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[null,"INSTRUCTIONS FOR USING THE MLR CALCULATOR WITH THE 2015 MLR ANNUAL REPORTING FORM"]
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[null,"The 2015 MLR Annual Reporting Form does not automatically perform the MLR and rebate calculations.  When a completed form is submitted, CMS' Health Insurance Oversight System (HIOS) will alert companies if their submitted values do not match HIOS calculated values.\n"]
[null,"Companies may do the MLR and rebate calculations themselves, following the 2015 MLR Annual Reporting Form Filing Instructions.  For the user's convenience, all 2015 MLR and rebate formulas are summarized on the Formula Reference tab of this file.\n"]
[null,"Companies may also use this MLR Calculator file to perform and/or verify their MLR and rebate calculations for the 2015 MLR reporting year.  To use the MLR Calculator, please follow Steps 1−5 below.  For your convenience, you can also choose to have this MLR Calculator copy all data entered in this file to the HIOS template file you specify.*  \n  *You may need to enable macros to use the optional MLR Calculator copy functionality; please contact your IT department for assistance."]
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[null,"Step 1.  Download the HIOS template file(s) from the HIOS MLR module.  You must use these template file(s) to submit MLR data (and Risk Corridors data, if any) through HIOS.  Do not attempt to upload the MLR Form or Risk Corridors Form posted on the MLR page of CCIIO's website, or this MLR Calculator file, into HIOS."]
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[null,"Step 2.  Make sure that this MLR Calculator file is placed in and opened from the same folder as the destination HIOS template file."]
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[null,"Step 3."]
[null,"(a) To ensure that the MLR Calculator functions correctly, do NOT insert or delete rows or columns anywhere in this file."]
[null,"(b) Populate the \"Business in the State of\" and the \"Federal Tax Exempt\" fields on the Company Information tab of this MLR Calculator file."]
[null,"(c) Populate all relevant blank cells on Parts 1, 2, and 3 of this MLR Calculator file.  Do not alter the green cells, as these contain formulas."]
[null,"(i) Optionally, populate all relevant blank cells on Parts 4 and 5, if you wish the MLR Calculator to automatically copy these data to the HIOS template.  "]
[null,"(d) If your company did not have any QHPs in 2015, skip to Step 4.\n      If your company had QHPs in 2015, populate all relevant cells of the Risk Corridors Plan-Level Data template that you downloaded from HIOS.  Use the calculated amounts from Part 3, Columns 4A and 8A of this MLR Calculator file to complete Tab 3 of the Risk Corridors template.  The Risk Corridors template contains formulas and will perform calculations automatically."]
[null,"(d) Copy the amounts from Tab 3, Lines 9 and 10 of the completed Risk Corridors template to Part 3, Lines 3.11 and 3.12 of this MLR Calculator file."]
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[null,"Step 4.  Do one of the following:"]
[null,"(i) Use the calculated fields (green cells) in Parts 1, 2, 3, and 4 of this file to complete the corresponding fields of your HIOS template file.  Make sure to use \"Paste Special: Values\" option in order to avoid pasting formulas into the HIOS template file; OR "]
[null,"(ii) To have the MLR Calculator copy all data to your HIOS template file, enter the destination HIOS template filename in the box below (cell B24), and click the \"Copy to HIOS Template\" button below it.*  \n  *Please note that if you use the MLR Calculator copy functionality, all fields (both white and green cells) on all Parts (1-5) will be copied over."]
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[null,"MLR_Template_Grand_Total.xlsx"]
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[null,"Step 5.  Review the HIOS template file to ensure that it has been correctly and accurately populated before saving it.  Remember to complete any remaining Parts, as required."]

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["2015 MLR Annual Reporting Form: Formula Resource"]
["2015 Form Line","2015 Form Calculation References"]
["Part 1 Line 1.1\n(Total direct premium earned)","Part 2 Lines 1.1 + 1.2 – 1.3 – 1.7 + 1.8 + 1.9 + 1.10 + 1.11"]
["Part 1 Line 2.1\n(Total incurred claims)","Part 2 Line 2.16\nPlease note that on the 2011 MLR Form, this line was equal to Part 2 Lines 2.16 + 2.17"]
["Part 1 Line 2.11\n(Allowable claims recovered through fraud reduction efforts)","Part 2 Line 2.17"]
["Part 1 Line 7.5\n(Life-years)","Part 1 Line 7.4 / 12"]
["Part 2 Line 2.16\n(Total incurred claims)","Column \"Total as of 12/31/YY\":\nPart 2 Lines 2.1a + 2.2a – 2.3 + 2.4a – 2.5 + 2.6a – 2.7 + 2.8a + 2.9a – 2.10 + 2.11a + 2.11b – 2.11c – 2.12a + 2.12b + 2.13 + 2.14 + 2.15\n\nAll other columns (\"3/31/YY\", \"Dual Contract\", \"Deferred PY1\", \"Deferred CY\"):\nPart 2 Lines 2.1b + 2.2b + 2.4b + 2.6b – 2.7 + 2.8b + 2.9b + 2.11a + 2.11b – 2.12a + 2.13 + 2.14 + 2.15"]
["Part 2 Line 2.17\n(Allowable claims recovered through fraud reduction efforts)","The lesser of: Part 2 Line 2.17a or 2.17b"]
["Part 3 Line 1.1\n(Adjusted incurred claims as reported on MLR Form for prior year(s))","Column \"PY2\":\n2013 MLR Form, (Part 1 Line 2.1, Columns \"3/31/YY\" + \"Deferred PY\" – \"Deferred CY\") + (Part 2 Line 2.17, Columns \"3/31/YY\" + \"Deferred PY\" – \"Deferred CY\")\n\nColumn \"PY1\":\n2014 MLR Form, Part 1 Lines 2.1 + 2.11, Columns \"3/31/YY\" + \"Deferred PY\" – \"Deferred CY\""]
["Part 3 Line 1.2\n(Adjusted incurred claims as of 3/31 of the year following the MLR reporting year)","Column \"PY2\":\nAdjusted claims incurred in the 2013 MLR reporting year, restated as of 3/31/16\n\nColumn \"PY1\":\nAdjusted claims incurred in the 2014 MLR reporting year, restated as of 3/31/16\n\nColumn \"CY\":\nPart 1 Lines 2.1 + 2.11, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\"\n\nColumn \"RC\":\nPart 1 Lines 2.1 + 2.11, Column [RC] \"3/31/YY\"\n\nColumn \"Total\":\nPart 3 Line 1.2, Columns PY2 + PY1 + CY\n"]
["Part 3 Line 1.3\n(Quality improvement expenses)","Columns \"PY2\" and \"PY1\":\n2013 (for \"PY2\") and 2014 (for \"PY1\") MLR Forms, respectively,\nPart 1 Lines 4.1 + 4.2 + 4.3 + 4.4 + 4.5 + 4.6, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\"\n\nColumn \"CY\":\nPart 1 Lines 4.1 + 4.2 + 4.3 + 4.4 + 4.5 + 4.6, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\"\n\nColumn \"RC\":\nPart 1 Lines 4.1 + 4.2 + 4.3 + 4.4 + 4.5 + 4.6, Column [RC] \"3/31/YY\"\n\nColumn \"Total\":\nPart 3 Line 1.3, Columns PY2 + PY1 + CY\n"]
["Part 3 Line 1.4\n(Cost-sharing reduction payments)","Column \"CY\":\nPart 2, Line 2.18, Columns \"3/31/YY\" + \"Deferred PY\" – \"Deferred CY\"\n\nColumn \"RC\":\nPart 2, Line 2.18, Column [RC] \"3/31/YY\"\n\nColumn \"Total\":\nPart 3 Line 1.4, Columns PY1 + CY"]
["Part 3 Line 1.5\n(Federal Transitional Reinsurance Program payments)","Column \"CY\":\nPart 2 Line 1.9, Columns \"3/31/YY\" + \"Deferred PY\" – \"Deferred CY\"\n\nColumn \"RC\":\nPart 2 Line 1.9, Column [RC] \"3/31/YY\"\n\nColumn \"Total\":\nPart 3 Line 1.5, Columns PY1 + CY"]
["Part 3 Line 1.6\n(Federal Risk Adjustment Program payments or charges)","Column \"CY\":\nPart 2 Line 1.10, Columns \"3/31/YY\" + \"Deferred PY\" – \"Deferred CY\"\n\nColumn \"RC\":\nPart 2 Line 1.10, Column [RC] \"3/31/YY\"\n\nColumn \"Total\":\nPart 3 Line 1.6, Columns PY1 + CY"]
["Part 3 Line 1.7\n(Federal Risk Corridors Program payments or charges)","Column \"CY\":\nPart 2 Line 1.11, Columns \"3/31/YY\" + \"Deferred PY\" – \"Deferred CY\"\n\nColumn \"RC\":\nPart 2 Line 1.11, Column [RC] \"3/31/YY\"\n\nColumn \"Total\":\nPart 3 Line 1.7, Columns PY1 + CY"]
["Part 3 Line 1.8\n(MLR numerator)","Individual, Small Group, and Large Group Column \"PY2\" except DC, MA, and VT merged markets:\nPart 3, Lines 1.2 + 1.3\nIndividual and Small Group Column \"PY2\" if Business State is DC, MA, or VT:\n(Part 3, Individual Column, Lines 1.2 + 1.3) + (Part 3, Small Group Column, Lines 1.2 + 1.3)\n\nIndividual, Small Group, and Large Group Columns \"PY1,\" \"CY,\" and \"Total,\" except DC, MA, and VT merged markets:\nPart 3, Lines 1.2 + 1.3 – 1.4 – 1.5 – 1.6 – 1.7\nIndividual and Small Group Columns \"CY\" and \"Total\", if Business State is DC, MA, or VT:\n(Part 3, Individual Column, Lines 1.2 + 1.3 – 1.4 – 1.5 – 1.6 – 1.7) + (Part 3, Small Group Column, Lines 1.2 + 1.3 – 1.4 – 1.5 – 1.6 – 1.7)"]
["Part 3 Line 1.9\n(MLR numerator: Mini-Med and Student Health Plans)","Mini-Med Column \"PY2\", except DC, MA, and VT merged markets:\n1.5 x (Part 3 Lines 1.2 + 1.3)\nMini-Med Individual and Small Group Columns \"PY2\", if Business State is DC, MA, or VT:\n1.5 x [(Part 3, Mini-Med Individual Column, Lines 1.2 + 1.3) + (Part 3, Mini-Med Small Group Column, Lines 1.2 + 1.3)]\n\nMini-Med Column \"PY1\", except DC, MA, and VT merged markets:\n1.25 x (Part 3 Lines 1.2 + 1.3)\nMini-Med Individual and Small Group Columns \"PY1\", if Business State is DC, MA, or VT:\n1.25 x [(Part 3, Mini-Med Individual Column, Lines 1.2 + 1.3) + (Part 3, Mini-Med Small Group Column, Lines 1.2 + 1.3)]\n\nMini-Med Column \"CY\", except DC, MA, and VT merged markets:\nPart 3 Lines 1.2 + 1.3\nMini-Med Individual and Small Group Columns \"CY\", if Business State is DC, MA, or VT:\n(Part 3, Mini-Med Individual Column, Lines 1.2 + 1.3) + (Part 3, Mini-Med Small Group Column, Lines 1.2 + 1.3)\n\nMini-Med Column \"Total\", except DC, MA, and VT merged markets:\nPart 3 Lines 1.2 + 1.3\nMini-Med Individual and Small Group Columns \"Total\", if Business State is DC, MA, or VT:\n(Part 3, Mini-Med Individual Column, Lines 1.2 + 1.3) + (Part 3, Mini-Med Small Group Column, Lines 1.2 + 1.3)\n\nStudent Health Plans Column \"PY2\":\n1.15 x (Part 3 Column \"PY2\", Lines 1.2 + 1.3)\n\nStudent Health Plans Columns \"PY1\", \"CY\" and \"Total\":\nPart 3, Lines 1.2 + 1.3"]
["Part 3 Line 2.1\n(Premium earned including Federal and State high risk programs)","Column \"PY2\":\n2013 MLR Form\n(Part 1 Lines 1.1 + 1.2 + 1.3, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") – (Part 4 Line 6.1a, Column \"CY\")\n\nColumn \"PY1\":\n2014 MLR Form\n(Part 1 Lines 1.1 + 1.2 + 1.3, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") – (Part 3 Lines 1.5 + 1.6 + 1.7, Column \"CY\") + Part 3 Line 7.1a, Column \"PY1\"\n\nColumn \"CY\":\n(Part 1 Lines 1.1 + 1.2 + 1.3, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") – (Part 3 Lines 1.5 + 1.6 + 1.7, Column \"CY\")\n\nColumn \"RC\":\n(Part 1 Lines 1.1+ 1.2 + 1.3, Column [RC] \"3/31/YY\") – (Part 3 Lines 1.5 + 1.6, Column \"RC\")\n\nColumn \"Total\":\nPart 3 Line 2.1, Columns PY2 + PY1 + CY\n"]
