35 HMO Silver KP OR Silver 2600/25% HSA HMO Silver KP OR Silver 3500/40 HMO Bronze KP OR Bronze 4500/50 HMO Bronze KP OR Bronze 3800/50% HSA HMO Bronze KP OR Bronze 6600/35 HMO Platinum KP OR Platinum 250/10 3T POS POS Platinum KP OR Platinum 250/10 3T POS - OOA POS Gold KP OR Gold 600/35 3T POS POS Gold KP OR Gold 1000/35 3T POS POS Gold KP OR Gold 1000/35 3T POS- OOA POS Silver KP OR Silver 2000/40 3T POS POS Platinum KP OR Platinum 0/20 w/vx HMO Platinum KP OR Platinum 250/20 w/vx HMO Gold KP OR Gold 0/30 w/vx HMO Gold KP OR Gold 500/20 w/vx HMO Gold KP OR Gold 1000/20 w/vx HMO Silver KP OR Silver 0/50 w/vx HMO Silver KP OR Silver 1500/35 w/vx HMO Silver KP OR Silver 2000/35 w/vx HMO Silver KP OR Silver 2600/25% HSA w/vx HMO Silver KP OR Silver 3500/40 w/vx HMO Bronze KP OR Bronze 4500/50 w/vx HMO Bronze KP OR Bronze 3800/50% HSA w/vx HMO Bronze KP OR Bronze 6600/35 w/vx HMO Platinum KP OR Platinum 250/10 3T POS w/vx POS Platinum KP OR Platinum 250/10 3T POS w/vx - OOA POS Gold KP OR Gold 600/35 3T POS w/vx POS Gold KP OR Gold 1000/35 3T POS w/vx POS Gold KP OR Gold 1000/35 3T POS w/vx - OOA POS Silver KP OR Silver 2000/40 3T POS w/vx POS Platinum KP OR Platinum 0/20 w/altc HMO Platinum KP OR Platinum 250/20 w/altc HMO Gold KP OR Gold 0/30 w/altc HMO Gold KP OR Gold 500/20 w/altc HMO Gold KP OR Gold 1000/20 w/altc HMO Silver KP OR Silver 0/50 w/altc HMO Silver KP OR Silver 1500/35 w/altc HMO Silver KP OR Silver 2000/35 w/altc HMO Silver KP OR Silver 2600/25% HSA w/altc HMO Silver KP OR Silver 3500/40 w/altc HMO Bronze KP OR Bronze 4500/50 w/altc HMO Bronze KP OR Bronze 3800/50% HSA w/altc HMO Bronze KP OR Bronze 6600/35 w/altc HMO Platinum KP OR Platinum 250/10 3T POS w/altc POS Platinum KP OR Platinum 250/10 3T POS w/altc - OOA POS Gold KP OR Gold 600/35 3T POS w/altc POS Gold KP OR Gold 1000/35 3T POS w/altc POS Gold KP OR Gold 1000/35 3T POS w/altc - OOA POS Silver KP OR Silver 2000/40 3T POS w/altc POS Platinum KP OR Platinum 0/20 w/vx & ALTC HMO Platinum KP OR Platinum 250/20 w/vx & ALTC HMO Gold KP OR Gold 0/30 w/vx & ALTC HMO Gold KP OR Gold 500/20 w/vx & ALTC HMO Gold KP OR Gold 1000/20 w/vx & ALTC HMO Silver KP OR Silver 0/50 w/vx & ALTC HMO Silver KP OR Silver 1500/35 w/vx & ALTC HMO Silver KP OR Silver 2000/35 w/vx & ALTC HMO Silver KP OR Silver 2600/25% HSA w/vx & ALTC HMO Silver KP OR Silver 3500/40 w/vx & ALTC HMO Bronze KP OR Bronze 4500/50 w/vx & ALTC HMO Bronze KP OR Bronze 3800/50% HSA w/vx & ALTC HMO Bronze KP OR Bronze 6600/35 w/vx & ALTC HMO Platinum KP OR Platinum 250/10 3T POS w/vx & ALTC POS Platinum KP OR Platinum 250/10 3T POS w/vx & ALTC - OOA POS Gold KP OR Gold 600/35 3T POS w/vx & ALTC POS Gold KP OR Gold 1000/35 3T POS w/vx & ALTC POS Gold KP OR Gold 1000/35 3T POS w/vx & ALTC - OOA POS Silver KP OR Silver 2000/40 3T POS w/vx & ALTC POS Average Value See Exhibit 7 for development. 2 Network Design = Adjustment of the pricing AV to account for provider contracting.

75 Kaiser Foundation Health Plan of the Northwest Market: Small Group Exhibit 11 Summary of Filed Rating Assumptions 2016 Non-Grandfathered, ACA Compliant Plans Rating Assumption Kaiser Permanente of the Northwest Starting Point 2014 Small Group Experience Projected Member Months 137,244 Morbidity Changes 96.1% Market Merger Impact 97.2% Pent-up Demand 0.0% Bad Debt Adjustments 0.0% Net State, Federal Reinsurance Impact & User Adj 100.8% Risk Adjustment/Average Market Risk Impact 0.0% Risk Corridor Impact 0.0% 2015 Net Paid Claims PMPM (prior filing) $ Net Paid Claims PMPM $ Average Annual Rate Change -10.6%

76 Kaiser Foundation Health Plan of the Northwest Market: Small Group Exhibit 12 Minimum Loss Ratio Premium Buildup PMPM Formula Net Claims PMPM $ (1) Administrative Expenses Quality Improvement 4.11 (2) All Other Admin $64.92 (3) Total (4) Taxes/Fees Exchange Fee $0.00 (5) ACA Health Insurer Tax $3.43 (8) PCORI $0.17 (9) Risk Adjustment User Fee $0.15 (10) Total $3.75 (11) 3R's Federal Reinsurance Contribution $2.25 (12) Federal Reinsurance Receivable $0.00 (13) Risk Adjustment Result $0.00 (14) Risk Corridor Contribution $0.00 (15) Risk Corridor Receivable $0.00 (16) Total $2.25 (17) Risk Margin $ (18) Total Premium PMPM $ (19) = (1)+(4)+(11)+(17)+(18) Traditional Loss Ratio 78.75% (20) = [ (1)+ (17) ] / (19) ACA MLR 80.43% (21) = [ (1)+(2)+(13)+(14) ] / [ (19)-(11)-(12) ]

