Market Rating Reforms - Centers for Medicare & Medicaid Services
State Specific Rating Variations
The Market Rules and Rate Review Final Rule (45 CFR Part 147) provides that
each state will have age rating ratios of 3:1 using a federally established age
curve, tobacco rating ratios of no more than 1.5:1 and per member rating unless
a state requests ratios less than the standard, is a community rating state with
uniform family tiers, or allows for averaging of enrollee premiums in the small
group market.
The table below includes only states that have implemented standards other
than the federal defaults. If a cell is blank or a state is not listed,
the federal default applies. Please scroll down for more specific information
on:
Updated June 4, 2013
| |
Individual Market |
Small Group Market |
| State |
Age Rating Ratio |
State-Established Age Curve |
Tobacco Rating
Ratio |
Uniform Family Tiers |
Age Rating
Ratio |
State-Established Age Curve |
Tobacco Rating
Ratio |
Uniform Family Tiers |
Average Enrollee Premiums |
| Arkansas |
|
|
1.2:1 |
|
|
|
1.2:1 |
|
|
| California |
|
|
1:1 |
|
|
|
1:1 |
|
|
| Colorado |
|
|
1.15:1 |
|
|
|
1.15:1 |
|
|
| Connecticut |
|
|
1.5:1 |
|
|
|
1:1 |
|
|
| Delaware |
|
|
|
|
|
|
|
|
Yes |
| District of Columbia |
|
Yes |
1:1 |
|
|
Yes |
1:1 |
|
|
| Kentucky |
|
|
1.4:1 |
|
|
|
1.4:1 |
|
|
| Massachusetts |
2.1 |
Yes |
1:1 |
|
2.1 |
Yes |
1:1 |
|
|
| Minnesota |
|
Yes |
|
|
|
Yes |
|
|
|
| New Jersey |
|
|
1:1 |
|
1.824:1* |
Yes |
1:1 |
|
|
| New York |
1:1 |
|
1:1 |
Yes |
1:1 |
|
1:1 |
Yes |
Yes |
| Oregon |
|
|
|
|
3:1** |
|
1.5:1** |
|
Yes |
| Rhode Island |
|
|
1:1 |
|
|
|
1:1 |
|
Yes |
| Utah |
|
Yes |
|
|
|
Yes |
|
|
|
| Vermont |
1:1 |
|
1:1 |
Yes |
1:1 |
|
1:1 |
Yes |
|
* Overall 2:1 variation for small groups: NJSA
17B:27A-25.
**Overall 3:1 variation for small
groups: ORS 743.737(11).