["Part 3 Line 2.2\n(Federal and State taxes and licensing or regulatory fees)","Column \"PY2\": 2013 MLR Form,\nFederal Tax-Exempt Issuers:\n(Part 1 Lines 3.1a + 3.1b + 3.1c + 3.2a + 3.2b +3.2c +3.3, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") + [The greater of: (Part 1 Line 3.2b, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") or (Part 1 Line 3.2c, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\")] + (Part 1 Line 3.3, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") – Part 4 Line 6.1b, Column \"CY\"\nNon Federal Tax-Exempt Issuers:\n(Part 1 Lines 3.1a + 3.1b + 3.1c + 3.2a, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") + [The greater of: (Part 1 Line 3.2b, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") or (Part 1 Line 3.2c, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\")] + (Part 1 Line 3.3, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") – Part 4 Line 6.1b, Column \"CY\"\n\nColumn \"PY1\": 2014 MLR Form,\nFederal Tax-Exempt Issuers:\n(Part 1 Lines 3.1a + 3.1b + 3.1c + 3.1d + 3.2a + 3.2b + 3.2c + 3.3a + 3.3b, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") + Part 3 Line 7.1b, Column \"PY1\"\nNon Federal Tax-Exempt Issuers:\n(Part 1 Lines 3.1a + 3.1b + 3.1c + 3.1d + 3.2a, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") + [The greater of: (Part 1 Line 3.2b, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") or (Part 1 Line 3.2c, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\")] + (Part 1 Line 3.3a + 3.3b, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") + Part 3 Line 7.1b, Column \"PY1\"\n\nColumn \"CY\":\nFederal Tax-Exempt Issuers:\n(Part 1 Line 3.1a + 3.1b + 3.1c + 3.1d + 3.2a + 3.2b + 3.2c + 3.3a + 3.3b, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\")\nNon Federal Tax-Exempt Issuers:\n(Part 1 Line 3.1a + 3.1b + 3.1c + 3.1d + 3.2a, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") + [The greater of: (Part 1 Line 3.2b, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") or (Part 1 Line 3.2c, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\")] + (Part 1 Lines 3.3a + 3.3b, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") \n\nColumn \"RC\":\nFederal Tax-Exempt Issuers:\nPart 1 Lines 3.1a + 3.1b + 3.1c + 3.1d + 3.2a + 3.2b + 3.2c + 3.3a +3.3b, Column [RC] \"3/31/YY\"\nNon Federal Tax-Exempt Issuers:\n(Part 1 Lines 3.1a + 3.1b +3.1c + 3.1d + 3.2a, Column [RC] \"3/31/YY\") + [The greater of: Part 1 Line 3.2b or 3.2c, Column [RC] \"3/31/YY\"] + (Part 1 Lines 3.3a + 3.3b, Column [RC] \"3/31/YY\")\n\nColumn \"Total\":\nPart 3 Line 2.2, Columns PY2 + PY1 + CY\n"]
["Part 3 Line 2.3\n(MLR denominator)","Individual, Small Group, and Large Group Columns, except DC, MA, and VT merged markets:\nPart 3, Lines 2.1 – 2.2\n\nIndividual and Small Group Columns, if Business State is DC, MA, or VT:\n(Part 3, Individual Column, Lines 2.1 – 2.2) + (Part 3, Small Group Column, Lines 2.1 – 2.2)"]
["Part 3 Line 3.1\n(Allowable costs)","Column \"RC\", except DC, MA, and VT merged markets:\nPart 3 Lines 1.2 + 1.3 – 1.4 – 1.5 – 1.6 + 7.2\n\nColumn \"RC\", if Business State is DC, MA, or VT:\n(Part 3, Individual Column, Lines 1.2 + 1.3 – 1.4 – 1.5 – 1.6 + 7.2) + (Part 3, Small Group Column, Lines 1.2 + 1.3 – 1.4 – 1.5 – 1.6 + 7.2)"]
["Part 3 Line 3.2\n(Administrative costs excluding Taxes)","Column \"RC\", except DC, MA, and VT merged markets:\nPart 1 Lines 5.1 + 5.2 + 5.3 + 5.4 + 5.5 + 5.6, Column [RC] \"3/31/YY\"\n\nColumn \"RC\", if Business State is DC, MA, or VT:\n(Part 1, Lines 5.1 + 5.2 + 5.3 + 5.4 + 5.5 + 5.6, Individual Column [RC] \"3/31/YY\") + (Part 1, Lines 5.1 + 5.2 + 5.3 + 5.4 + 5.5 + 5.6, Small Group Column [RC] \"3/31/YY\")"]
["Part 3 Line 3.3a\n(Earned profit)","Column \"RC\", except DC, MA, and VT merged markets:\nPart 3 Lines 2.1 – 3.1 – 2.2 – 3.2\n\nColumn \"RC\", if Business State is DC, MA, or VT:\n(Part 3, Individual Column, Lines 2.1 – 3.1 – 2.2 – 3.2) + (Part 3, Small Group Column, Lines 2.1 – 2.2)"]
["Part 3 Line 3.3b\n(Capped profit)","Column \"RC\", except DC, MA, and VT merged markets:\n(3% + 2%) x (Part 3 Lines 2.1 – 2.2)\n\nColumn \"RC\", if Business State is DC, MA, or VT:\n(3% + 2%) / (Part 3 Line 2.1 Individual Column – Part 3 Line 2.2 Individual Column + Part 3 Line 2.1 Small Group Column – Part 3 Line 2.2 Small Group Column)"]
["Part 3 Line 3.3c\n(Capped profit without adjustment)","Column \"RC\", except DC, MA, and VT merged markets:\n3% x (Part 3 Lines 2.1 – 2.2)\n\nColumn \"RC\", if Business State is DC, MA, or VT:\n3% x (Part 3 Line 2.1 Individual Column – Part 3 Line 2.2 Individual Column + Part 3 Line 2.1 Small Group Column – Part 3 Line 2.2 Small Group Column)"]
["Part 3 Line 3.3\n(Profit for risk corridors calculation)","Column \"RC\":\nThe greater of: Part 3 Lines 3.3a or 3.3b"]
["Part 3 Line 3.4a\n(Profit and administrative costs)","Column \"RC\":\nPart 3 Lines 3.2 + 3.3 + 2.2"]
["Part 3 Line 3.4b\n(Capped administrative costs)","Column \"RC\", except DC, MA, and VT merged markets:\n(20% + 2%) x (Part 3 Lines 2.1 – 2.2) + Part 3 Line 2.2\n\nColumn \"RC\", if Business State is DC, MA, or VT:\n(20% + 2%) x (Part 3 Line 2.1 Individual Column – Part 3 Line 2.2 Individual Column + Part 3 Line 2.1 Small Group Column – Part 3 Line 2.2 Small Group Column) + (Part 3 Line 2.2 Individual Column + Part 3 Line 2.2 Small Group Column)"]
["Part 3 Line 3.4\n(Allowable administrative costs)","Column \"RC\":\nThe lesser of: Part 3 Lines 3.4a or 3.4b"]
["Part 3 Line 3.5\n(Risk corridors adjusted target amount)","Column \"RC\", except DC, MA, and VT merged markets:\nPart 3 Lines 2.1 – 3.4\n\nColumn \"RC\", if Business State is DC, MA, or VT:\n(Part 3 Line 2.1 Individual Column + Part 3 Line 2.1 Small Group Column) – Part 3 Line 3.4"]
["Part 3 Line 3.6a\n(Profit without adjustment)","Column \"RC\":\nThe greater of: Part 3 Lines 3.3a or 3.3c"]
["Part 3 Line 3.6b\n(Profit and administrative costs without adjustment)","Column \"RC\":\nPart 3 Lines 3.2 + 3.6a + 2.2"]
["Part 3 Line 3.6c\n(Capped administrative costs without adjustment)","Column \"RC\", except DC, MA, and VT merged markets:\n20% x (Part 3 Lines 2.1 – 2.2) + Part 3 Line 2.2\n\nColumn \"RC\", if Business State is DC, MA, or VT:\n20% x (Part 3 Line 2.1 Individual Column – Part 3 Line 2.2 Individual Column + Part 3 Line 2.1 Small Group Column – Part 3 Line 2.2 Small Group Column) + (Part 3 Line 2.2 Individual Column + Part 3 Line 2.2 Small Group Column)"]
["Part 3 Line 3.6\n(Allowable administrative costs without adjustment)","Column \"RC\":\nThe lesser of: Part 3 Lines 3.6b or 3.6c"]
["Part 3 Line 3.7\n(Risk corridors unadjusted target amount)","Column \"RC\", except DC, MA, and VT merged markets:\nPart 3 Lines 2.1 – 3.6\n\nColumn \"RC\", if Business State is DC, MA, or VT:\n(Part 3 Line 2.1 Individual Column + Part 3 Line 2.1 Small Group Column) – Part 3 Line 3.6"]
["Part 3 Line 3.8\n(Unadjusted risk corridors ratio)","Column \"RC\":\nPart 3 Lines 3.1 / 3.7"]
["Part 3 Line 3.9\n(Risk corridors aggregate amount by market without adjustment)","Column \"RC\":\n2015 Risk Corridors Plan Level Data Form, Tab 3, Line 9"]
["Part 3 Line 3.10\n(Risk Corridors Total Payment or Charge Amount Used for MLR calculation)","Column \"RC\":\n2015 Risk Corridors Plan Level Data Form, Tab 3, Line 10"]
["Part 3 Line 4.1\n(Life-years to determine credibility)","Columns \"PY2\" and \"PY1\", except DC, MA, and VT merged markets:\n2013 (for \"PY2\") and 2014 (for \"PY1\") MLR Forms, respectively,\nPart 1 Line 7.5, Columns \"3/31/14\" + \"Deferred PY1\" – \"Deferred CY\" \nColumns \"PY2\" and \"PY1\", Individual and Small Group Columns, if Business State is DC, MA, or VT:\n2013 (for \"PY2\") and 2014 (for \"PY1\") MLR Forms, respectively \n(Part 1 Line 7.5, Individual Columns \"3/31/YY\" + \"Deferred PY\" – \"Deferred CY\") + (Part 1 Line 7.5, Small Group Columns \"3/31/YY\" + \"Deferred PY\" – \"Deferred CY\")\n\nColumn \"CY\", except DC, MA, and VT merged markets:\nPart 1 Line 7.5, Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\" \nColumn \"CY\", Individual and Small Group Columns, if Business State is DC, MA, or VT:\n(Part 1 Line 7.5, Individual Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\") + (Part 1 Line 7.5, Small Group Columns \"3/31/YY\" + \"Deferred PY1\" – \"Deferred CY\")\n\nColumn \"Total\":\nPart 3 Line 4.1, Columns PY2 + PY1 + CY\n"]
["Part 3 Line 4.2\n(Base credibility factor)","Column \"Total\":\n   ● if Column \"Total\" Part 3 Line 4.1 < 1,000 or ≥ 75,000: \n      0 (zero)\n   ● if Column \"PY2\" Part 3 Line 4.1 ≥ 1,000 and Line 5.1a or 5.1b < Line 6.1, and \n         Column \"PY1\" Part 3 Line 4.1 ≥ 1,000 and Line 5.1a or 5.1b < Line 6.1, and\n         Column \"CY\"   Part 3 Line 4.1 ≥ 1,000 and Line 5.1a or 5.1b < Line 6.1:\n      0 (zero)\n   ● if 1,000 ≤ Column \"Total\" Part 3 Line 4.1 < 75,000 and none of the conditions above apply: \n      Calculate using linear interpolation and Table 1 (do not round)\n\nTable 1:\nLife-Years    Base credibility factor\n   <1,000          0.0%\n     1,000          8.3%\n     2,500          5.2%\n     5,000          3.7%\n   10,000          2.6%\n   25,000          1.6%\n   50,000          1.2%\n ≥75,000          0.0%\n\nLinear Interpolation Formula (x = life-years, y = base credibility factor) where x2 = Part 3 Line 4.1 Column \"Total\": \ny2 = y1 + [(y3 – y1) / (x3 – x1)] * (x2 – x1)\n\nLinear Interpolation Example:\nThe base credibility factor for 16,525 life-years can be calculated as follows:\n2.6% + [(1.6% – 2.6%) / (25,000 – 10,000)] x (16,525 – 10,000) = 2.6% – 0.435% = 2.165%\n(Note: do not round the base credibility factor when calculating the MLR.  Add the unrounded credibility factor multiplied by the unrounded deductible factor to the unrounded preliminary MLR from Part 3 Line 5.1 Total Column, then round the resulting credibility-adjusted MLR to 3 decimal places (e.g. 80.1%) and enter on Part 3 Line 5.3."]
["Part 3 Line 4.4\n(Deductible factor)","Column \"Total\":\n   ● if Part 3 Line 4.3 < 2,500: \n      1.000\n   ● if Part 3 Line 4.3 ≥ 10,000: \n      1.736\n   ● if 2,500 ≤ Part 3 Line 4.3 < 10,000: \n      Calculate using linear interpolation and Table 2 (do not round).\n\nTable 2:\nAverage Deductible    Deductible factor\n    <2,500                         1.000\n      2,500                         1.164\n      5,000                         1.402\n  ≥10,000                         1.736\n\nLinear Interpolation Formula (x = average health plan deductible, y = deductible factor) where x2 = Part 3 Line 4.3 Column \"Total\": \ny2 = y1 + [(y3 – y1) / (x3 – x1)] * (x2 – x1)\n\nLinear interpolation example:\nThe deductible factor for a $3,500 average deductible can be calculated as follows:\n1.164 + [(1.402 – 1.164) / (5,000 – 2,500)] x (3,500 – 2,500) = 1.164 + 0.0952 = 1.2592\n(Note: do not round the credibility factor multiplied by the deductible factor when calculating the MLR.  Add the unrounded credibility factor multiplied by the unrounded deductible factor to the unrounded preliminary MLR from Part 3 Line 5.1, then round the result to 3 decimal places (e.g. 80.1%) and enter on Part 3 Line 5.3."]