77 Kaiser Foundation Health Plan of the Northwest Market: Small Group Exhibit 13 Projected Risk Corridor Calculation Component PMPM Formula (1) Premium $ Exhibit 12, row (19) (2) After Tax Premium $ (1) - (17) (3) Incurred Claims $ Exhibit 12, row (1) (4) IBNR $0.00 Assumption (5) Net Risk Adjustment $0.15 Exhibit 12, rows (13) and (14) (6) Net Reinsurance $2.25 Exhibit 12, summation of rows (9) to (12) (7) Claim Costs $ Summation of (3) to (6) (8) Claim Costs $ (7) (9) Quality Expenses $0.00 Assumption (10) IT $0.00 Assumption (11) Allowable Costs $ Summation of (8) to (10) (12) Premium $ (1) (13) Allowable Costs $ (11) (14) Non-Claim Costs $72.78 Exhibit 12, rows (13) and (19) (15) Profits $11.85 Maximum of [(12) - (13) - (14), 3% of (2)] (16) Non-Claim Costs $72.78 (14) (17) Taxes and Fees $3.75 Exhibit 12, row (19) (18) Administrative Costs $69.03 (16) - (17) (19) Taxes and Fees $3.75 (17) (20) Admin Costs +Profit $79.03 Minimum of [ (15) + (18), 20% of (2) ] (21) Allowable Admin Costs $82.79 (19) + (20) (22) Premium $ (1) (23) Allowable Admin Costs $82.79 (21) (24) Target Amount $ (22) - (23) (25) Allowable Costs $ (11) (26) Target Amount $ (24) (27) Risk Corridor Ratio 99.43% (11) / (24)

78 DEVELOPMENT OF RATE CHANGE Company Name: Market: Effective Date: Kaiser Foundation Health Plan of the Northwest Market: Small Group Exhibit 1 Exhibit 1 Development of Rate Change Experience Period (from Jan 2014 to Dec 2014) Rating Period (from Jan 2016 to Dec 2016) Experience: Total PMPM % of Revenue ( A ) Experience Period Member Months 97,855 na na Data ( B ) Expected Member Months in the Rating Period 137,244 na na Data ( C ) Experience Period Premium $38,475,934 $ % Data ( D ) Experience Period Completed Incurred Claims $30,349,993 $ % Data ( E ) Adjustments (Explain) -$331, $ % Data ( F ) Adjusted Incurred Claims $30,018,828 $ % Data Experience Period Medical Loss Ratio 78.9% na na Calculation Claims development: Total PMPM % of Revenue Adjusted Incurred Claims ( F ) $30,018,828 $ % Data ( G ) Benefit Adjustments $247,441 $ % Assumption ( H ) Plan Adjustments $464, $ % ( I ) Network Adjustments $ % ( J ) Morbidity Adjustments -$1,973, $ % Assumption ( K ) Average Market Risk Adjustment $ % ( L ) Pricing Trend $ % ( M ) Months of Trend 24 na na Calculation ( N ) Trend Factor na na Assumption ( O ) Reinsurance Recoveries: State $ % ( P ) Reinsurance Recoveries: Federal $ % ( Q ) Projected Incurred Claims $30,508,429 $ % Calculation Admin Development Total PMPM % of Revenue ( R ) Administrative Expenses $7,671, % Assumption ( S ) Commissions $1,802, % Assumption ( T ) Taxes and Fees $824, % Data ( U ) Total Administrative Costs 2 $10,297, % Premium development Total PMPM % of Revenue ( V ) Experience Period Premium ( C ) $38,475,934 $ Calculation ( W ) Adjustments for Approved Rate Changes $43,362,378 $ Calculation ( X ) Adjusted Earned Premium 3 $54,729,181 $ Calculation Proposed Base Rate Development: Total PMPM % of Revenue ( Y ) Projected Incurred Claims $42,788,808 $ % Calculation ( U ) Total Administrative Costs $10,297, % Calculation ( Z ) Margin / Profit $1,642, % Calculation ( AA ) Required Revenue $54,729,181 $ % Calculation ( AB ) Requested Base Rate $54,729,181 $ % Calculation ( AC ) Requested Q1 Rate Increase -$6,087,601 -$ % Calculation Target Medical Loss Ratio 78.18% Calculation Federal MLR Calculation 80.43% Calculation

