2001 Survey Documentation
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2001 Survey Overview |
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Survey Document |
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Field Definitions |
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Response Summary |
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General Survey Parameters |
2001 Survey Overview
During March and April 2001, MCOL conducted an HMO premium rate survey of agents and employer groups regarding commercial plan premiums quoted or in effect between January 1, 2001 and May 1, 2001.
Every eligible Set of Rates collected from respondents was entered into the MCOL master database for this project as described in our General Survey Parameters.
Respondents were motivated to participate by receiving a copy of the survey results specific for their county, plus an executive report and entry into a prize drawing.
The MCOL master database was then compiled to produce average premium rates for each homogeneous Sets of Rates with identical category information, along with the number of respondent individual Sets of Rates for each average premium rate. This compiled rate database is the client database that has been released.
While the client database is completely available for custom analysis by clients, standard report queries and pre-set excel reports have been created for convenience.
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Click here to to review the on-line employer survey |
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Click here to review the on-line agent survey |
The fields contained in the client database are as follows:
Plan: HMO Name
County: Name of applicable California County
Grp_Sze: The size of group: 1= Individual; 49= Small Group (2-49 eligible employees); 999= Mid Size Group (50-999 eligibles); 1000= Large Group (1,000+ eligibles)
Ben_Lev: The relative level of the plan of benefits: A=Highest; B=High; C=Medium; D=Low; E=Point of Service. Refer to General Parameters for discussion of the benefit level calculation.
Tiers: The number of type of rates contained in each Set of Rates: 2=Two Tier Rates (Single, Family); 3=Three Tier Rates (Single, Couple, Family); 4=Four Tier Rates (Single, Couple, Family, Employee + Child(ren); 5=Five Tier Rates (Single, Couple, Family, Employee + Children, Employee + Child)
Age_Group: The applicable age group that applies to each set of rates: All= not age rated; Age rated rates are categorized as follows: 0-29, 30-39, 40-49, 50-54, 55-59, 60-64, 65+
sng_r: Single Monthly Premium Rate
cpl_r: Couple Monthly Premium Rate (will be $0.00 for 2 Tier Rates)
fam_r: Family Monthly Premium Rate
empch_r: Employee plus Child(ren) Monthly Premium Rate: (will be $0.00 for 2 or 3 Tier Rates)
empchn_r: Employee plus Child Monthly Premium Rate: (will be $0.00 for 2, 3 or 4 Tier Rates)
Click here to review the summary of 2000 survey responses.
Survey participants were assured that their responses would be confidential. As such, individual sets of rates are not included in the survey database released to clients; instead average rates and total responses for each homogeneous set of rates are provided in the client database.
Survey participants included California insurance agents and brokers, benefit consultants, and employer group benefit managers. In addition, plan information was directly obtained for individual plans.
In order for rates to be included in the database, it needed to meet the following criteria:
Sets of Rates are defined as the rate cells and accompanying category information for a tiered plan rate. Each Set of Rates has unique accompanying category information, thus if multiple category information applies (i.e., the group operates in two counties with the same rates, then two sets of rates are entered). An example of one set of rates for a three tiered rate quoted by one plan for one group would be the single rate, couple rate and family rate with accompanying category information. An age rated group with seven age categories would generate seven sets of rates of each plan of benefits. A group receiving a two tiered and three tiered rate quotes would have separate sets of rates for each tier.
The effective dates ranged between 1/01 and 5/01.
County
Each set of plan rates was applied to all applicable counties that a group had
locations in. For example, if a group had locations in Los Angeles and Orange County, and
had plan rates that applied to employees in either county, then the set of rates was
recorded as a response for both counties.
Benefit Level
A Benefit Level was assigned to each set of rates. Point of Service plans were
all assigned to the POS Benefit Level. All non POS plans were assigned benefit
levels based upon the benefit information collected. Three copayment/consinsurance
items were collected for all plan rates: the office visit copayment, the generic drug
copayment, and the inpatient hospital copayment, deductible or coinsurance. A calculation
was made based on these three items to determine the total annual projected out-of-pocket
spending per member for these three benefits for all plan rates. This calculation was then
used to assign the benefit level for all plan rates. The methodology for the calculation
involved multiplying an assumed annual utilization rate for each item by the copayment
amount and adding these three items. The specific formula applied was (3 visits per
member per year x office visit copayment) + (6 Rxs per member per year x Rx copayment) +
(.06 admissions per year x Hospital Inpatient copayment) = Total out-of-pocket spending
for selected items. The purpose of this calculation was not to determine the total
out-of-pocket spending for a plan (as significant additional information and calculations
would need to be made), but rather to establish a relative measure to assign benefit
levels. The assignment is based upon the following ranges:
Level Total Annual Out-of-Pocket Spending for Items
Highest Less than $50
High $50-99
Medium $100-$149
Low $150+
Return to CA HMO Rate 2001 Main Page
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