["Part 3 Line 4.5\n(Credibility adjustment)","Column \"Total\":\n   ● if Column \"Total\" Part 3 Line 4.1 < 1,000 or ≥ 75,000: \n      0 (zero)\n   ● if Column \"PY2\" Part 3 Line 4.1 ≥ 1,000 and Line 5.1a or 5.1b < Line 6.1, and \n         Column \"PY1\" Part 3 Line 4.1 ≥ 1,000 and Line 5.1a or 5.1b < Line 6.1, and\n         Column \"CY\"   Part 3 Line 4.1 ≥ 1,000 and Line 5.1a or 5.1b < Line 6.1:\n      0 (zero)\n   ● if 1,000 ≤ Column \"Total\" Part 3 Line 4.1 < 75,000 and none of the conditions above apply: \n      Part 3 Line 4.2 x 4.4 (do not round)"]
["Part 3 Line 5.1a\n(Preliminary MLR)","Columns \"PY2\", \"PY1\", \"CY\", \"Total\":\n   ● if Part 3 Line 4.1 < 1,000: \n      blank\n   ● if Part 3 Line 4.1 ≥ 1,000: \n      Part 3 Lines 1.8 / 2.3 (do not round)"]
["Part 3 Line 5.1b\n(Preliminary MLR: Mini-Med and Student Health Plans)","Columns \"PY2\", \"PY1\", \"CY\", \"Total\":\n   ● if Part 3 Line 4.1 < 1,000: \n      blank\n   ● if Part 3 Line 4.1 ≥ 1,000: \n      Part 3 Lines 1.9 / 2.3 (do not round)"]
["Part 3 Line 5.2\n(Credibility adjustment)","Part 3, Line 4.5"]
["Part 3 Line 5.3\n(Credibility-adjusted MLR)","Column \"Total\":\n   ● if Column \"Total\" Part 3 Line 4.1 < 1,000: \n      blank\n   ● if Column \"Total\" Part 3 Line 4.1 ≥ 1,000: \n      Health Insurance Coverage columns:    Part 3 Lines 5.1a + 5.2\n      Mini-Med and Student Health columns:  Part 3 Lines 5.1b + 5.2\n   (round to three decimal places, e.g. 0.801 or 80.1%)"]
["Part 3 Line 6.1\n(MLR standard)","Standards deviating from 80% and 85% are highlighted in red.\n\n                      Individual market         Small Group market            Large Group market\n                      2013  2014  2015        2013  2014  2015              2013  2014  2015\nMA                  90%  89%  88%          90%  89%  88%               85%   85%   85%\nNY                  82%  82%  82%          82%  82%  82%               85%   85%   85%\nNM                  80%  80%  80%          80%  80%  85%              85%   85%   85%\nAll others        80%  80%  80%         80%  80%  80%               85%   85%   85%"]
["Part 3 Line 6.2\n(Credibility-adjusted MLR)","Part 3, Line 5.3"]
["Part 3 Line 6.3\n(Adjusted earned premium less Federal and State taxes and licensing or regulatory fees)","Column \"Total\":\n   ● if Column \"Total\" Part 3 Line 4.1 < 1,000: \n      blank\n   ● if Column \"Total\" Part 3 Line 4.1 ≥ 1,000: \n      Part 3 Column \"CY\", Lines 2.1 – 2.2 (if negative, set to 0 (zero))"]
["Part 3 Line 6.4\n(Rebate amount)","Column \"Total\":\n   ● if Column \"Total\" Part 3 Line 4.1 < 1,000: \n      0 (zero)\n   ● if Column \"Total\" Part 3 Line 4.1 ≥ 1,000 and Part 3 Line 6.2 ≥ Line 6.1: \n      0 (zero)\n   ● if Column \"Total\" Part 3 Line 4.1 ≥ 1,000 and Part 3 Line 6.2 < Line 6.1: \n      Part 3 (Lines 6.1 – 6.2) x Line 6.3"]
["Part 3 Line 7.2\n(Risk Corridors claims liabilities/ reserves true-up)","Column \"RC\":\nPart 3 Lines 7.2b - 7.2a"]
["Part 3 Line 7.2a\nAdjusted incurred claims as reported on MLR Form for prior year","Column \"RC\":\n2014 MLR Form, Part 3 Lines 1.2 – 1.4 – 1.5, Column [RC]\n"]
["Part 3 Line 7.2b\n(Adjusted incurred claims as of 3/31 of the year following the benefit year)","Column \"RC\":\nAdjusted claims incurred in the 2014 benefit year, restated as of 3/31/16"]

{"sheet":"Company Information","index":2,"n_rows":18,"n_cols":3,"rows_kept":18,"cut":false,"hidden":false,"merged":[]}
[null,"Company Information "]
[]
[null,"Line Description","Value"]
[null,"Company Name:"]
[null,"Group Affiliation:"]
[null,"Federal EIN:"]
[null,"A.M. Best Number:"]
[null,"NAIC Group Code:"]
[null,"NAIC Company Code:"]
[null,"DBA / Marketing Name:"]
[null,"HIOS Issuer ID:"]
[null,"Business in the State of:"]
[null,"Domiciliary State:","Grand Total"]
[null,"Address:"]
[null,"Federal Tax Exempt:"]
[null,"Marketplace:","No"]
[null,"Not-For-Profit:"]
[null,"MLR Reporting Year:"]

{"sheet":"Pt 1 Summary of Data","index":3,"n_rows":62,"n_cols":49,"rows_kept":62,"cut":false,"hidden":false,"merged":[]}
[null,"Part 1 Summary of Data"]
[]
[null,"Line Description","SHCE","1\nHealth Insurance\nINDIVIDUAL\nTotal as of 12/31/15","2\nHealth Insurance\nINDIVIDUAL\nTotal as of 3/31/16","3\nHealth Insurance\nINDIVIDUAL\nDual Contracts\n(Included in Total as of 3/31/16)","4\nHealth Insurance\nINDIVIDUAL\nDeferred PY1\n(Add)","5\nHealth Insurance\nINDIVIDUAL\nDeferred CY\n(Subtract)","2A\nHealth Insurance\nINDIVIDUAL\n[Risk Corridors]\nTotal as of 3/31/16","6\nHealth Insurance\nSMALL GROUP\nTotal as of 12/31/15","7\nHealth Insurance\nSMALL GROUP\nTotal as of 3/31/16","8\nHealth Insurance\nSMALL GROUP\nDual Contracts\n(Included in Total as of 3/31/16)","9\nHealth Insurance\nSMALL GROUP\nDeferred PY1\n(Add)","10\nHealth Insurance\nSMALL GROUP\nDeferred CY\n(Subtract)","7A\nHealth Insurance\nSMALL GROUP\n[Risk Corridors]\nTotal as of 3/31/16","11\nHealth Insurance\nLARGE GROUP\nTotal as of 12/31/15","12\nHealth Insurance\nLARGE GROUP\nTotal as of 3/31/16","13\nHealth Insurance\nLARGE GROUP\nDual Contracts\n(Included in Total as of 3/31/16)","14\nHealth Insurance\nLARGE GROUP\nDeferred PY1\n(Add)","15\nHealth Insurance\nLARGE GROUP\nDeferred CY\n(Subtract)","16\nMini-Med\nINDIVIDUAL\nTotal as of 12/31/15","17\nMini-Med\nINDIVIDUAL\nTotal as of 3/31/16","18\nMini-Med\nINDIVIDUAL\nDual Contracts\n(Included in Total as of 3/31/16)","19\nMini-Med\nSMALL GROUP\nTotal as of 12/31/15","20\nMini-Med\nSMALL GROUP\nTotal as of 3/31/16","21\nMini-Med\nSMALL GROUP\nDual Contracts\n(Included in Total as of 3/31/16)","22\nMini-Med\nLARGE GROUP\nTotal as of 12/31/15","23\nMini-Med\nLARGE GROUP\nTotal as of 3/31/16","24\nMini-Med\nLARGE GROUP\nDual Contracts\n(Included in Total as of 3/31/16)","25\nExpat\nSMALL GROUP\nTotal as of 12/31/15","26\nExpat\nSMALL GROUP\nTotal as of 3/31/16","27\nExpat\nSMALL GROUP\nDual Contracts\n(Included in Total as of 3/31/16)","28\nExpat\nSMALL GROUP\nDeferred PY1\n(Add)","29\nExpat\nSMALL GROUP\nDeferred CY\n(Subtract)","30\nExpat\nLARGE GROUP\nTotal as of 12/31/15","31\nExpat\nLARGE GROUP\nTotal as of 3/31/16","32\nExpat\nLARGE GROUP\nDual Contracts\n(Included in Total as of 3/31/16)","33\nExpat\nLARGE GROUP\nDeferred PY1\n(Add)","34\nExpat\nLARGE GROUP\nDeferred CY\n(Subtract)","35\nStudent Health\nINDIVIDUAL\nTotal as of 12/31/15","36\nStudent Health\nINDIVIDUAL\nTotal as of 3/31/16","37\nStudent Health\nINDIVIDUAL\nDual Contracts\n(Included in Total as of 3/31/16)","38\nStudent Health\nINDIVIDUAL\nDeferred PY1\n(Add)","39\nStudent Health\nINDIVIDUAL\nDeferred CY\n(Subtract)","40\nGovernment Program Plans \nTotal as of 12/31/15","41\nOther Health Business \nTotal as of 12/31/15","42\nMedicare MLR Business\nTotal as of 12/31/15","43\nUninsured Plans\nTotal as of 12/31/15","44\nGrand Total\nTotal as of 12/31/15"]
[null,"1. Premium"]
[null,"1.1 Total direct premium earned",null,{"$f":"SUM('Pt 2 Premium and Claims'!D$5,'Pt 2 Premium and Claims'!D$6,-'Pt 2 Premium and Claims'!D$7,-'Pt 2 Premium and Claims'!D$13,'Pt 2 Premium and Claims'!D$14:'Pt 2 Premium and Claims'!D$17)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!E$5,'Pt 2 Premium and Claims'!E$6,-'Pt 2 Premium and Claims'!E$7,-'Pt 2 Premium and Claims'!E$13,'Pt 2 Premium and Claims'!E$14:'Pt 2 Premium and Claims'!E$17)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!F$5,'Pt 2 Premium and Claims'!F$6,-'Pt 2 Premium and Claims'!F$7,-'Pt 2 Premium and Claims'!F$13,'Pt 2 Premium and Claims'!F$14:'Pt 2 Premium and Claims'!F$17)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!G$5,'Pt 2 Premium and Claims'!G$6,-'Pt 2 Premium and Claims'!G$7,-'Pt 2 Premium and Claims'!G$13,'Pt 2 Premium and Claims'!G$14:'Pt 2 Premium and Claims'!G$17)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!H$5,'Pt 2 Premium and Claims'!H$6,-'Pt 2 Premium and Claims'!H$7,-'Pt 2 Premium and Claims'!H$13,'Pt 2 Premium and Claims'!H$14:'Pt 2 Premium and Claims'!H$17)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!I$5,'Pt 2 Premium and Claims'!I$6,-'Pt 2 Premium and Claims'!I$7,-'Pt 2 Premium and Claims'!I$13,'Pt 2 Premium and Claims'!I$14:'Pt 2 Premium and Claims'!I$16)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!J$5,'Pt 2 Premium and Claims'!J$6,-'Pt 2 Premium and Claims'!J$7,-'Pt 2 Premium and Claims'!J$13,'Pt 2 Premium and Claims'!J$14,'Pt 2 Premium and Claims'!J$16:'Pt 2 Premium and Claims'!J$17)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!K$5,'Pt 2 Premium and Claims'!K$6,-'Pt 2 Premium and Claims'!K$7,-'Pt 2 Premium and Claims'!K$13,'Pt 2 Premium and Claims'!K$14,'Pt 2 Premium and Claims'!K$16:'Pt 2 Premium and Claims'!K$17)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!L$5,'Pt 2 Premium and Claims'!L$6,-'Pt 2 Premium and Claims'!L$7,-'Pt 2 Premium and Claims'!L$13,'Pt 2 Premium and Claims'!L$14,'Pt 2 Premium and Claims'!L$16:'Pt 2 Premium and Claims'!L$17)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!M$5,'Pt 2 Premium and Claims'!M$6,-'Pt 2 Premium and Claims'!M$7,-'Pt 2 Premium and Claims'!M$13,'Pt 2 Premium and Claims'!M$14,'Pt 2 Premium and Claims'!M$16:'Pt 2 Premium and Claims'!M$17)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!N$5,'Pt 2 Premium and Claims'!N$6,-'Pt 2 Premium and Claims'!N$7,-'Pt 2 Premium and Claims'!N$13,'Pt 2 Premium and Claims'!N$14,'Pt 2 Premium and Claims'!N$16:'Pt 2 Premium and Claims'!N$17)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!O$5,'Pt 2 Premium and Claims'!O$6,-'Pt 2 Premium and Claims'!O$7,-'Pt 2 Premium and Claims'!O$13,'Pt 2 Premium and Claims'!O$14,'Pt 2 Premium and Claims'!O$16)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!P$5,'Pt 2 Premium and Claims'!P$6,-'Pt 2 Premium and Claims'!P$7,-'Pt 2 Premium and Claims'!P$13,'Pt 2 Premium and Claims'!P$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!Q$5,'Pt 2 Premium and Claims'!Q$6,-'Pt 2 Premium and Claims'!Q$7,-'Pt 2 Premium and Claims'!Q$13,'Pt 2 Premium and Claims'!Q$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!R$5,'Pt 2 Premium and Claims'!R$6,-'Pt 2 Premium and Claims'!R$7,-'Pt 2 Premium and Claims'!R$13,'Pt 2 Premium and Claims'!R$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!S$5,'Pt 2 Premium and Claims'!S$6,-'Pt 2 Premium and Claims'!S$7,-'Pt 2 Premium and Claims'!S$13,'Pt 2 Premium and Claims'!S$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!T$5,'Pt 2 Premium and Claims'!T$6,-'Pt 2 