79 Covered Benefit Level Changes Vision exams are no longer covered for renewing plans that do not cover vision hardwear. The impact on premium is -1.0% for these plans. Member Cost Sharing Changes Please see the table labeled "Summary of 2015=>2016 Cost-Sharing Changes" on the 2nd page of this exhibit for a summary of cost share changes. Please see the table labeled "Price Impact of Benefit Changes" on the 3rd page of this exhibit to see the impact on premium and number of members impacted. Elimination of Plans The following plans have been eliminated. HIOS ID Discontinued 2015 Plan 71287OR KP OR Bronze 3500/ OR KP OR Bronze 3500/50 w/vx & ALTC 71287OR KP OR Bronze 5000/60 HSA w/ VX & ALTC 71287OR KP OR Silver 2000/40 2T POS 71287OR KP OR Bronze 4500/50 2T POS 71287OR KP OR Silver 2000/40 2T POS w/vx & ALTC 71287OR KP OR Bronze 4500/50 2T POS w/vx & ALTC 71287OR KP OR Gold 600/35 3T POS - OOA 71287OR KP OR Gold 600/35 3T POS w/vx & ALTC - OOA 71287OR KP OR Bronze 4500/50 3T POS- OOA 71287OR KP OR Bronze 4500/50 3T POS w/vx & ALTC - OOA 71287OR KP OR Silver 2000/40 3T POS - OOA 71287OR KP OR Silver 2000/40 3T POS w/vx & ALTC - OOA Implementation of New Plan Designs The following is a list of new plan. Plan ID Marketing Name Plan ID Marketing Name 71287OR KP OR Silver 3500/ OR KP OR Platinum 0/20 w/altc 71287OR KP OR Bronze 3800/50% HSA 71287OR KP OR Platinum 250/20 w/altc 71287OR KP OR Bronze 6600/ OR KP OR Gold 0/30 w/altc 71287OR KP OR Platinum 250/10 3T POS 71287OR KP OR Gold 500/20 w/altc 71287OR KP OR Platinum 250/10 3T POS - OOA 71287OR KP OR Gold 1000/20 w/altc 71287OR KP OR Gold 1000/35 3T POS 71287OR KP OR Silver 0/50 w/altc 71287OR KP OR Gold 1000/35 3T POS- OOA 71287OR KP OR Silver 1500/35 w/altc 71287OR KP OR Silver 2000/40 3T POS 71287OR KP OR Silver 2000/35 w/altc 71287OR KP OR Platinum 0/20 w/vx 71287OR KP OR Silver 2600/25% HSA w/altc 71287OR KP OR Platinum 250/20 w/vx 71287OR KP OR Silver 3500/40 w/altc 71287OR KP OR Gold 0/30 w/vx 71287OR KP OR Bronze 4500/50 w/altc 71287OR KP OR Gold 500/20 w/vx 71287OR KP OR Bronze 3800/50% HSA w/altc 71287OR KP OR Gold 1000/20 w/vx 71287OR KP OR Bronze 6600/35 w/altc 71287OR KP OR Silver 0/50 w/vx 71287OR KP OR Platinum 250/10 3T POS w/altc 71287OR KP OR Silver 1500/35 w/vx 71287OR KP OR Platinum 250/10 3T POS w/altc - OOA 71287OR KP OR Silver 2000/35 w/vx 71287OR KP OR Gold 600/35 3T POS w/altc 71287OR KP OR Silver 2600/25% HSA w/vx 71287OR KP OR Gold 1000/35 3T POS w/altc 71287OR KP OR Silver 3500/40 w/vx 71287OR KP OR Gold 1000/35 3T POS w/altc - OOA 71287OR KP OR Bronze 4500/50 w/vx 71287OR KP OR Silver 2000/40 3T POS w/altc 71287OR KP OR Bronze 3800/50% HSA w/vx 71287OR KP OR Silver 3500/40 w/vx & ALTC 71287OR KP OR Bronze 6600/35 w/vx 71287OR KP OR Bronze 3800/50% HSA w/vx & ALTC 71287OR KP OR Platinum 250/10 3T POS w/vx 71287OR KP OR Bronze 6600/35 w/vx & ALTC 71287OR KP OR Platinum 250/10 3T POS w/vx - OOA 71287OR KP OR Platinum 250/10 3T POS w/vx & ALTC 71287OR KP OR Gold 600/35 3T POS w/vx 71287OR KP OR Platinum 250/10 3T POS w/vx & ALTC - OOA 71287OR KP OR Gold 1000/35 3T POS w/vx 71287OR KP OR Gold 1000/35 3T POS w/vx & ALTC 71287OR KP OR Gold 1000/35 3T POS w/vx - OOA 71287OR KP OR Gold 1000/35 3T POS w/vx & ALTC - OOA 71287OR KP OR Silver 2000/40 3T POS w/vx 71287OR KP OR Silver 2000/40 3T POS w/vx & ALTC Provider Network Changes na New Utilization or Prior Authorization Changes na Changes to Exclusion na Any Other changes in Offering That Impact Cost or Coverage Provided na Changed Due to Federal Healthcare Reform na

80 Summary of 2015=>2016 Cost-Sharing Changes Plan KP OR PLATINUM 0/20 KP OR PLATINUM 250/20 KP OR GOLD 0/30 KP OR GOLD 500/20 KP OR GOLD 1000/20 KP OR KAISER SILVER 0/50 PERMANENTE OREGON STANDARD GOLD PLAN KP OR SILVER 1500/35 KP OR Silver 2000/35 KAISER PERMANENTE OREGON STANDARD SILVER PLAN KP OR Silver 2600/25% HSA KP OR Silver 3500/40 KP OR BRONZE 4500/50 KAISER PERMANENTE OREGON STANDARD BRONZE PLAN Year Ded/OOPM Accumulation Agg/Agg=>Em Agg/Agg=>Emb/Emb b/emb Family Deductible 2600=> =>5200 Individual Deductible 1300=> 1750=>2600 $1,250 Drug Deductible 0=>200 Out-of-Pocket Family 8000=> => => => => => =>13700 Out-of-Pocket Individual 4000=> => => => => => =>6850 Ambulance Services 20% 20% 30% AD=>25% AD AD=>25% AD AD=>40% AD DME & P&O 20% 20% 30% AD=>25% AD AD=>25% AD AD=>40% AD Emergency room 20% 20% 30% AD=>25% AD AD=>25% AD AD=>40% AD Inpatient $300/day 20% 20% 30% $1500 max admit=>$300/d ay $1500 max/ admit AD=>25% AD AD=>25% AD AD=>40% AD 20% 20% 30% CT/MRI/PET AD=>25% AD AD=>25% AD AD=>40% AD Outpatient Surgery 20% 20% 30% AD=>25% AD AD=>25% AD AD=>40% AD (OV) PCP 30=>35 50=>40 KP OR GOLD 600/35 3T Tier 1 KP OR GOLD 600/35 3T Tier 2 KP OR GOLD 600/35 3T Tier 3 (Prev) Preventive (all inclusive) (OV) Specialty 40=>50 45=>50 70=>50 60=>$60 AD Generic $20 AD=>20 Brand 75=>40 Non-Preferred Brand 0.5=>0.3 Specialty 150=> => => => => => =>0.5 30% AD=>50% AD 150=>0.5 Therapies $30 AD=>30 $30 AD=>30 $30 AD=>30 $40 AD=>50 $45 AD=>50 60=>50 $45 AD=>45 $70 AD=>70 (OV) Mental Health/Substance Abuse OV Urgent Care Skilled Nursing (60 visits per year) 40=>20 30=>35 50=>40 50=>$60 AD $100 AD=>$60 AD 20% 20% AD=>25% AD AD=>25% AD 70=>$70 AD 30% AD=>40% AD Plan Coinsurance 0.2=> => % AD=> =>0.4 What does not apply to the Ded: HSA qualified ADMD 20% INFO INFT MAT OVIJ OVVX $300/day $1500 max admit=>$300/d ay $1500 max/ admit 20=>Not Covered 20=>Not Covered 30=>Not Covered 20=>Not Covered 50=>Not Covered AD=>25% AD 20% AD=>25% AD 20% 20% AD=>25% AD AD=>25% AD 30=>Not Covered 35=>Not Covered 25% AD=>Not Covered 50=>Not Covered 30% AD=>40% AD 30% AD=>40% AD 50=>Not Covered 35=>Not Covered 60=>Not Covered 0.5=>Not Covered

