The Insurance Mom, brought to you by Alison Gordon Insurance Services, Inc, CA Lic. 0780178

As I told you at the beginning of this actuarial dance, the State’s findings will be different from those of Anthem BC’s.  Et voila!  As a result of the State’s actuarial analysis, the following is hot off the presses:

Commissioner Poizner released the following statement today regarding Anthem’s decision to withdraw its rate filing:

“This is a great victory for California consumers. I’m pleased that California consumers will not face rate hikes of up to 39 percent. In late January, because I was highly skeptical of the rate increase, I ordered an outside review to ensure that Anthem’s filing complied with state law. Anthem agreed to delay their increase pending this review. The independent actuarial analysis found numerous and substantial errors in their filing that would have led to massive and unjustified rate increases.  We notified Anthem of these errors and they admitted to the mistakes.”

The independent, outside actuarial analysis was performed by Axene Health Partners, LLC. The report was conducted over a 10-week period and required 500 hours of work by four licensed actuaries. The summary of the review is available at www.insurance.ca.gov and the entire report is expected to be completed next week.

[Or you can simply read the initial report.]

Based upon a thorough review of Anthem’s calculations, Axene found numerous errors in the methodology used by Anthem to project total lifetime loss ratios. Correcting these errors resulted in lower lifetime loss ratios than initially calculated by Anthem.

The errors identified included:

• Error #1: Double counting of aging in the calculation of underlying medical trend for the projection of total lifetime loss ratio.
• Error #2: Anthem overstated the initial medical trend used to project claims for September 2009 for known risk factors.

Both of these errors are errors of math and not differences in actuarial opinion.