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The Center for Consumer Information & Insurance Oversight

 

Market Rating Reforms

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 August 9, 2013

 

 Individual MarketSmall Group Market
StateAge Rating RatioState-Established Age CurveTobacco Rating RatioUniform Family TiersAge Rating RatioState-Established Age CurveTobacco Rating RatioUniform Family TiersAverage 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 Yes1:1  Yes1:1  Yes
Kentucky  1.4:1   1.4:1  
Massachusetts2.1Yes1:1 2.1Yes1:1  
Minnesota Yes   Yes   
New Jersey  1:1 1.824:1*Yes 1:1  
New York1:1 1:1Yes1:1 1:1Yes 
Oregon    3:1** 1.5:1** Yes
Rhode Island  1:1   1:1 Yes
Utah Yes   Yes   
Vermont1:1 1:1Yes1:1 1:1Yes 

* Overall 2:1 variation for small groups: NJSA 17B:27A-25.
**Overall 3:1 variation for small groups: ORS 743.737(11).

State Specific Age Curve Variations

State Specific Age Curve Variations 8-9-2013 [PDF, 94 KB]

State Specific Family Tier Ratios

 

StateOne AdultTwo AdultsOne Adult and One or More ChildrenTwo Adults and One or More Children
New York121.72.85
Vermont121.932.81