81 Kaiser Foundation Health Plan of the Northwest Oregon Small Group Plans Price Impact of Benefit Changes for Plans with Modifications 2015 Plans Members Impacted Cost Sharing Design Non-EHB Network Combine d Factor 2016 Plans Cost Sharing Design Non-EHB Network Combine d Factor Pricing Relativity Change Justification of Modification KP OR Gold 1300/20 STANDARD Kaiser Permanente Oregon Standard Gold Plan % Plan Design Dictated by OR KP OR Silver 2500/35 STANDARD Kaiser Permanente Oregon Standard Silver Plan % Plan Design Dictated by OR KP OR Bronze 5000/60 HSA STANDARD Kaiser Permanente Oregon Standard Bronze Plan % Plan Design Dictated by OR KP OR Platinum 0/ KP OR Platinum 0/ % Change w/in +/-2% KP OR Platinum 250/ KP OR Platinum 250/ % Change w/in +/-2% KP OR Gold 0/ KP OR Gold 0/ % Change w/in +/-2% KP OR Gold 500/ KP OR Gold 500/ % Change w/in +/-2% KP OR Gold 1000/ KP OR Gold 1000/ % Change w/in +/-2% KP OR Silver 0/ KP OR Silver 0/ % Change w/in +/-2% KP OR Silver 1500/ KP OR Silver 1500/ % Changes needed to maintain metal tier KP OR Silver 2000/ KP OR Silver 2000/ % Changes needed to maintain metal tier KP OR Silver 1750/25% H.S.A KP OR Silver 2600/25% HSA % Changes needed for new HSA rules KP OR Bronze 4500/ KP OR Bronze 4500/ % Changes needed to maintain metal tier KP OR Gold 600/35 3T POS KP OR Gold 600/35 3T POS % Change w/in +/-2% KP OR Platinum 0/20 w/vx & ALTC KP OR Platinum 0/20 w/vx & ALTC % Change w/in +/-2% KP OR Platinum 250/20 w/vx & ALTC KP OR Platinum 250/20 w/vx & ALTC % Change w/in +/-2% KP OR Gold 0/30 w/vx & ALTC KP OR Gold 0/30 w/vx & ALTC % Change w/in +/-2% KP OR Gold 500/20 w/vx & ALTC KP OR Gold 500/20 w/vx & ALTC % Change w/in +/-2% KP OR Gold 1000/20 w/vx & ALTC KP OR Gold 1000/20 w/vx & ALTC % Change w/in +/-2% KP OR Silver 0/50 w/vx & ALTC KP OR Silver 0/50 w/vx & ALTC % Change w/in +/-2% KP OR Silver 1500/30 w/vx & ALTC KP OR Silver 1500/35 w/vx & ALTC % Changes needed to maintain metal tier KP OR Silver 2000/35 w/vx & ALTC KP OR Silver 2000/35 w/vx & ALTC % Changes needed to maintain metal tier KP OR Silver 1750/25% H.S.A w/vx & ALTC KP OR Silver 2600/25% HSA w/vx & ALTC % Changes needed for new HSA rules KP OR Bronze 4500/50 w/vx & ALTC KP OR Bronze 4500/50 w/vx & ALTC % Changes needed to maintain metal tier KP OR Gold 600/35 3T POS w/vx & ALTC KP OR Gold 600/35 3T POS w/vx & ALTC % Change w/in +/-2% 4/30/2015 Price Impact of Bft Change Covered Benefits or Plan Design Changes.xlsx

82 AVERAGE ANNUAL RATE CHANGE Company Name: Kaiser Foundation Health Plan Market: Small Group Effective Date: 1/1/ Rate Effective Date Requested Annual Rate Change From Last Effective Date Minimum Rate Change Maximum Rate Change Renewing Members January % % -4.66% 2,091 April (small group only) % % -4.62% 1,345 July (small group only) % % -5.39% 2,466 October (small group only) % % -6.56% 563 Total % % -4.62% 6,464 Exhibit 3 Distribution of rate changes (across all effective dates) Rate increase Distribution Members LT -20% 0% 0-20% to -15% 1% 85-15% to -10% 58% % to -5% 41% 2644 GT -5% 0% 0 Estimate of Contributing Factors in Rate Request Contributing Factors Magnitude of Impact Trend -4.2% Improvement in Paid/Allowed -4.9% OID 2015 Adjustment -1.2% Administrative expenses 4.3% Profit 3.1% Taxes/Fees -2.7% Change in Benefits 0.6% Change in age/area distribution 0.0% Mandates 0.0% Morbidity -2.8% Quarterly Adjustment -0.6% Other -2.4% Total -10.6%

83 Kaiser Foundation Health Plan of the Northwest Oregon Small Group Trend Information and Projection Member Experience (pmpm) Average Plan Factors Normalization of Allowed YYYYMM Months Premium Net_Med_Cost Allowed Net_Admin UW Margin Demo Factor Adj. PF - Util 1 Demo Factor Utilization Comb $ $ $ $49.96 $ $ $ $ $ $ $ $46.92 ($29.56) $ $ $ $ $ $ $48.99 ($3.40) $ $ $ $ $ $ $49.96 $ $ $ $ $ $ $ $51.70 ($13.30) $ $ $ $ $ $ $48.65 $ $ $ $ $ $ $ $46.46 $ $ $ $ $ $ $ $50.13 ($38.87) $ $ $ $ $ $ $47.93 $ $ $ $ $ $ $ $57.22 ($22.30) $ $ $ $ $ $ $54.50 $ $ $ $ $ $ $ $61.11 $ $ $ $ $ $ $ $47.39 $ $ $ $ $ $ $ $46.55 $ $ $ $ $ $ $ $50.02 $ $ $ $ $ $ $ $50.55 $ $ $ $ $ $ $ $52.25 $ $ $ $ $ $ $ $47.17 $ $ $ $ $ $ $ $50.81 $ $ $ $ $ $ $ $51.06 $ $ $ $ $ $ $ $52.10 $ $ $ $ $ $ $ $52.67 ($67.96) $ $ $ $ $ $ $51.52 $ $ $ $ $ $ $ $57.47 $ $ $ $ $ $ $ $62.96 ($33.12) $ $ $ $ $ $ $59.58 $ $ $ $ $ $ $ $67.24 ($0.65) $ $ $ $ $ $ $59.89 $ $ $ $ $ $ $ $64.67 ($7.11) $ $ $ $ $ $ $63.83 $ $ $ $ $ $ $ $66.81 $ $ $ $ $ $ $ $59.84 ($9.77) $ $ $ $ $ $ $70.80 $ $ $ $ $ $ $ $66.29 $ $ $ $ $ $ $ $71.72 $ $ $ $ $ $ $ $73.63 ($11.96) $ $ $ OD - 4/30/2015 Trend Information and Projection.xlsx