Premium and Claims'!T$7,-'Pt 2 Premium and Claims'!T$13,'Pt 2 Premium and Claims'!T$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!U$5,'Pt 2 Premium and Claims'!U$6,-'Pt 2 Premium and Claims'!U$7,-'Pt 2 Premium and Claims'!U$13,'Pt 2 Premium and Claims'!U$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!V$5,'Pt 2 Premium and Claims'!V$6,-'Pt 2 Premium and Claims'!V$7,-'Pt 2 Premium and Claims'!V$13,'Pt 2 Premium and Claims'!V$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!W$5,'Pt 2 Premium and Claims'!W$6,-'Pt 2 Premium and Claims'!W$7,-'Pt 2 Premium and Claims'!W$13,'Pt 2 Premium and Claims'!W$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!X$5,'Pt 2 Premium and Claims'!X$6,-'Pt 2 Premium and Claims'!X$7,-'Pt 2 Premium and Claims'!X$13,'Pt 2 Premium and Claims'!X$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!Y$5,'Pt 2 Premium and Claims'!Y$6,-'Pt 2 Premium and Claims'!Y$7,-'Pt 2 Premium and Claims'!Y$13,'Pt 2 Premium and Claims'!Y$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!Z$5,'Pt 2 Premium and Claims'!Z$6,-'Pt 2 Premium and Claims'!Z$7,-'Pt 2 Premium and Claims'!Z$13,'Pt 2 Premium and Claims'!Z$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!AA$5,'Pt 2 Premium and Claims'!AA$6,-'Pt 2 Premium and Claims'!AA$7,-'Pt 2 Premium and Claims'!AA$13,'Pt 2 Premium and Claims'!AA$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!AB$5,'Pt 2 Premium and Claims'!AB$6,-'Pt 2 Premium and Claims'!AB$7,-'Pt 2 Premium and Claims'!AB$13,'Pt 2 Premium and Claims'!AB$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!AC$5,'Pt 2 Premium and Claims'!AC$6,-'Pt 2 Premium and Claims'!AC$7,-'Pt 2 Premium and Claims'!AC$13,'Pt 2 Premium and Claims'!AC$14)","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"SUM('Pt 2 Premium and Claims'!AN$5,'Pt 2 Premium and Claims'!AN$6,-'Pt 2 Premium and Claims'!AN$7,-'Pt 2 Premium and Claims'!AN$13,'Pt 2 Premium and Claims'!AN$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!AO$5,'Pt 2 Premium and Claims'!AO$6,-'Pt 2 Premium and Claims'!AO$7,-'Pt 2 Premium and Claims'!AO$13,'Pt 2 Premium and Claims'!AO$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!AP$5,'Pt 2 Premium and Claims'!AP$6,-'Pt 2 Premium and Claims'!AP$7,-'Pt 2 Premium and Claims'!AP$13,'Pt 2 Premium and Claims'!AP$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!AQ$5,'Pt 2 Premium and Claims'!AQ$6,-'Pt 2 Premium and Claims'!AQ$7,-'Pt 2 Premium and Claims'!AQ$13,'Pt 2 Premium and Claims'!AQ$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!AR$5,'Pt 2 Premium and Claims'!AR$6,-'Pt 2 Premium and Claims'!AR$7,-'Pt 2 Premium and Claims'!AR$13,'Pt 2 Premium and Claims'!AR$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!AS$5,'Pt 2 Premium and Claims'!AS$6,-'Pt 2 Premium and Claims'!AS$7,-'Pt 2 Premium and Claims'!AS$13,'Pt 2 Premium and Claims'!AS$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!AT$5,'Pt 2 Premium and Claims'!AT$6,-'Pt 2 Premium and Claims'!AT$7,-'Pt 2 Premium and Claims'!AT$13,'Pt 2 Premium and Claims'!AT$14)","v":0},{"$f":"SUM('Pt 2 Premium and Claims'!AU$5,'Pt 2 Premium and Claims'!AU$6,-'Pt 2 Premium and Claims'!AU$7,-'Pt 2 Premium and Claims'!AU$13,'Pt 2 Premium and Claims'!AU$14)","v":0}]
[null,"1.2 Federal high risk pools","Pt 1, Ln 1.2"]
[null,"1.3 State high risk pools","Pt 1, Ln 1.3"]
[null,"1.4 Net assumed less ceded reinsurance premium earned (exclude amounts already reported in Line 1.1)","Pt 1, Ln 1.9"]
[null,"1.5 Other adjustments due to MLR calculations - premium","Pt 1, Ln 1.10"]
[null,"1.6 Risk revenue","Pt 1, Ln 1.11"]
[null,"2. Claims"]
[null,"2.1 Total incurred claims (MLR Form Part 2, Line 2.16)",null,{"$f":"'Pt 2 Premium and Claims'!D$54","v":0},{"$f":"'Pt 2 Premium and Claims'!E$54","v":0},{"$f":"'Pt 2 Premium and Claims'!F$54","v":0},{"$f":"'Pt 2 Premium and Claims'!G$54","v":0},{"$f":"'Pt 2 Premium and Claims'!H$54","v":0},{"$f":"'Pt 2 Premium and Claims'!I$54","v":0},{"$f":"'Pt 2 Premium and Claims'!J$54","v":0},{"$f":"'Pt 2 Premium and Claims'!K$54","v":0},{"$f":"'Pt 2 Premium and Claims'!L$54","v":0},{"$f":"'Pt 2 Premium and Claims'!M$54","v":0},{"$f":"'Pt 2 Premium and Claims'!N$54","v":0},{"$f":"'Pt 2 Premium and Claims'!O$54","v":0},{"$f":"'Pt 2 Premium and Claims'!P$54","v":0},{"$f":"'Pt 2 Premium and Claims'!Q$54","v":0},{"$f":"'Pt 2 Premium and Claims'!R$54","v":0},{"$f":"'Pt 2 Premium and Claims'!S$54","v":0},{"$f":"'Pt 2 Premium and Claims'!T$54","v":0},{"$f":"'Pt 2 Premium and Claims'!U$54","v":0},{"$f":"'Pt 2 Premium and Claims'!V$54","v":0},{"$f":"'Pt 2 Premium and Claims'!W$54","v":0},{"$f":"'Pt 2 Premium and Claims'!X$54","v":0},{"$f":"'Pt 2 Premium and Claims'!Y$54","v":0},{"$f":"'Pt 2 Premium and Claims'!Z$54","v":0},{"$f":"'Pt 2 Premium and Claims'!AA$54","v":0},{"$f":"'Pt 2 Premium and Claims'!AB$54","v":0},{"$f":"'Pt 2 Premium and Claims'!AC$54","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"'Pt 2 Premium and Claims'!AN$54","v":0},{"$f":"'Pt 2 Premium and Claims'!AO$54","v":0},{"$f":"'Pt 2 Premium and Claims'!AP$54","v":0},{"$f":"'Pt 2 Premium and Claims'!AQ$54","v":0},{"$f":"'Pt 2 Premium and Claims'!AR$54","v":0},{"$f":"'Pt 2 Premium and Claims'!AS$54","v":0},{"$f":"'Pt 2 Premium and Claims'!AT$54","v":0},{"$f":"'Pt 2 Premium and Claims'!AU$54","v":0}]
[null,"2.2 Prescription drugs (informational only; already included in total incurred claims above)","Pt 1, Ln 2.2"]
[null,"2.3 Pharmaceutical rebates (informational only; already excluded from total incurred claims above)","Pt 1, Ln 2.3"]
[null,"2.4 State stop loss, market stabilization and claim/census based assessments\n(informational only; already excluded from total incurred claims above)","Pt 1, Ln 2.4"]
[null,"2.5 Net assumed less ceded claims incurred (exclude amounts already reported in Line 2.1)","Pt 1, Ln 5.1"]
[null,"2.6 Other adjustments due to MLR calculations – claims incurred","Pt 1, Ln 5.2"]
[null,"2.7 Rebates paid","Pt 1, Ln 5.3"]
[null,"2.8 Estimated rebates unpaid at the end of the previous MLR reporting year","Pt 1, Ln 5.4"]
[null,"2.9 Estimated rebates unpaid at the end of the MLR reporting year","Pt 1, Ln 5.5"]
[null,"2.10 Fee-for-service and co-pay revenue (net of expenses)","Pt 1, Ln 5.6"]
[null,"2.11 Allowable claims recovered through fraud reduction efforts (MLR Form Part 2, Line 2.17)","Pt 1, Ln 4",{"$f":"'Pt 2 Premium and Claims'!D$55","v":0},{"$f":"'Pt 2 Premium and Claims'!E$55","v":0},{"$f":"'Pt 2 Premium and Claims'!F$55","v":0},{"$f":"'Pt 2 Premium and Claims'!G$55","v":0},{"$f":"'Pt 2 Premium and Claims'!H$55","v":0},{"$f":"'Pt 2 Premium and Claims'!I$55","v":0},{"$f":"'Pt 2 Premium and Claims'!J$55","v":0},{"$f":"'Pt 2 Premium and Claims'!K$55","v":0},{"$f":"'Pt 2 Premium and Claims'!L$55","v":0},{"$f":"'Pt 2 Premium and Claims'!M$55","v":0},{"$f":"'Pt 2 Premium and Claims'!N$55","v":0},{"$f":"'Pt 2 Premium and Claims'!O$55","v":0},{"$f":"'Pt 2 Premium and Claims'!P$55","v":0},{"$f":"'Pt 2 Premium and Claims'!Q$55","v":0},{"$f":"'Pt 2 Premium and Claims'!R$55","v":0},{"$f":"'Pt 2 Premium and Claims'!S$55","v":0},{"$f":"'Pt 2 Premium and Claims'!T$55","v":0},{"$f":"'Pt 2 Premium and Claims'!U$55","v":0},{"$f":"'Pt 2 Premium and Claims'!V$55","v":0},{"$f":"'Pt 2 Premium and Claims'!W$55","v":0},{"$f":"'Pt 2 Premium and Claims'!X$55","v":0},{"$f":"'Pt 2 Premium and Claims'!Y$55","v":0},{"$f":"'Pt 2 Premium and Claims'!Z$55","v":0},{"$f":"'Pt 2 Premium and Claims'!AA$55","v":0},{"$f":"'Pt 2 Premium and Claims'!AB$55","v":0},{"$f":"'Pt 2 Premium and Claims'!AC$55","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"'Pt 2 Premium and Claims'!AN$55","v":0},{"$f":"'Pt 2 Premium and Claims'!AO$55","v":0},{"$f":"'Pt 2 Premium and Claims'!AP$55","v":0},{"$f":"'Pt 2 Premium and Claims'!AQ$55","v":0},{"$f":"'Pt 2 Premium and Claims'!AR$55","v":0},{"$f":"'Pt 2 Premium and Claims'!AS$55","v":0},{"$f":"'Pt 2 Premium and Claims'!AT$55","v":0},{"$f":"'Pt 2 Premium and Claims'!AU$55","v":0}]
[null,"3. Federal and State Taxes and Licensing or Regulatory Fees"]
[null,"3.1 Federal taxes and assessments incurred by the reporting issuer during the MLR reporting year","Pt 1, Ln 1.5"]
[null,"3.1a Federal income taxes deductible from premium in MLR calculations"]
[null,"3.1b Patient Centered Outcomes Research Institute (PCORI) Fee"]
[null,"3.1c Affordable Care Act section 9010 Fee"]
[null,"3.1d Other Federal Taxes and assessments deductible from premium"]
[null,"3.2 State insurance, premium and other taxes incurred by the reporting issuer during the MLR reporting year (deductible from premium in MLR calculation)","Pt 1, Ln 1.6"]
[null,"3.2a State income, excise, business, and other taxes"]
[null,"3.2b State premium taxes"]
[null,"3.2c Community benefit expenditures deductible from premium in MLR calculations","Pt 1, Ln 1.6a"]
[null,"3.3 Regulatory authority licenses and fees","Pt 1, Ln 1.7"]
[null,"3.3a Federal Transitional Reinsurance Program contributions"]
[null,"3.3b Other Federal and State regulatory authority licenses and fees"]
[null,"4. Health Care Quality Improvement Expenses Incurred"]
[null,"4.1 Improve health outcomes","Pt 1, Ln 6.1"]
[null,"4.2 Activities to prevent hospital readmission","Pt 1, Ln 6.2"]
[null,"4.3 Improve patient safety and reduce medical errors","Pt 1, Ln 6.3"]
[null,"4.4 Wellness and health promotion activities","Pt 1, Ln 6.4"]
[null,"4.5 Health information technology expenses related to improving health care quality","Pt 1, Ln 6.5"]
[null,"4.6 Allowable Implementation ICD-10 expenses (not to exceed 0.3% of premium)","Pt 1, Ln 16a"]
[null,"5. Non-Claims Costs"]
[null,"5.1 Cost containment expenses not included in quality improvement expenses in Section 4","Pt 1, Ln 8.1"]
[null,"5.2 All other claims adjustment expenses","Pt 1, Ln 8.2"]
[null,"5.3 Direct sales salaries and benefits","Pt 1, Ln 10.1"]
[null,"5.4 Agents and brokers fees and commissions","Pt 1, Ln 10.2"]
[null,"5.5 Other taxes"]
[null,"5.5a Taxes and assessments (exclude amounts reported in Section 3 or Line 9)"]
[null,"5.5b Fines and penalties of regulatory authorities (exclude amounts reported in Line 3.3)"]
[null,"5.6 Other general and administrative expenses"]
[null,"5.7 Community benefit expenditures (informational only; include amounts reported in Lines 3.2c and 5.6)","Pt 1, Ln 10.4a"]
[null,"5.8 ICD-10 implementation expenses (informational only; include amounts reported in Lines 4.6 and 5.6)","Pt 1, Ln 16"]
