The Carrier assumes that the eyeglasses benefit represents 0.5% of each of the proposed premiums and, therefore, 0.5% of the composite rate. The Benefits Factor equals 0.9550 (which is 1 - 0.0050).
Example 1: Company X markets throughout Massachusetts, but proposes that its annual premium rate be $1,800 in western Massachusetts and $2,400 in eastern Massachusetts. Company X projects that 100 eligible individuals will enroll in Company X from western Massachusetts and 200 eligible individuals will enroll in Company X from eastern Massachusetts.
Example 2: Company Y markets a closed network plan in eastern Massachusetts and proposes that its annual premium rate be $2,500 in eastern Massachusetts. Company Y projects that 200 eligible individuals will enroll in Company Y from eastern Massachusetts.
Example: Company Z proposes that its annual premium rate is $1,800 for contractholders age 40 and under and $2,100 for contractholders over 40 years old. Company Z projects that 100 eligible individuals 40 and under will enroll in Company Z and 200 eligible individuals over 40 years old will enroll in Company Z.
211 CMR 41.99