84 Kaiser Foundation Health Plan of the Northwest Oregon Small Group Trend Information and Projection Trend Methodology Rolling 12 Month Analysis - Prior to Normalization Normalized Allowed End Month Paid Allowed Net_Admin Demo Utilization Comb % -5.7% -0.6% -6.2% -5.9% -6.4% % -5.4% 2.3% -5.9% -5.5% -6.0% % -3.9% 4.5% -4.4% -3.9% -4.4% % -3.0% 7.2% -3.4% -2.9% -3.3% % -3.6% 8.6% -4.0% -3.5% -3.9% % -2.6% 10.5% -3.0% -2.5% -2.8% % -1.7% 13.5% -2.0% -1.6% -1.8% % -1.4% 15.3% -1.5% -1.3% -1.4% % 0.5% 16.5% 0.6% 0.6% 0.7% % -1.4% 18.8% -1.2% -1.5% -1.2% % -5.6% 21.9% -5.1% -5.8% -5.3% % -6.4% 25.7% -5.7% -6.8% -6.1% % -4.7% 29.2% -3.8% -5.2% -4.4% Ave. 1.7% -3.4% 13.3% -3.5% -3.5% -3.6% excl. hi and lo 1.7% -3.5% 13.2% -3.6% -3.6% -3.7% Cost Trend Used We reviewed our monthly 12-month trends for net medical costs and net administrative expenses. Additionally allowed medical cost trend was reviewed after normalizing for changes in demographic factor and plan factor, shown in the table labeled Average Plan Factors above. The column headed plan factor is a measure of the change in benefits richness by month The historical allowed medical cost trend normalized for demographics and utilization is summarized on a rolling 12 month basis in the table above. Average rolling 12 month trend is -3.5% for allowed claims normalized for both demographics and utilization. The trend amounts amounts chosen for the projections (i.e. 3.0% for both medical and admin) are based on this review, also taking into consideration apparent outliers, KFHPNW's overall cost trend, and other factors such as anticipated increases in procedural intensity. These trend assumptions would be comparable to trend assumptions for Medicare and Medicaid as the medical delivery system serving all these segments is the same. No cost shifting from Medicare or Medicaid is included in the above cost figures and resulting trend. KFHPNW is part of an integrated care delivery system, therefore the bulk of our claims costs are based on the actual cost of delivering the services and not affected by changes in hospital and professional agreements. Additional factors such as durational data are not directly considered as part of trend analysis. An adjustment for bad debt has not been made to trend. We looked at the change in bad debt levels andit appears an adjustment was not warranted as uncompensated care increased in We are lowering our rating trend from 5% to 3% though. OD - 4/30/2015 Trend Information and Projection.xlsx

85 STATEMENT OF ADMINISTRATIVE EXPENSES Company Name: Market: Effective Date: Exhibit 5 Expenses Fixed or 2015 Fixed or Current Filing period PMPM PMPM PMPM PMPM PMPM Variable PMPM % of Premium Variable PMPM % of Premium Salaries, Wages, Employment Taxes & Other Benefits $27.88 $27.07 $24.48 $30.60 $45.97 Variable $ % Variable $ % Cost Depreciation: equipment, software, furniture, etc. $0.14 $0.12 $0.06 $0.14 $0.01 Variable $ % Variable $ % Rent (Occupancy) $1.40 $1.22 $0.86 $1.05 $1.63 Variable $ % Variable $ % Marketing & Advertising $0.98 $1.38 $1.24 $1.95 $2.31 Variable $ % Variable $ % General Office Expenses: sundries, supplies, telephone, printing, postage, etc. $7.62 $6.58 $5.86 $6.02 $0.68 Variable $ % Variable $ % Third Party Administration Expenses or Fees or Other Group Service Expense or Fees $0.24 $0.86 $0.67 $0.79 $1.44 Variable $ % Variable $ % Legal Fees and Expenses & Other Professional or Consulting Fees $8.07 $7.52 $6.15 $5.29 $0.50 Variable $ % Variable $ % Traveling Expenses $0.15 $0.15 $0.12 $0.16 $0.16 Variable $ % Variable $ % Total Expenses Incurred $46.48 $44.90 $39.43 $46.01 $52.69 $ % $ % Premium Retention Fixed or 2015 Fixed or Current Filing period PMPM PMPM PMPM PMPM PMPM Variable PMPM % of Premium Variable PMPM % of Premium Expenses (from above table) $46.48 $44.90 $39.43 $46.01 $52.69 Variable $ % Variable $ % Commissions $6.95 $6.26 $4.86 $5.35 $13.13 Variable $ % Variable $ % Insurer Fee $0.00 $0.00 $0.00 $0.00 $2.80 Variable $ % Variable $ % Risk Adjustment Program Fee $0.00 $0.00 $0.00 $0.00 $0.08 Fixed $ % Fixed $ % Oregon Supplemental Reinsurance program fee $0.00 $0.00 $0.00 $0.00 $4.00 Fixed $ % Fixed $ % HCR - Funding of Patient-Centered Outcomes Research Fee $0.00 $0.00 $0.02 $0.10 $0.17 Fixed $ % Fixed $ % ACA Federal Reinsurance Fee $0.00 $0.00 $0.00 $0.00 $5.25 Fixed $ % Fixed $ % Oregon Exchange Fee $0.00 $0.00 $0.00 $0.00 $0.00 Variable $ % Variable $ % Profit/Margin $ % Total Premium Retention $53.43 $51.16 $44.31 $51.46 $78.12 $ % $ % Note The Federal reinsurance fee and risk adjustment program fee are included in claims in the summary exhibit and development of admin exhibit which is different than the exhibit above. The commissions shows in 2013 and prior are from our annual statement which allocates commissions evenly across all line of business while commissions in 2014 and later are SG specific. Impact on Premium Administrative expenses are projected to increase and cause a 4.8% increase in premium. Allocation of Admin Expenses Some of the expenses (rent, travel expense, cost depreciation, Ect) are a according to the annual statement while line specific expenses such as commissions, federal reinsurance, PCORI, ect are allocated directly to the small group line of business. Description of Retention Retention means the amount to be retained by the insurer to cover all of the insurers non-claims costs including expected contribution to surplus.