[null,"6. Income from fees of uninsured plans","Pt 1, Ln 12"]
[null,"7. Other Indicators or information"]
[null,"7.1 Number of policies/certificates","Pt 1 Other, Ln 1"]
[null,"7.2 Number of covered lives","Pt 1 Other, Ln 2"]
[null,"7.3 Number of groups","Pt 1 Other, Ln 3"]
[null,"7.4 Member months","Pt 1 Other, Ln 4"]
[null,"7.5 Number of life-years",null,{"$f":"D$59/12","v":0},{"$f":"E$59/12","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,0,null,null,null,null,null,null,null,null,null,null,{"$f":"AN$59/12","v":0},0,0,0,0,0,0,0,0]
[null,"8. Net investment income and other gain / (loss)","Pt 1, Ln 13"]
[null,"9. Other Federal income taxes (exclude taxes on Lines 3.1a-d)","Pt 1, Ln 14"]

{"sheet":"Pt 2 Premium and Claims","index":4,"n_rows":58,"n_cols":49,"rows_kept":58,"cut":false,"hidden":false,"merged":[]}
[null,"Part 2 Premium and Claims"]
[]
[null,"Line Description","SHCE","1\nHealth Insurance\nINDIVIDUAL\nTotal as of 12/31/15","2\nHealth Insurance\nINDIVIDUAL\nTotal as of 3/31/16","3\nHealth Insurance\nINDIVIDUAL\nDual Contracts\n(Included in Total as of 3/31/16)","4\nHealth Insurance\nINDIVIDUAL\nDeferred PY1\n(Add)","5\nHealth Insurance\nINDIVIDUAL\nDeferred CY\n(Subtract)","2A\nHealth Insurance\nINDIVIDUAL\n[Risk Corridors]\nTotal as of 3/31/16","6\nHealth Insurance\nSMALL GROUP\nTotal as of 12/31/15","7\nHealth Insurance\nSMALL GROUP\nTotal as of 3/31/16","8\nHealth Insurance\nSMALL GROUP\nDual Contracts\n(Included in Total as of 3/31/16)","9\nHealth Insurance\nSMALL GROUP\nDeferred PY1\n(Add)","10\nHealth Insurance\nSMALL GROUP\nDeferred CY\n(Subtract)","7A\nHealth Insurance\nSMALL GROUP\n[Risk Corridors]\nTotal as of 3/31/16","11\nHealth Insurance\nLARGE GROUP\nTotal as of 12/31/15","12\nHealth Insurance\nLARGE GROUP\nTotal as of 3/31/16","13\nHealth Insurance\nLARGE GROUP\nDual Contracts\n(Included in Total as of 3/31/16)","14\nHealth Insurance\nLARGE GROUP\nDeferred PY1\n(Add)","15\nHealth Insurance\nLARGE GROUP\nDeferred CY\n(Subtract)","16\nMini-Med\nINDIVIDUAL\nTotal as of 12/31/15","17\nMini-Med\nINDIVIDUAL\nTotal as of 3/31/16","18\nMini-Med\nINDIVIDUAL\nDual Contracts\n(Included in Total as of 3/31/16)","19\nMini-Med\nSMALL GROUP\nTotal as of 12/31/15","20\nMini-Med\nSMALL GROUP\nTotal as of 3/31/16","21\nMini-Med\nSMALL GROUP\nDual Contracts\n(Included in Total as of 3/31/16)","22\nMini-Med\nLARGE GROUP\nTotal as of 12/31/15","23\nMini-Med\nLARGE GROUP\nTotal as of 3/31/16","24\nMini-Med\nLARGE GROUP\nDual Contracts\n(Included in Total as of 3/31/16)","25\nExpat\nSMALL GROUP\nTotal as of 12/31/15","26\nExpat\nSMALL GROUP\nTotal as of 3/31/16","27\nExpat\nSMALL GROUP\nDual Contracts\n(Included in Total as of 3/31/16)","28\nExpat\nSMALL GROUP\nDeferred PY1\n(Add)","29\nExpat\nSMALL GROUP\nDeferred CY\n(Subtract)","30\nExpat\nLARGE GROUP\nTotal as of 12/31/15","31\nExpat\nLARGE GROUP\nTotal as of 3/31/16","32\nExpat\nLARGE GROUP\nDual Contracts\n(Included in Total as of 3/31/16)","33\nExpat\nLARGE GROUP\nDeferred PY1\n(Add)","34\nExpat\nLARGE GROUP\nDeferred CY\n(Subtract)","35\nStudent Health\nINDIVIDUAL\nTotal as of 12/31/15","36\nStudent Health\nINDIVIDUAL\nTotal as of 3/31/16","37\nStudent Health\nINDIVIDUAL\nDual Contracts\n(Included in Total as of 3/31/16)","38\nStudent Health\nINDIVIDUAL\nDeferred PY1\n(Add)","39\nStudent Health\nINDIVIDUAL\nDeferred CY\n(Subtract)","40\nGovernment Program Plans \nTotal as of 12/31/15","41\nOther Health Business \nTotal as of 12/31/15","42\nMedicare MLR Business\nTotal as of 12/31/15","43\nUninsured Plans\nTotal as of 12/31/15","44\nGrand Total\nTotal as of 12/31/15"]
[null,"1. Premium"]
[null,"1.1 Direct premium written"]
[null,"1.2 Unearned premium prior year","Pt 2, Ln 1.2"]
[null,"1.3 Unearned premium MLR Reporting year","Pt 2, Ln 1.3"]
[null,"1.4 Experience rating refunds (rate credits) paid"]
[null,"1.4a Experience rating refunds, with all incurred dates, paid in the MLR reporting year","Pt 2, Ln 1.5"]
[null,"1.4b Experience rating refunds associated with premium earned only in the reporting year and paid through 3/31 of the following year"]
[null,"1.5 Reserve for experience rating refunds (rate credits) MLR Reporting year","Pt 2, Ln 1.6"]
[null,"1.6 Reserve for experience rating refunds (rate credits) prior year","Pt 2, Ln 1.7"]
[null,"1.7 Premium balances written off","Pt 2, Ln 1.9"]
[null,"1.8 Group conversion charges","Pt 2, Ln 1.10"]
[null,"1.9 Federal Transitional Reinsurance Program payments expected from HHS (as indicated by HHS as of 6/30)"]
[null,"1.10 Federal Risk Adjustment Program net payments expected from HHS / (charges payable to HHS) (as indicated by HHS as of 6/30)"]
[null,"1.11 Federal Risk Corridors Program net payments / (charges)"]
[null,"1.12 Premium ceded under 100% reinsurance (informational only; already excluded from Lines 1.1-1.11)"]
[null,"1.13 Premium assumed under 100% reinsurance (informational only; already included in Lines 1.1-1.11)"]
[null,"1.14 Advance payments of the premium tax credit received from HHS (informational only; already included in Lines 1.1-1.11)"]
[null,"2. Claims"]
[null,"2.1 Claims Paid"]
[null,"2.1a  Claims paid during the MLR reporting year regardless of incurred date"]
[null,"2.1b  Claims incurred only during the MLR reporting year, paid through 3/31 of the following year"]
[null,"2.2 Direct claim liability"]
[null,"2.2a Liability as of 12/31 of MLR reporting year for all claims regardless of incurred date","Pt 2, Ln 2.2"]
[null,"2.2b Liability for claims incurred only during the MLR reporting year, calculated as of 3/31 of the following year"]
[null,"2.3 Direct claim liability prior year","Pt 2, Ln 2.3"]
[null,"2.4 Direct claim reserves"]
[null,"2.4a Reserves as of 12/31 of MLR reporting year for all claims regardless of incurred date","Pt 2, Ln 2.4"]
[null,"2.4b Reserves for claims incurred only during the MLR reporting year, calculated as of 3/31 of the following year"]
[null,"2.5 Direct claim reserves prior year","Pt 2, Ln 2.5"]
[null,"2.6 Direct contract reserves"]
[null,"2.6a Direct contract reserves 12/31 column","Pt 2, Ln 2.6"]
[null,"2.6b Direct contract reserves 3/31, dual contract, deferred columns"]
[null,"2.7 Direct contract reserves prior year","Pt 2, Ln 2.7"]
[null,"2.8 Experience rating refunds (rate credits) paid"]
[null,"2.8a Experience rating refunds, with all incurred dates, paid in the MLR reporting year","Pt 2, Ln 2.8"]
[null,"2.8b Experience rating refunds associated with premium earned only in the reporting year and paid through 3/31 of the following year"]
[null,"2.9 Reserve for experience rating refunds (rate credits)"]
[null,"2.9a Reserved in MLR reporting year regardless of incurred date","Pt 2, Ln 2.9"]
[null,"2.9b Reserves specific to the MLR reporting year through 3/31 of the following year"]
[null,"2.10 Reserve for experience rating refunds (rate credits) prior year","Pt 2, Ln 2.10"]
[null,"2.11 Incurred medical incentive pool and bonuses"]
[null,"2.11a  Paid medical incentive pools and bonuses MLR Reporting year","Pt 2, Ln 2.11a"]
[null,"2.11b  Accrued medical incentive pools and bonuses MLR Reporting year","Pt 2, Ln 2.11b"]
[null,"2.11c  Accrued medical incentive pools and bonuses prior year","Pt 2, Ln 2.11c"]
[null,"2.12 Net healthcare receivables "]
[null,"2.12a  Healthcare receivables MLR Reporting year","Pt 2, Ln 2.12a"]
[null,"2.12b  Healthcare receivables prior year","Pt 2, Ln 2.12b"]
[null,"2.13 Contingent benefit and lawsuit reserves"]
[null,"2.14 Group conversion charges","Pt 2, Ln 2.13"]
[null,"2.15 Blended rate adjustment","Pt 2, Ln 2.14"]
[null,"2.16 Total incurred claims ","Pt 2, Ln 2.15",{"$f":"D23+D26-D28+D30-D32+D34-D36+D38+D41-D43+D45+D46-D47-D49+D50+D51+D52+D53","v":0},{"$f":"E24+E27+E31+E35-E36+E39+E42+E45+E46-E49+E51+E52+E53","v":0},{"$f":"F24+F27+F31+F35-F36+F39+F42+F45+F46-F49+F51+F52+F53","v":0},{"$f":"G24+G27+G31+G35-G36+G39+G42+G45+G46-G49+G51+G52+G53","v":0},{"$f":"H24+H27+H31+H35-H36+H39+H42+H45+H46-H49+H51+H52+H53","v":0},{"$f":"I24+I27+I31+I35-I36+I39+I42+I45+I46-I49+I51+I52+I53","v":0},{"$f":"J23+J26-J28+J30-J32+J34-J36+J38+J41-J43+J45+J46-J47-J49+J50+J51+J52+J53","v":0},{"$f":"K24+K27+K31+K35-K36+K39+K42+K45+K46-K49+K51+K52+K53","v":0},{"$f":"L24+L27+L31+L35-L36+L39+L42+L45+L46-L49+L51+L52+L53","v":0},{"$f":"M24+M27+M31+M35-M36+M39+M42+M45+M46-M49+M51+M52+M53","v":0},{"$f":"N24+N27+N31+N35-N36+N39+N42+N45+N46-N49+N51+N52+N53","v":0},{"$f":"O24+O27+O31+O35-O36+O39+O42+O45+O46-O49+O51+O52+O53","v":0},{"$f":"P23+P26-P28+P30-P32+P34-P36+P38+P41-P43+P45+P46-P47-P49+P50+P51+P52+P53","v":0},{"$f":"Q24+Q27+Q31+Q35-Q36+Q39+Q42+Q45+Q46-Q49+Q51+Q52+Q53","v":0},{"$f":"R24+R27+R31+R35-R36+R39+R42+R45+R46-R49+R51+R52+R53","v":0},{"$f":"S24+S27+S31+S35-S36+S39+S42+S45+S46-S49+S51+S52+S53","v":0},{"$f":"T24+T27+T31+T35-T36+T39+T42+T45+T46-T49+T51+T52+T53","v":0},{"$f":"U23+U26-U28+U30-U32+U34-U36+U38+U41-U43+U45+U46-U47-U49+U50+U51+U52+U53","v":0},{"$f":"V24+V27+V31+V35-V36+V39+V42+V45+V46-V49+V51+V52+V53","v":0},{"$f":"W24+W27+W31+W35-W36+W39+W42+W45+W46-W49+W51+W52+W53","v":0},{"$f":"X23+X26-X28+X30-X32+X34-X36+X38+X41-X43+X45+X46-X47-X49+X50+X51+X52+X53","v":0},{"$f":"Y24+Y27+Y31+Y35-Y36+Y39+Y42+Y45+Y46-Y49+Y51+Y52+Y53","v":0},{"$f":"Z24+Z27+Z31+Z35-Z36+Z39+Z42+Z45+Z46-Z49+Z51+Z52+Z53","v":0},{"$f":"AA23+AA26-AA28+AA30-AA32+AA34-AA36+AA38+AA41-AA43+AA45+AA46-AA47-AA49+AA50+AA51+AA52+AA53","v":0},{"$f":"AB24+AB27+AB31+AB35-AB36+AB39+AB42+AB45+AB46-AB49+AB51+AB52+AB53","v":0},{"$f":"AC24+AC27+AC31+AC35-AC36+AC39+AC42+AC45+AC46-AC49+AC51+AC52+AC53","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"AN23+AN26-AN28+AN30-AN32+AN34-AN36+AN38+AN41-AN43+AN45+AN46-AN47-AN49+AN50+AN51+AN52+AN53","v":0},{"$f":"AO24+AO27+AO31+AO35-AO36+AO39+AO42+AO45+AO46-AO49+AO51+AO52+AO53","v":0},{"$f":"AP24+AP27+AP31+AP35-AP36+AP39+AP42+AP45+AP46-AP49+AP51+AP52+AP53","v":0},{"$f":"AQ24+AQ27+AQ31+AQ35-AQ36+AQ39+AQ42+AQ45+AQ46-AQ49+AQ51+AQ52+AQ53","v":0},{"$f":"AR24+AR27+AR31+AR35-AR36+AR39+AR42+AR45+AR46-AR49+AR51+AR52+AR53","v":0},{"$f":"AS23+AS26-AS28+AS30-AS32+AS34-AS36+AS38+AS41-AS43+AS45+AS46-AS47-AS49+AS50+AS51+AS52+AS53","v":0},{"$f":"AT23+AT26-AT28+AT30-AT32+AT34-AT36+AT38+AT41-AT43+AT45+AT46-AT47-AT49+AT50+AT51+AT52+AT53","v":0},{"$f":"AU23+AU26-AU28+AU30-AU32+AU34-AU36+AU38+AU41-AU43+AU45+AU46-AU47-AU49+AU50+AU51+AU52+AU53","v":0}]
[null,"2.17 Allowable claims recovered through fraud reduction efforts (the smaller of Lines 2.17a or 2.17b)","Pt 1, Ln 4",{"$f":"MIN(MAX(0,D56),MAX(0,D57))","v":0},0,0,0,0,0,0,0,0,0,0,0,{"$f":"MIN(MAX(0,P56),MAX(0,P57))","v":0},0,0,0,0,0,0,0,0,0,0,0,0,0,null,null,null,null,null,null,null,null,null,null,0,0,0,0,0,0,0,0]
[null,"2.17a  Total fraud reduction expense","Pt 3, Col 7, Ln 1.11/2.11/3.11/5.11/6.11"]
[null,"2.17b  Total fraud recoveries that reduced paid claims in Line 2.1","Pt 2, Ln 3"]
[null,"2.18 Reconciled payments of cost-sharing reductions"]

{"sheet":"Pt 3 MLR and Rebate Calculation","index":5,"n_rows":64,"n_cols":40,"rows_kept":64,"cut":false,"hidden":false,"merged":[]}
[null,"Part 3 MLR and Rebate Calculation"]
[]
[null,"Line Description","1\nHealth Insurance Coverage\nINDIVIDUAL\nPY2","2\nHealth Insurance Coverage\nINDIVIDUAL\nPY1","3\nHealth Insurance Coverage\nINDIVIDUAL\nCY","4\nHealth Insurance Coverage\nINDIVIDUAL\nTotal ","4A\nHealth Insurance Coverage\nINDIVIDUAL\nRC","5\nHealth Insurance Coverage\nSMALL GROUP\nPY2","6\nHealth Insurance Coverage\nSMALL GROUP\nPY1","7\nHealth Insurance Coverage\nSMALL GROUP\nCY","8\nHealth Insurance Coverage\nSMALL GROUP\nTotal","8A\nHealth Insurance Coverage\nSMALL GROUP\nRC","9\nHealth Insurance Coverage\nLARGE GROUP\nPY2","10\nHealth Insurance Coverage\nLARGE GROUP\nPY1","11\nHealth Insurance Coverage\nLARGE GROUP\nCY","12\nHealth Insurance Coverage\nLARGE GROUP\nTotal","13\nMini-Med Plans\nINDIVIDUAL\nPY2","14\nMini-Med Plans\nINDIVIDUAL\nPY1","15\nMini-Med Plans\nINDIVIDUAL\nCY","16\nMini-Med Plans\nINDIVIDUAL\nTotal ","17\nMini-Med Plans\nSMALL GROUP\nPY2","18\nMini-Med Plans\nSMALL GROUP\nPY1","19\nMini-Med Plans\nSMALL GROUP\nCY","20\nMini-Med Plans\nSMALL GROUP\nTotal","21\nMini-Med Plans\nLARGE GROUP\nPY2","22\nMini-Med Plans\nLARGE GROUP\nPY1","23\nMini-Med Plans\nLARGE GROUP\nCY","24\nMini-Med Plans\nLARGE GROUP\nTotal","25\nExpatriate Plans\nSMALL GROUP\nPY2","26\nExpatriate Plans\nSMALL GROUP\nPY1","27\nExpatriate Plans\nSMALL GROUP\nCY","28\nExpatriate Plans\nSMALL GROUP\nTotal ","29\nExpatriate Plans\nLARGE GROUP\nPY2","30\nExpatriate Plans\nLARGE GROUP\nPY1","31\nExpatriate Plans\nLARGE GROUP\nCY","32\nExpatriate Plans\nLARGE GROUP\nTotal","33\nStudent Health Plans\nINDIVIDUAL\nPY2","34\nStudent Health Plans\nINDIVIDUAL\nPY1","35\nStudent Health Plans\nINDIVIDUAL\nCY","36\nStudent Health Plans\nINDIVIDUAL\nTotal"]
[null,"1. Medical Loss Ratio Numerator"]
[null,"1.1 Adjusted incurred claims as reported on MLR Form for prior year(s)"]
[null,"1.2 Adjusted incurred claims as of 3/31 of the year following the MLR reporting year",null,null,{"$f":"SUM('Pt 1 Summary of Data'!E$12,'Pt 1 Summary of Data'!E$22)+SUM('Pt 1 Summary of Data'!G$12,'Pt 1 Summary of Data'!G$22)-SUM('Pt 1 Summary of Data'!H$12,'Pt 1 Summary of Data'!H$22)","v":0},{"$f":"SUM(C6:E6)","v":0},{"$f":"SUM('Pt 1 Summary of Data'!I$12,'Pt 1 Summary of Data'!I$22)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!K$12,'Pt 1 Summary of Data'!K$22)+SUM('Pt 1 Summary of Data'!M$12,'Pt 1 Summary of Data'!M$22)-SUM('Pt 1 Summary of Data'!N$12,'Pt 1 Summary of Data'!N$22)","v":0},{"$f":"SUM(H6:J6)","v":0},{"$f":"SUM('Pt 1 Summary of Data'!O$12,'Pt 1 Summary of Data'!O$22)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!Q$12,'Pt 1 Summary of Data'!Q$22)+SUM('Pt 1 Summary of Data'!S$12,'Pt 1 Summary of Data'!S$22)-SUM('Pt 1 Summary of Data'!T$12,'Pt 1 Summary of Data'!T$22)","v":0},{"$f":"SUM(M6:O6)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!V$12,'Pt 1 Summary of Data'!V$22)","v":0},{"$f":"SUM(Q6:S6)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!Y$12,'Pt 1 Summary of Data'!Y$22)","v":0},{"$f":"SUM(U6:W6)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!AB$12,'Pt 1 Summary of Data'!AB$22)","v":0},{"$f":"SUM(Y6:AA6)","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"SUM('Pt 1 Summary of Data'!AO$12,'Pt 1 Summary of Data'!AO$22)+SUM('Pt 1 Summary of Data'!AQ$12,'Pt 1 Summary of Data'!AQ$22)-SUM('Pt 1 Summary of Data'!AR$12,'Pt 1 Summary of Data'!AR$22)","v":0},{"$f":"SUM(AK6:AM6)","v":0}]
[null,"1.3 Improving Health Care Quality Expenses ",null,null,{"$f":"SUM('Pt 1 Summary of Data'!E$37:E$41)+SUM('Pt 1 Summary of Data'!G$37:G$41)-SUM('Pt 1 Summary of Data'!H$37:H$41)+MAX(0,MIN('Pt 1 Summary of Data'!E$42+'Pt 1 Summary of Data'!G$42-'Pt 1 Summary of Data'!H$42,0.3%*('Pt 1 Summary of Data'!E$5+'Pt 1 Summary of Data'!G$5-'Pt 1 Summary of Data'!H$5-SUM(E$9:E$11))))","v":0},0,{"$f":"SUM('Pt 1 Summary of Data'!I$37:I$41)+MAX(0,MIN(VALUE('Pt 1 Summary of Data'!I$42),0.3%*('Pt 1 Summary of Data'!I$5-SUM(G$9:G$10))))","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!K$37:K$41)+SUM('Pt 1 Summary of Data'!M$37:M$41)-SUM('Pt 1 Summary of Data'!N$37:N$41)+MAX(0,MIN('Pt 1 Summary of Data'!K$42+'Pt 1 Summary of Data'!M$42-'Pt 1 Summary of Data'!N$42,0.3%*('Pt 1 Summary of Data'!K$5+'Pt 1 Summary of Data'!M$5-'Pt 1 Summary of Data'!N$5-SUM(J$10:J$11))))","v":0},{"$f":"SUM(H7:J7)","v":0},{"$f":"SUM('Pt 1 Summary of Data'!O$37:O$41)+MAX(0,MIN(VALUE('Pt 1 Summary of Data'!O$42),0.3%*('Pt 1 Summary of Data'!O$5-L$10)))","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!Q$37:Q$41)+SUM('Pt 1 Summary of Data'!S$37:S$41)-SUM('Pt 1 Summary of Data'!T$37:T$41)+MAX(0,MIN('Pt 1 Summary of Data'!Q$42+'Pt 1 Summary of Data'!S$42-'Pt 1 Summary of Data'!T$42,0.3%*('Pt 1 Summary of Data'!Q$5+'Pt 1 Summary of Data'!S$5-'Pt 1 Summary of Data'!T$5)))","v":0},{"$f":"SUM(M7:O7)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!V$37:V$41)+MAX(0,MIN('Pt 1 Summary of Data'!V$42,0.3%*'Pt 1 Summary of Data'!V$5))","v":0},{"$f":"SUM(Q7:S7)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!Y$37:Y$41)+MAX(0,MIN('Pt 1 Summary of Data'!Y$42,0.3%*'Pt 1 Summary of Data'!Y$5))","v":0},{"$f":"SUM(U7:W7)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!AB$37:AB$41)+MAX(0,MIN('Pt 1 Summary of Data'!AB$42,0.3%*'Pt 1 Summary of Data'!AB$5))","v":0},{"$f":"SUM(Y7:AA7)","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"SUM('Pt 1 Summary of Data'!AO$37:AO$41)+SUM('Pt 1 Summary of Data'!AQ$37:AQ$41)-SUM('Pt 1 Summary of Data'!AR$37:AR$41)+MAX(0,MIN('Pt 1 Summary of Data'!AO$42+'Pt 1 Summary of Data'!AQ$42-'Pt 1 Summary of Data'!AR$42,0.3%*('Pt 1 Summary of Data'!AO$5+'Pt 1 Summary of Data'!AQ$5-'Pt 1 Summary of Data'!AR$5)))","v":0},{"$f":"SUM(AK7:AM7)","v":0}]
[null,"1.4 Reconciled payments of cost-sharing reductions",null,null,{"$f":"'Pt 2 Premium and Claims'!E58+'Pt 2 Premium and Claims'!G58-'Pt 2 Premium and Claims'!H58","v":0},0,{"$f":"'Pt 2 Premium and Claims'!I58","v":0}]
[null,"1.5 Federal Transitional Reinsurance Program payments expected from HHS (as indicated by HHS as of 6/30)",null,null,{"$f":"'Pt 2 Premium and Claims'!E$15+'Pt 2 Premium and Claims'!G$15-'Pt 2 Premium and Claims'!H$15","v":0},0,{"$f":"'Pt 2 Premium and Claims'!I$15","v":0}]
[null,"1.6 Federal Risk Adjustment Program net payments expected from HHS / (charges payable to HHS) (as indicated by HHS as of 6/30)",null,null,{"$f":"'Pt 2 Premium and Claims'!E$16+'Pt 2 Premium and Claims'!G$16-'Pt 2 Premium and Claims'!H$16","v":0},0,{"$f":"'Pt 2 Premium and Claims'!I$16","v":0},null,null,{"$f":"'Pt 2 Premium and Claims'!K$16+'Pt 2 Premium and Claims'!M$16-'Pt 2 Premium and Claims'!N$16","v":0},{"$f":"SUM(H10:J10)","v":0},{"$f":"'Pt 2 Premium and Claims'!O$16","v":0}]
[null,"1.7 Federal Risk Corridors Program net payments / (charges)",null,null,{"$f":"'Pt 2 Premium and Claims'!E$17+'Pt 2 Premium and Claims'!G$17-'Pt 2 Premium and Claims'!H$17","v":0},0,null,null,null,{"$f":"'Pt 2 Premium and Claims'!K$17+'Pt 2 Premium and Claims'!M$17-'Pt 2 Premium and Claims'!N$17","v":0},{"$f":"SUM(H11:J11)","v":0}]
[null,"1.8 MLR numerator ",{"$f":"SUM(C$6:C$7)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($C$6:$F$11,$C$15:$F$16,$C$38:$D$38)<>0),SUM(H$6:H$7),0)","v":0},{"$f":"SUM(D$6:D$7) - SUM(D$8:D$11)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($C$6:$F$11,$C$15:$F$16,$C$38:$D$38)<>0),SUM(I$6:I$7) - SUM(I$10:I$11),0)","v":0},{"$f":"SUM(E$6:E$7)-SUM(E$8:E$11)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($C$6:$F$11,$C$15:$F$16,$C$38:$D$38)<>0),SUM(J$6:J$7)-SUM(J$10:J$11),0)","v":0},{"$f":"IFERROR(SUM(C$12:E$12)+C$17*MAX(0,E$50-C$50)+D$17*MAX(0,E$50-D$50),0)","v":0},null,{"$f":"SUM(H$6:H$7)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($H$6:$K$11,$H$15:$K$16,$H$38:$I$38)<>0),SUM(C$6:C$7),0)","v":0},{"$f":"SUM(I$6:I$7) - SUM(I$10:I$11)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($H$6:$K$11,$H$15:$K$16,$H$38:$I$38)<>0),SUM(D$6:D$7) - SUM(D$8:D$11),0)","v":0},{"$f":"SUM(J$6:J$7)-SUM(J$10:J$11)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($H$6:$K$11,$H$15:$K$16,$H$38:$I$38)<>0),SUM(E$6:E$7)-SUM(E$8:E$11),0)","v":0},{"$f":"IFERROR(SUM(H$12:J$12)+H$17*MAX(0,J$50-H$50)+I$17*MAX(0,J$50-I$50),0)","v":0},null,{"$f":"SUM(M$6:M$7)","v":0},{"$f":"SUM(N$6:N$7)","v":0},{"$f":"SUM(O$6:O$7)","v":0},{"$f":"SUM(M$12:O$12)+M$17*MAX(0,O$50-M$50)+N$17*MAX(0,O$50-N$50)","v":0}]
[null,"1.9 MLR numerator Mini-Med and Student Health (using adjustment factor)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"1.5*(SUM(Q$6:Q$7)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($Q$6:$T$7,$Q$15:$T$16,$Q$38:$R$38)<>0),SUM(U$6:U$7),0))","v":0},{"$f":"1.25*(SUM(R$6:R$7)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($Q$6:$T$7,$Q$15:$T$16,$Q$38:$R$38)<>0),SUM(V$6:V$7),0))","v":0},{"$f":"SUM(S$6:S$7)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($Q$6:$T$7,$Q$15:$T$16,$Q$38:$R$38)<>0),SUM(W$6:W$7),0)","v":0},{"$f":"IFERROR(SUM(T$6:T$7)+Q$17*MAX(0,S$50-Q$50)+R$17*MAX(0,S$50-R$50)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($Q$6:$T$7,$Q$15:$T$16,$Q$38:$R$38)<>0),SUM(X$6:X$7),0),0)","v":0},{"$f":"1.5*(SUM(U$6:U$7)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($U$6:$X$7,$U$15:$X$16,$U$38:$V$38)<>0),SUM(Q$6:Q$7),0))","v":0},{"$f":"1.25*(SUM(V$6:V$7)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($U$6:$X$7,$U$15:$X$16,$U$38:$V$38)<>0),SUM(R$6:R$7),0))","v":0},{"$f":"SUM(W$6:W$7)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($U$6:$X$7,$U$15:$X$16,$U$38:$V$38)<>0),SUM(S$6:S$7),0)","v":0},{"$f":"IFERROR(SUM(X$6:X$7)+U$17*MAX(0,W$50-U$50)+V$17*MAX(0,W$50-V$50)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($U$6:$X$7,$U$15:$X$16,$U$38:$V$38)<>0),SUM(T$6:T$7),0),0)","v":0},{"$f":"1.5*SUM(Y$6:Y$7)","v":0},{"$f":"1.25*SUM(Z$6:Z$7)","v":0},{"$f":"SUM(AA$6:AA$7)","v":0},{"$f":"SUM(AB$6:AB$7)+Y$17*MAX(0,AA$50-Y$50)+Z$17*MAX(0,AA$50-Z$50)","v":0},null,null,null,null,null,null,null,null,{"$f":"1.15*SUM(AK$6:AK$7)","v":0},{"$f":"SUM(AL$6:AL$7)","v":0},{"$f":"SUM(AM$6:AM$7)","v":0},{"$f":"SUM(AN$6:AN$7)","v":0}]