86 Kaiser Permanente of the Northwest Small group Effective 01/01/2016 Previous Plan Actuarial % change in plan Identify quarter Benefit Geographic Areas Pediatric Dental Plan ID Marketing Name Metal Tier AV Calculator Used Filing Plan Plan Relativity Exchange Status Value relativity and year Substitution(s) Offered Embedded Relativity 71287OR Kaiser Permanente Oregon Standard Gold Plan Gold Yes Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR Kaiser Permanente Oregon Standard Silver Plan Silver Yes Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR Kaiser Permanente Oregon Standard Bronze Plan Bronze Yes Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Platinum 0/20 Platinum Yes Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Platinum 250/20 Platinum Yes Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Gold 0/30 Gold Yes Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Gold 500/20 Gold Yes Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Gold 1000/20 Gold Yes Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 0/50 Silver Yes Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 1500/35 Silver Yes Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 2000/35 Silver Yes Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 2600/25% HSA Silver Yes Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 3500/40 Silver Yes na na 2016 Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Bronze 4500/50 Bronze Yes Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Bronze 3800/50% HSA Bronze Yes na na 2016 Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Bronze 6600/35 Bronze Yes na na 2016 Q1 n/a In & Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Platinum 250/10 3T POS Platinum Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Platinum 250/10 3T POS - OOA Platinum Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Gold 600/35 3T POS Gold Yes Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Gold 1000/35 3T POS Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Gold 1000/35 3T POS- OOA Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Silver 2000/40 3T POS Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Platinum 0/20 w/vx Platinum Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Platinum 250/20 w/vx Platinum Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Gold 0/30 w/vx Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Gold 500/20 w/vx Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Gold 1000/20 w/vx Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 0/50 w/vx Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 1500/35 w/vx Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 2000/35 w/vx Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 2600/25% HSA w/vx Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 3500/40 w/vx Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Bronze 4500/50 w/vx Bronze Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Bronze 3800/50% HSA w/vx Bronze Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Bronze 6600/35 w/vx Bronze Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Platinum 250/10 3T POS w/vx Platinum Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Platinum 250/10 3T POS w/vx - OOA Platinum Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Gold 600/35 3T POS w/vx Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Gold 1000/35 3T POS w/vx Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Gold 1000/35 3T POS w/vx - OOA Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Silver 2000/40 3T POS w/vx Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Platinum 0/20 w/altc Platinum Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Platinum 250/20 w/altc Platinum Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Gold 0/30 w/altc Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Gold 500/20 w/altc Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Gold 1000/20 w/altc Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 0/50 w/altc Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 1500/35 w/altc Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 2000/35 w/altc Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 2600/25% HSA w/altc Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 3500/40 w/altc Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Bronze 4500/50 w/altc Bronze Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Bronze 3800/50% HSA w/altc Bronze Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Bronze 6600/35 w/altc Bronze Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Platinum 250/10 3T POS w/altc Platinum Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Platinum 250/10 3T POS w/altc - OOA Platinum Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Gold 600/35 3T POS w/altc Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Gold 1000/35 3T POS w/altc Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Gold 1000/35 3T POS w/altc - OOA Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Silver 2000/40 3T POS w/altc Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Platinum 0/20 w/vx & ALTC Platinum Yes Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Platinum 250/20 w/vx & ALTC Platinum Yes Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Gold 0/30 w/vx & ALTC Gold Yes Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Gold 500/20 w/vx & ALTC Gold Yes Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Gold 1000/20 w/vx & ALTC Gold Yes Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 0/50 w/vx & ALTC Silver Yes Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 1500/35 w/vx & ALTC Silver Yes Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 2000/35 w/vx & ALTC Silver Yes Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 2600/25% HSA w/vx & ALTC Silver Yes Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Silver 3500/40 w/vx & ALTC Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Bronze 4500/50 w/vx & ALTC Bronze Yes Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Bronze 3800/50% HSA w/vx & ALTC Bronze Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Bronze 6600/35 w/vx & ALTC Bronze Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 5, & 6 No 71287OR KP OR Platinum 250/10 3T POS w/vx & ALTC Platinum Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Platinum 250/10 3T POS w/vx & ALTC - OOA Platinum Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Gold 600/35 3T POS w/vx & ALTC Gold Yes Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Gold 1000/35 3T POS w/vx & ALTC Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Gold 1000/35 3T POS w/vx & ALTC - OOA Gold Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No 71287OR KP OR Silver 2000/40 3T POS w/vx & ALTC Silver Yes na na 2016 Q1 n/a Out of Exchange 1, 2, 3, 4, 5, 6, & 7 No Notes we are not including the impact of deductible leveraging in the plan relativity factors.