[null,"2. Medical Loss Ratio Denominator"]
[null,"2.1 Premium earned including Federal and State high risk programs and adjusted for net premium stabilization program payments / (charges)",null,null,{"$f":"SUM('Pt 1 Summary of Data'!E$5:E$7)+SUM('Pt 1 Summary of Data'!G$5:G$7)-SUM('Pt 1 Summary of Data'!H$5:H$7)-SUM(E$9:E$11)","v":0},{"$f":"SUM(C15:E15)","v":0},{"$f":"SUM('Pt 1 Summary of Data'!I$5:I$7)-SUM(G$9:G$10)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!K$5:K$7)+SUM('Pt 1 Summary of Data'!M$5:M$7)-SUM('Pt 1 Summary of Data'!N$5:N$7)-SUM(J$10:J$11)","v":0},{"$f":"SUM(H15:J15)","v":0},{"$f":"SUM('Pt 1 Summary of Data'!O$5:O$7)-L$10","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!Q$5:Q$7)+SUM('Pt 1 Summary of Data'!S$5:S$7)-SUM('Pt 1 Summary of Data'!T$5:T$7)+N$56","v":0},{"$f":"SUM(M15:O15)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!V$5:V$7)+R$56","v":0},{"$f":"SUM(Q15:S15)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!Y$5:Y$7)+V$56","v":0},{"$f":"SUM(U15:W15)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!AB$5:AB$7)+Z$56","v":0},{"$f":"SUM(Y15:AA15)","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"SUM('Pt 1 Summary of Data'!AO$5:AO$7)+SUM('Pt 1 Summary of Data'!AQ$5:AQ$7)-SUM('Pt 1 Summary of Data'!AR$5:AR$7)+AL$56","v":0},{"$f":"SUM(AK15:AM15)","v":0}]
[null,"2.2 Federal and State taxes and licensing or regulatory fees",null,null,{"$f":"SUM('Pt 1 Summary of Data'!E$25:E$28,'Pt 1 Summary of Data'!E$30,'Pt 1 Summary of Data'!E$34:E$35)+SUM('Pt 1 Summary of Data'!G$25:G$28,'Pt 1 Summary of Data'!G$30,'Pt 1 Summary of Data'!G$34:G$35)-SUM('Pt 1 Summary of Data'!H$25:H$28,'Pt 1 Summary of Data'!H$30,'Pt 1 Summary of Data'!H$34:H$35)+IF('Company Information'!$C$15=\"No\",IF(MAX('Pt 1 Summary of Data'!E$31:E$32)=0,MIN('Pt 1 Summary of Data'!E$31:E$32),MAX('Pt 1 Summary of Data'!E$31:E$32))+IF(MAX('Pt 1 Summary of Data'!G$31:G$32)=0,MIN('Pt 1 Summary of Data'!G$31:G$32),MAX('Pt 1 Summary of Data'!G$31:G$32))-IF(MAX('Pt 1 Summary of Data'!H$31:H$32)=0,MIN('Pt 1 Summary of Data'!H$31:H$32),MAX('Pt 1 Summary of Data'!H$31:H$32)),SUM('Pt 1 Summary of Data'!E$31:E$32)+SUM('Pt 1 Summary of Data'!G$31:G$32)-SUM('Pt 1 Summary of Data'!H$31:H$32))","v":0},{"$f":"SUM(C16:E16)","v":0},{"$f":"SUM('Pt 1 Summary of Data'!I$25:I$28,'Pt 1 Summary of Data'!I$30,'Pt 1 Summary of Data'!I$34:I$35)+IF('Company Information'!$C$15=\"No\",IF(MAX('Pt 1 Summary of Data'!I$31:I$32)=0,MIN('Pt 1 Summary of Data'!I$31:I$32),MAX('Pt 1 Summary of Data'!I$31:I$32)),SUM('Pt 1 Summary of Data'!I$31:I$32))","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!K$25:K$28,'Pt 1 Summary of Data'!K$30,'Pt 1 Summary of Data'!K$34:K$35)+SUM('Pt 1 Summary of Data'!M$25:M$28,'Pt 1 Summary of Data'!M$30,'Pt 1 Summary of Data'!M$34:M$35)-SUM('Pt 1 Summary of Data'!N$25:N$28,'Pt 1 Summary of Data'!N$30,'Pt 1 Summary of Data'!N$34:N$35)+IF('Company Information'!$C$15=\"No\",IF(MAX('Pt 1 Summary of Data'!K$31:K$32)=0,MIN('Pt 1 Summary of Data'!K$31:K$32),MAX('Pt 1 Summary of Data'!K$31:K$32))+IF(MAX('Pt 1 Summary of Data'!M$31:M$32)=0,MIN('Pt 1 Summary of Data'!M$31:M$32),MAX('Pt 1 Summary of Data'!M$31:M$32))-IF(MAX('Pt 1 Summary of Data'!N$31:N$32)=0,MIN('Pt 1 Summary of Data'!N$31:N$32),MAX('Pt 1 Summary of Data'!N$31:N$32)),SUM('Pt 1 Summary of Data'!K$31:K$32)+SUM('Pt 1 Summary of Data'!M$31:M$32)-SUM('Pt 1 Summary of Data'!N$31:N$32))","v":0},{"$f":"SUM(H16:J16)","v":0},{"$f":"SUM('Pt 1 Summary of Data'!O$25:O$28,'Pt 1 Summary of Data'!O$30,'Pt 1 Summary of Data'!O$34:O$35)+IF('Company Information'!$C$15=\"No\",IF(MAX('Pt 1 Summary of Data'!O$31:O$32)=0,MIN('Pt 1 Summary of Data'!O$31:O$32),MAX('Pt 1 Summary of Data'!O$31:O$32)),SUM('Pt 1 Summary of Data'!O$31:O$32))","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!Q$25:Q$28,'Pt 1 Summary of Data'!Q$30,'Pt 1 Summary of Data'!Q$34:Q$35)+SUM('Pt 1 Summary of Data'!S$25:S$28,'Pt 1 Summary of Data'!S$30,'Pt 1 Summary of Data'!S$34:S$35)-SUM('Pt 1 Summary of Data'!T$25:T$28,'Pt 1 Summary of Data'!T$30,'Pt 1 Summary of Data'!T$34:T$35)+IF('Company Information'!$C$15=\"No\",IF(MAX('Pt 1 Summary of Data'!Q$31:Q$32)=0,MIN('Pt 1 Summary of Data'!Q$31:Q$32),MAX('Pt 1 Summary of Data'!Q$31:Q$32))+IF(MAX('Pt 1 Summary of Data'!S$31:S$32)=0,MIN('Pt 1 Summary of Data'!S$31:S$32),MAX('Pt 1 Summary of Data'!S$31:S$32))-IF(MAX('Pt 1 Summary of Data'!T$31:T$32)=0,MIN('Pt 1 Summary of Data'!T$31:T$32),MAX('Pt 1 Summary of Data'!T$31:T$32)),SUM('Pt 1 Summary of Data'!Q$31:Q$32)+SUM('Pt 1 Summary of Data'!S$31:S$32)-SUM('Pt 1 Summary of Data'!T$31:T$32))+N$57","v":0},{"$f":"SUM(M16:O16)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!V$25:V$28,'Pt 1 Summary of Data'!V$30,'Pt 1 Summary of Data'!V$34:V$35)+IF('Company Information'!$C$15=\"No\",IF(MAX('Pt 1 Summary of Data'!V$31:V$32)=0,MIN('Pt 1 Summary of Data'!V$31:V$32),MAX('Pt 1 Summary of Data'!V$31:V$32)),SUM('Pt 1 Summary of Data'!V$31:V$32))+R$57","v":0},{"$f":"SUM(Q16:S16)","v":0},null,null,{"$f":"SUM('Pt 1 Summary of Data'!Y$25:Y$28,'Pt 1 Summary of Data'!Y$30,'Pt 1 Summary of Data'!Y$34:Y$35)+IF('Company Information'!$C$15=\"No\",IF(MAX('Pt 1 Summary of Data'!Y$31:Y$32)=0,MIN('Pt 1 Summary of Data'!Y$31:Y$32),MAX('Pt 1 Summary of Data'!Y$31:Y$32)),SUM('Pt 1 Summary of 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Data'!AQ$31:AQ$32)=0,MIN('Pt 1 Summary of Data'!AQ$31:AQ$32),MAX('Pt 1 Summary of Data'!AQ$31:AQ$32))-IF(MAX('Pt 1 Summary of Data'!AR$31:AR$32)=0,MIN('Pt 1 Summary of Data'!AR$31:AR$32),MAX('Pt 1 Summary of Data'!AR$31:AR$32)),SUM('Pt 1 Summary of Data'!AO$31:AO$32)+SUM('Pt 1 Summary of Data'!AQ$31:AQ$32)-SUM('Pt 1 Summary of Data'!AR$31:AR$32))+AL$57","v":0},{"$f":"SUM(AK16:AM16)","v":0}]
[null,"2.3 MLR Denominator (Lines 2.1 - 2.2) ",{"$f":"C$15-C$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($C$6:$F$11,$C$15:$F$16,$C$38:$D$38)<>0),H$15-H$16,0)","v":0},{"$f":"D$15-D$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($C$6:$F$11,$C$15:$F$16,$C$38:$D$38)<>0),I$15-I$16,0)","v":0},{"$f":"E$15-E$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($C$6:$F$11,$C$15:$F$16,$C$38:$D$38)<>0),J$15-J$16,0)","v":0},{"$f":"F$15-F$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($C$6:$F$11,$C$15:$F$16,$C$38:$D$38)<>0),K$15-K$16,0)","v":0},null,{"$f":"H$15-H$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($H$6:$K$11,$H$15:$K$16,$H$38:$I$38)<>0),C$15-C$16,0)","v":0},{"$f":"I$15-I$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($H$6:$K$11,$H$15:$K$16,$H$38:$I$38)<>0),D$15-D$16,0)","v":0},{"$f":"J$15-J$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($H$6:$K$11,$H$15:$K$16,$H$38:$I$38)<>0),E$15-E$16,0)","v":0},{"$f":"K$15-K$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($H$6:$K$11,$H$15:$K$16,$H$38:$I$38)<>0),F$15-F$16,0)","v":0},null,{"$f":"M$15-M$16","v":0},{"$f":"N$15-N$16","v":0},{"$f":"O$15-O$16","v":0},{"$f":"P$15-P$16","v":0},{"$f":"Q$15-Q$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($Q$6:$T$7,$Q$15:$T$16,$Q$38:$R$38)<>0),U$15-U$16,0)","v":0},{"$f":"R$15-R$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($Q$6:$T$7,$Q$15:$T$16,$Q$38:$R$38)<>0),V$15-V$16,0)","v":0},{"$f":"S$15-S$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($Q$6:$T$7,$Q$15:$T$16,$Q$38:$R$38)<>0),W$15-W$16,0)","v":0},{"$f":"T$15-T$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($Q$6:$T$7,$Q$15:$T$16,$Q$38:$R$38)<>0),X$15-X$16,0)","v":0},{"$f":"U$15-U$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($U$6:$X$7,$U$15:$X$16,$U$38:$V$38)<>0),Q$15-Q$16,0)","v":0},{"$f":"V$15-V$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($U$6:$X$7,$U$15:$X$16,$U$38:$V$38)<>0),R$15-R$16,0)","v":0},{"$f":"W$15-W$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($U$6:$X$7,$U$15:$X$16,$U$38:$V$38)<>0),S$15-S$16,0)","v":0},{"$f":"X$15-X$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($U$6:$X$7,$U$15:$X$16,$U$38:$V$38)<>0),T$15-T$16,0)","v":0},{"$f":"Y$15-Y$16","v":0},{"$f":"Z$15-Z$16","v":0},{"$f":"AA$15-AA$16","v":0},{"$f":"AB$15-AB$16","v":0},null,null,null,null,null,null,null,null,{"$f":"AK$15-AK$16","v":0},{"$f":"AL$15-AL$16","v":0},{"$f":"AM$15-AM$16","v":0},{"$f":"AN$15-AN$16","v":0}]
[null,"3. Risk Corridors Calculation"]
[null,"3.1 Allowable costs (Lines 1.2 + 1.3 - 1.4 - 1.5 - 1.6 + 7.2)",null,null,null,null,{"$f":"SUM(G$6:G$7)-SUM(G$8:G$10)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),SUM(L$6:L$7)-L$10,0)+G$58","v":0},null,null,null,null,{"$f":"SUM(L$6:L$7)-L$10+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),SUM(G$6:G$7)-SUM(G$8:G$10),0)+L$58","v":0}]
[null,"3.2 Administrative costs excluding taxes (Part 1 Lines 5.1 + 5.2 + 5.3 + 5.4 + 5.5a + 5.5b + 5.6)",null,null,null,null,{"$f":"SUM('Pt 1 Summary of Data'!I$44:I$47,'Pt 1 Summary of Data'!I$49:I$51)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),SUM('Pt 1 Summary of Data'!O$44:O$47,'Pt 1 Summary of Data'!O$49:O$51),0)","v":0},null,null,null,null,{"$f":"SUM('Pt 1 Summary of Data'!O$44:O$47,'Pt 1 Summary of Data'!O$49:O$51)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),SUM('Pt 1 Summary of Data'!I$44:I$47,'Pt 1 Summary of Data'!I$49:I$51),0)","v":0}]
[null,"3.3 Profit for risk corridors calculation (the greater of Lines 3.3a or 3.3b)",null,null,null,null,{"$f":"MAX(G$22,G$23)","v":0},null,null,null,null,{"$f":"MAX(L$22,L$23)","v":0}]
[null,"3.3a  Earned profit (Lines 2.1 - 3.1 - 2.2 - 3.2)",null,null,null,null,{"$f":"G$15-G$19-G$16-G$20+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),L$15-L$16,0)","v":0},null,null,null,null,{"$f":"L$15-L$19-L$16-L$20+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),G$15-G$16,0)","v":0}]
[null,"3.3b  Capped profit ((3% + 2%) x (Lines 2.1 - 2.2))",null,null,null,null,{"$f":"(3%+2%)*(G$15-G$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),L$15-L$16,0))","v":0},null,null,null,null,{"$f":"(3%+2%)*(L$15-L$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),G$15-G$16,0))","v":0}]
[null,"3.3c  Capped profit without adjustment (3% x (Lines 2.1 - 2.2))",null,null,null,null,{"$f":"3%*(G$15-G$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),L$15-L$16,0))","v":0},null,null,null,null,{"$f":"3%*(L$15-L$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),G$15-G$16,0))","v":0}]