87 Insurer s Financial Position Kaiser Foundation Health Plan of the Northwest (KFHPNW) 2016 Oregon Rate Filings Kaiser s strategy is focused on sustaining affordable premiums in the marketplace for our high quality health care offering. We strive to be the most affordable and highest quality offering in the market. Our focus in 2016 will be to continue to deliver on this goal. Kaiser Permanente s premium increases are consistently among the lowest in the market. We have accomplished this without sacrificing the high quality, comprehensive care delivered to our membership each and every day. Attached is Kaiser s 2014 annual statutory statement of revenues and expenses, which contains results through year- end 12/31/2013 and 12/31/2014. Net income as a percentage of total revenue was (0.5%) for year-end 2014 and (0.5%) for year-end Kaiser s capital and surplus was $480.1M for year-end 12/31/2013 and $203.2M for year-end 12/31/2014. It should be noted that Kaiser s reserves as recognized by Generally Accepted Accounting Principles (GAAP) include provisions for long-term liabilities related to retirement expenses for our employees. Our net investment income was $32.7M in 2014 and 35.7M in We are holding $52.8M in reserve for unpaid claims and unpaid claims adjustment expense as of December The rate change requested in this filing is needed to keep the line of business within an acceptable range of contribution to surplus and be consistent with our long term business strategy. The table below illustrates our five year history of risk based capital. Year Risk Based Capital 2014 $54,849, $51,378, $45,928, $43,451, $42,346,463

88 ANNUAL STATEMENT FOR THE YEAR 2014 OF THE KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST ASSETS 1 Current Year 2 3 Prior Year 4 Assets Nonadmitted Assets Net Admitted Assets (Cols. 1-2) Net Admitted Assets 1. Bonds (Schedule D) 864,559, ,559, ,278, Stocks (Schedule D): 2.1 Preferred stocks Common stocks Mortgage loans on real estate (Schedule B): 3.1 First liens Other than first liens Real estate (Schedule A): 4.1 Properties occupied by the company (less $ 8,135,803 encumbrances) 202,894, ,894, ,677, Properties held for the production of income (less $ 0 encumbrances) 6,206,918 6,206,918 4,213, Properties held for sale (less $ encumbrances) Cash ($ (1,641,249), Schedule E-Part 1), cash equivalents ($ 0, Schedule E-Part 2) and short-term investments ($ 35,023,434, Schedule DA) 33,382,185 33,382,185 52,628, Contract loans (including $ premium notes) Derivatives (Schedule DB) Other invested assets (Schedule BA) Receivables for securities 0 5, Securities lending reinvested collateral assets (Schedule DL) Aggregate write-ins for invested assets Subtotals, cash and invested assets (Lines 1 to 11) 1,107,042, ,107,042,900 1,055,803, Title plants less $ charged off (for Title insurers only) Investment income due and accrued 3,548,037 3,548,037 3,218, Premiums and considerations: 15.1 Uncollected premiums and agents balances in the course of collection 24,789,274 47,996 24,741,278 26,540, Deferred premiums, agents balances and installments booked but deferred and not yet due (including $ earned but unbilled premiums) Accrued retrospective premiums Reinsurance: 16.1 Amounts recoverable from reinsurers 10,010,642 10,010, Funds held by or deposited with reinsured companies Other amounts receivable under reinsurance contracts Amounts receivable relating to uninsured plans Current federal and foreign income tax recoverable and interest thereon Net deferred tax asset Guaranty funds receivable or on deposit Electronic data processing equipment and software 2,001, ,239 1,083, , Furniture and equipment, including health care delivery assets ($ 69,753,347 ) 70,891,493 1,138,146 69,753,347 62,462, Net adjustment in assets and liabilities due to foreign exchange rates Receivables from parent, subsidiaries and affiliates 51,151,289 51,151,289 39,937, Health care ($ 33,502,502 ) and other amounts receivable 40,020,736 6,518,234 33,502,502 27,858, Aggregate write-ins for other-than-invested assets 7,458,265 7,458, Total assets excluding Separate Accounts, Segregated Accounts and Protected Cell Accounts (Lines 12 to 25) 1,316,914,044 16,080,880 1,300,833,164 1,216,487, From Separate Accounts, Segregated Accounts and Protected Cell Accounts Total (Lines 26 and 27) 1,316,914,044 16,080,880 1,300,833,164 1,216,487,332 DETAILS OF WRITE-INS Summary of remaining write-ins for Line 11 from overflow page Totals (Lines 1101 through 1103 plus 1198) (Line 11 above) Other Non-Admitted Assets 7,458,265 7,458, Summary of remaining write-ins for Line 25 from overflow page Totals (Lines 2501 through 2503 plus 2598) (Line 25 above) 7,458,265 7,458,

89 ANNUAL STATEMENT FOR THE YEAR 2014 OF THE KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST LIABILITIES, CAPITAL AND SURPLUS 1 Covered Current Year 2 Uncovered 3 Total Prior Year 4 Total 1. Claims unpaid (less $ 730,078 reinsurance ceded) 51,641,789 51,641,789 41,905, Accrued medical incentive pool and bonus amounts Unpaid claims adjustment expenses 1,194,769 1,194,769 1,053, Aggregate health policy reserves, including the liability of $ for medical loss ratio rebate per the Public Health Service Act Aggregate life policy reserves Property/casualty unearned premium reserves Aggregate health claim reserves Premiums received in advance 33,018,520 33,018,520 31,446, General expenses due or accrued 20,551,893 20,551,893 21,311, Current federal and foreign income tax payable and interest thereon (including $ on realized capital gains (losses)) Net deferred tax liability Ceded reinsurance premiums payable 903, , Amounts withheld or retained for the account of others 72,963,930 72,963,930 73,140, Remittances and items not allocated Borrowed money (including $ current) and interest thereon $ (including $ current) Amounts due to parent, subsidiaries and affiliates 63,483,355 63,483,355 32,831, Derivatives Payable for securities 996, , Payable for securities lending Funds held under reinsurance treaties (with $ authorized reinsurers, $ unauthorized reinsurers and $ certified reinsurers) Reinsurance in unauthorized and certified ($ ) companies Net adjustments in assets and liabilities due to foreign exchange rates Liability for amounts held under uninsured plans Aggregate write-ins for other liabilities (including $ 49,788,784 current) 852,924, ,924, ,655, Total liabilities (Lines 1 to 23) 1,097,678, ,097,678, ,345, Aggregate write-ins for special surplus funds XXX XXX 28,000, Common capital stock XXX XXX Preferred capital stock XXX XXX Gross paid in and contributed surplus XXX XXX 2,753,051 2,753, Surplus notes XXX XXX Aggregate write-ins for other-than-special surplus funds XXX XXX Unassigned funds (surplus) XXX XXX 172,401, ,389, Less treasury stock, at cost: 32.1 shares common (value included in Line 26 $ ) XXX XXX shares preferred (value included in Line 27 $ ) XXX XXX Total capital and surplus (Lines 25 to 31 minus Line 32) XXX XXX 203,154, ,142, Total liabilities, capital and surplus (Lines 24 and 33) XXX XXX 1,300,833,164 1,216,487,332 DETAILS OF WRITE-INS Pension 407,473, ,473, ,629, Post Retirement 386,153, ,153, ,586, Accrued Taxes 35,491,847 35,491,847 69, Summary of remaining write-ins for Line 23 from overflow page 23,805, ,805,460 23,369, Totals (Lines 2301 through 2303 plus 2398) (Line 23 above) 852,924, ,924, ,655, Health Insurance Provided Fee Payable XXX XXX 28,000, XXX XXX XXX XXX Summary of remaining write-ins for Line 25 from overflow page XXX XXX Totals (Lines 2501 through 2503 plus 2598) (Line 25 above) XXX XXX 28,000, XXX XXX XXX XXX XXX XXX Summary of remaining write-ins for Line 30 from overflow page XXX XXX Totals (Lines 3001 through 3003 plus 3098) (Line 30 above) XXX XXX 0 0 3

90 ANNUAL STATEMENT FOR THE YEAR 2014 OF THE KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST STATEMENT OF REVENUE AND EXPENSES Current Year 1 Uncovered 2 Total Prior Year 3 Total 1. Member Months XXX 5,620,628 5,623, Net premium income (including $ 0 non-health premium income) XXX 2,993,160,516 2,902,846, Change in unearned premium reserves and reserve for rate credits XXX Fee-for-service (net of $ medical expenses) XXX 57,914,713 52,595, Risk revenue XXX 79,525,345 41,558, Aggregate write-ins for other health care related revenues XXX 6,967,128 10,952, Aggregate write-ins for other non-health revenues XXX Total revenues (Lines 2 to 7) XXX 3,137,567,702 3,007,953,433 Hospital and Medical: 9. Hospital/medical benefits 1,400,756,415 1,312,581, Other professional services 335,240, ,307, Outside referrals 143,156, ,836, Emergency room and out-of-area 95,976,067 93,868, Prescription drugs 350,418, ,497, Aggregate write-ins for other hospital and medical 0 580,054, ,110, Incentive pool, withhold adjustments and bonus amounts Subtotal (Lines 9 to 15) 0 2,905,602,878 2,821,201,585 Less: 17. Net reinsurance recoveries 10,740, Total hospital and medical (Lines 16 minus 17) 0 2,894,862,158 2,821,201, Non-health claims (net) Claims adjustment expenses, including $ 24,924,295 cost containment expenses 49,472,744 41,939, General administrative expenses 228,802, ,275, Increase in reserves for life and accident and health contracts (including $ increase in reserves for life only) Total underwriting deductions (Lines 18 through 22) 0 3,173,137,015 3,037,416, Net underwriting gain or (loss) (Lines 8 minus 23) XXX (35,569,313) (29,463,552) 25. Net investment income earned (Exhibit of Net Investment Income, Line 17) 12,960,535 13,650, Net realized capital gains (losses) less capital gains tax of $ 7,513,444 (1,195,796) 27. Net investment gains (losses) (Lines 25 plus 26) 0 20,473,979 12,454, Net gain or (loss) from agents or premium balances charged off [(amount recovered $ 0 ) (amount charged off $ 2,755,131 )] (2,755,131) Aggregate write-ins for other income or expenses 0 2,255,900 2,067, Net income or (loss) after capital gains tax and before all other federal income taxes (Lines 24 plus 27 plus 28 plus 29) XXX (15,594,565) (14,941,651) 31. Federal and foreign income taxes incurred XXX Net income (loss) (Lines 30 minus 31) XXX (15,594,565) (14,941,651) DETAILS OF WRITE-INS Other Health Care Revenue XXX 3,757,275 4,364, Meaningful Use Grant Revenue XXX 3,209,853 6,588, XXX Summary of remaining write-ins for Line 6 from overflow page XXX Totals (Lines 0601 through 0603 plus 0698) (Line 6 above) XXX 6,967,128 10,952, XXX XXX XXX Summary of remaining write-ins for Line 7 from overflow page XXX Totals (Lines 0701 through 0703 plus 0798) (Line 7 above) XXX Medical Office Operation 561,855, ,379, Public & Professional Liability 18,199,488 18,731, Summary of remaining write-ins for Line 14 from overflow page Totals (Lines 1401 through 1403 plus 1498) (Line 14 above) 0 580,054, ,110, Other Revenue 2,255,900 2,067, Summary of remaining write-ins for Line 29 from overflow page Totals (Lines 2901 through 2903 plus 2998) (Line 29 above) 0 2,255,900 2,067,343 4

91 ANNUAL STATEMENT FOR THE YEAR 2014 OF THE KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST STATEMENT OF REVENUE AND EXPENSES (Continued) 1 Current Year 2 Prior Year CAPITAL & SURPLUS ACCOUNT 33. Capital and surplus prior reporting year 480,142, ,710, Net income or (loss) from Line 32 (15,594,565) (14,941,651) 35. Change in valuation basis of aggregate policy and claim reserves Change in net unrealized capital gains (losses) less capital gains tax of $ Change in net unrealized foreign exchange capital gain or (loss) Change in net deferred income tax Change in nonadmitted assets (100,923) (4,238,952) 40. Change in unauthorized and certified reinsurance Change in treasury stock Change in surplus notes Cumulative effect of changes in accounting principles Capital Changes: 44.1 Paid in Transferred from surplus (Stock Dividend) Transferred to surplus Surplus adjustments: 45.1 Paid in Transferred to capital (Stock Dividend) Transferred from capital Dividends to stockholders Aggregate write-ins for gains or (losses) in surplus (261,292,199) 27,612, Net change in capital and surplus (Lines 34 to 47) (276,987,687) 8,431, Capital and surplus end of reporting year (Line 33 plus 48) 203,154, ,142,101 DETAILS OF WRITE-INS Pension - SSAP 102 (141,307,403) 12,843, Post Retirement (119,984,796) 14,768, Summary of remaining write-ins for Line 47 from overflow page Totals (Lines 4701 through 4703 plus 4798) (Line 47 above) (261,292,199) 27,612,334 5

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