[null,"3.4 Allowable administrative costs (the lesser of Lines 3.4a or 3.4b)",null,null,null,null,{"$f":"MIN(G$26,G$27)","v":0},null,null,null,null,{"$f":"MIN(L$26,L$27)","v":0}]
[null,"3.4a  Profit and administrative costs (Lines 3.2 + 3.3 + 2.2)",null,null,null,null,{"$f":"G$20+G$21+G$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),L$16,0)","v":0},null,null,null,null,{"$f":"L$20+L$21+L$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),G$16,0)","v":0}]
[null,"3.4b  Capped administrative costs ((20% + 2%) x (Lines 2.1 - 2.2) + Line 2.2)",null,null,null,null,{"$f":"(20%+2%)*(G$15-G$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),L$15-L$16,0))+G$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),L$16,0)","v":0},null,null,null,null,{"$f":"(20%+2%)*(L$15-L$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),G$15-G$16,0))+L$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),G$16,0)","v":0}]
[null,"3.5 Risk corridors adjusted target amount (Lines 2.1 - 3.4)",null,null,null,null,{"$f":"G$15+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),L$15,0)-G$25","v":0},null,null,null,null,{"$f":"L$15+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),G$15,0)-L$25","v":0}]
[null,"3.6 Allowable administrative costs without adjustment\n(the lesser of Lines 3.6b or 3.6c)",null,null,null,null,{"$f":"MIN(G$31,G$32)","v":0},null,null,null,null,{"$f":"MIN(L$31,L$32)","v":0}]
[null,"3.6a  Profit without adjustment (the greater of Lines 3.3a or 3.3c)",null,null,null,null,{"$f":"MAX(G$22,G$24)","v":0},null,null,null,null,{"$f":"MAX(L$22,L$24)","v":0}]
[null,"3.6b  Profit and administrative costs without adjustment (Lines 3.2 + 3.6a + 2.2)",null,null,null,null,{"$f":"G$20+G30+G$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),L$16,0)","v":0},null,null,null,null,{"$f":"L$20+L30+L$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),G$16,0)","v":0}]
[null,"3.6c  Capped administrative costs w/o adjustment (20% x (Lines 2.1 - 2.2) + Line 2.2)",null,null,null,null,{"$f":"20%*(G$15-G$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),L$15-L$16,0))+G$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),L$16,0)","v":0},null,null,null,null,{"$f":"20%*(L$15-L$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),G$15-G$16,0))+L$16+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),G$16,0)","v":0}]
[null,"3.7 Risk corridors unadjusted target amount (Lines 2.1 - 3.6)",null,null,null,null,{"$f":"G$15+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($G$6:$G$10,$G$15:$G$16)<>0),L$15,0)-G$29","v":0},null,null,null,null,{"$f":"L$15+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($L$6:$L$10,$L$15:$L$16)<>0),G$15,0)-L$29","v":0}]
[null,"3.8 Unadjusted risk corridors ratio (Lines 3.1 / 3.7)",null,null,null,null,{"$f":"IF(G$33=0,0,G$19/G$33)","v":0},null,null,null,null,{"$f":"IF(L$33=0,0,L$19/L$33)","v":0}]
[null,"3.9 Risk corridors aggregate amount by market without adjustment (from Risk Corridors Plan Data Form, Part 3 Line 9)"]
[null,"3.10 Risk corridors total payment or charge amount used for MLR calculation (from Risk Corridors Plan Data Form, Part 3 Line 10)"]
[null,"4. Credibility Adjustment"]
[null,"4.1 Life-years",null,null,{"$f":"('Pt 1 Summary of Data'!E$59+'Pt 1 Summary of Data'!G$59-'Pt 1 Summary of Data'!H$59)/12+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($C$6:$F$11,$C$15:$F$16,$C$38:$D$38)<>0),'Pt 1 Summary of Data'!K$59+'Pt 1 Summary of Data'!M$59-'Pt 1 Summary of Data'!N$59,0)/12","v":0},{"$f":"SUM(C$38:E$38)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($C$6:$F$11,$C$15:$F$16,$C$38:$D$38)<>0,SUM(C$38:D$38)<>SUM(H$38:I$38)),SUM(H$38:I$38),0)","v":0},null,null,null,{"$f":"('Pt 1 Summary of Data'!K$59+'Pt 1 Summary of Data'!M$59-'Pt 1 Summary of Data'!N$59)/12+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($H$6:$K$11,$H$15:$K$16,$H$38:$I$38)<>0),'Pt 1 Summary of Data'!E$59+'Pt 1 Summary of Data'!G$59-'Pt 1 Summary of Data'!H$59,0)/12","v":0},{"$f":"SUM(H$38:J$38)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($H$6:$K$11,$H$15:$K$16,$H$38:$I$38)<>0,SUM(H$38:I$38)<>SUM(C$38:D$38)),SUM(C$38:D$38),0)","v":0},null,null,null,{"$f":"('Pt 1 Summary of Data'!Q$59+'Pt 1 Summary of Data'!S$59-'Pt 1 Summary of Data'!T$59)/12","v":0},{"$f":"SUM(M$38:O$38)","v":0},null,null,{"$f":"'Pt 1 Summary of Data'!V$59/12+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($Q$6:$T$7,$Q$15:$T$16,$Q$38:$R$38)<>0),'Pt 1 Summary of Data'!Y$59,0)/12","v":0},{"$f":"SUM(Q$38:S$38)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($Q$6:$T$7,$Q$15:$T$16,$Q$38:$R$38)<>0,SUM(Q$38:R$38)<>SUM(U$38:V$38)),SUM(U$38:V$38),0)","v":0},null,null,{"$f":"'Pt 1 Summary of Data'!Y$59/12+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($U$6:$X$7,$U$15:$X$16,$U$38:$V$38)<>0),'Pt 1 Summary of Data'!V$59,0)/12","v":0},{"$f":"SUM(U$38:W$38)+IF(AND(OR('Company Information'!$C$12=\"District of Columbia\",'Company Information'!$C$12=\"Massachusetts\",'Company Information'!$C$12=\"Vermont\"),SUM($U$6:$X$7,$U$15:$X$16,$U$38:$V$38)<>0,SUM(U$38:V$38)<>SUM(Q$38:R$38)),SUM(Q$38:R$38),0)","v":0},null,null,{"$f":"'Pt 1 Summary of Data'!AB$59/12","v":0},{"$f":"SUM(Y$38:AA$38)","v":0},null,null,null,null,null,null,null,null,null,null,{"$f":"('Pt 1 Summary of Data'!AO$59+'Pt 1 Summary of Data'!AQ$59-'Pt 1 Summary of Data'!AR$59)/12","v":0},{"$f":"SUM(AK38:AM38)","v":0}]
[null,"4.2 Base credibility factor ",null,null,null,{"$f":"IF(OR(F$38<1000,F$38>=75000,AND(C$38>=1000,D$38>=1000,E$38>=1000,C$45<C$50,D$45<D$50,E$45<E$50)),0,VLOOKUP(F$38,'Reference Tables'!$A$4:$B$11,2)+((F$38-VLOOKUP(F$38,'Reference Tables'!$A$4:$B$11,1))*(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(F$38,'Reference Tables'!$A$4:$A$11)),1,1)-VLOOKUP(F$38,'Reference Tables'!$A$4:$B$11,2))/(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(F$38,'Reference Tables'!$A$4:$A$11)),1,0)-VLOOKUP(F$38,'Reference Tables'!$A$4:$B$11,1))))","v":0},null,null,null,null,{"$f":"IF(OR(K$38<1000,K$38>=75000,AND(H$38>=1000,I$38>=1000,J$38>=1000,H$45<H$50,I$45<I$50,J$45<J$50)),0,VLOOKUP(K$38,'Reference Tables'!$A$4:$B$11,2)+((K$38-VLOOKUP(K$38,'Reference Tables'!$A$4:$B$11,1))*(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(K$38,'Reference Tables'!$A$4:$A$11)),1,1)-VLOOKUP(K$38,'Reference Tables'!$A$4:$B$11,2))/(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(K$38,'Reference Tables'!$A$4:$A$11)),1,0)-VLOOKUP(K$38,'Reference Tables'!$A$4:$B$11,1))))","v":0},null,null,null,null,{"$f":"IF(OR(P$38<1000,P$38>=75000,AND(M$38>=1000,N$38>=1000,O$38>=1000,M$45<M$50,N$45<N$50,O$45<O$50)),0,VLOOKUP(P$38,'Reference Tables'!$A$4:$B$11,2)+((P$38-VLOOKUP(P$38,'Reference Tables'!$A$4:$B$11,1))*(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(P$38,'Reference Tables'!$A$4:$A$11)),1,1)-VLOOKUP(P$38,'Reference Tables'!$A$4:$B$11,2))/(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(P$38,'Reference Tables'!$A$4:$A$11)),1,0)-VLOOKUP(P$38,'Reference Tables'!$A$4:$B$11,1))))","v":0},null,null,null,{"$f":"IF(OR(T$38<1000,T$38>=75000,AND(Q$38>=1000,R$38>=1000,S$38>=1000,Q$46<Q$50,R$46<R$50,S$46<S$50)),0,VLOOKUP(T$38,'Reference Tables'!$A$4:$B$11,2)+((T$38-VLOOKUP(T$38,'Reference Tables'!$A$4:$B$11,1))*(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(T$38,'Reference Tables'!$A$4:$A$11)),1,1)-VLOOKUP(T$38,'Reference Tables'!$A$4:$B$11,2))/(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(T$38,'Reference Tables'!$A$4:$A$11)),1,0)-VLOOKUP(T$38,'Reference Tables'!$A$4:$B$11,1))))","v":0},null,null,null,{"$f":"IF(OR(X$38<1000,X$38>=75000,AND(U$38>=1000,V$38>=1000,W$38>=1000,U$46<U$50,V$46<V$50,W$46<W$50)),0,VLOOKUP(X$38,'Reference Tables'!$A$4:$B$11,2)+((X$38-VLOOKUP(X$38,'Reference Tables'!$A$4:$B$11,1))*(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(X$38,'Reference Tables'!$A$4:$A$11)),1,1)-VLOOKUP(X$38,'Reference Tables'!$A$4:$B$11,2))/(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(X$38,'Reference Tables'!$A$4:$A$11)),1,0)-VLOOKUP(X$38,'Reference Tables'!$A$4:$B$11,1))))","v":0},null,null,null,{"$f":"IF(OR(AB$38<1000,AB$38>=75000,AND(Y$38>=1000,Z$38>=1000,AA$38>=1000,Y$46<Y$50,Z$46<Z$50,AA$46<AA$50)),0,VLOOKUP(AB$38,'Reference Tables'!$A$4:$B$11,2)+((AB$38-VLOOKUP(AB$38,'Reference Tables'!$A$4:$B$11,1))*(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(AB$38,'Reference Tables'!$A$4:$A$11)),1,1)-VLOOKUP(AB$38,'Reference Tables'!$A$4:$B$11,2))/(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(AB$38,'Reference Tables'!$A$4:$A$11)),1,0)-VLOOKUP(AB$38,'Reference Tables'!$A$4:$B$11,1))))","v":0},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AN$38<1000,AN$38>=75000),0,VLOOKUP(AN$38,'Reference Tables'!$A$4:$B$11,2)+((AN$38-VLOOKUP(AN$38,'Reference Tables'!$A$4:$B$11,1))*(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(AN$38,'Reference Tables'!$A$4:$A$11)),1,1)-VLOOKUP(AN$38,'Reference Tables'!$A$4:$B$11,2))/(OFFSET(INDEX('Reference Tables'!$A$4:$A$11,MATCH(AN$38,'Reference Tables'!$A$4:$A$11)),1,0)-VLOOKUP(AN$38,'Reference Tables'!$A$4:$B$11,1))))","v":0}]
[null,"4.3 Average deductible "]
[null,"4.4 Deductible factor ",null,null,null,{"$f":"IF(F$40<2500,1,(MIN(VLOOKUP(F$40,'Reference Tables'!$A$17:$B$20,2)+((F$40-VLOOKUP(F$40,'Reference Tables'!$A$17:$B$20,1))*(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(F$40,'Reference Tables'!$A$17:$A$20)),1,1)-VLOOKUP(F$40,'Reference Tables'!$A$17:$B$20,2))/(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(F$40,'Reference Tables'!$A$17:$A$20)),1,0)-VLOOKUP(F$40,'Reference Tables'!$A$17:$B$20,1))),1.736)))","v":1},null,null,null,null,{"$f":"IF(K$40<2500,1,(MIN(VLOOKUP(K$40,'Reference Tables'!$A$17:$B$20,2)+((K$40-VLOOKUP(K$40,'Reference Tables'!$A$17:$B$20,1))*(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(K$40,'Reference Tables'!$A$17:$A$20)),1,1)-VLOOKUP(K$40,'Reference Tables'!$A$17:$B$20,2))/(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(K$40,'Reference Tables'!$A$17:$A$20)),1,0)-VLOOKUP(K$40,'Reference Tables'!$A$17:$B$20,1))),1.736)))","v":1},null,null,null,null,{"$f":"IF(P$40<2500,1,(MIN(VLOOKUP(P$40,'Reference Tables'!$A$17:$B$20,2)+((P$40-VLOOKUP(P$40,'Reference Tables'!$A$17:$B$20,1))*(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(P$40,'Reference Tables'!$A$17:$A$20)),1,1)-VLOOKUP(P$40,'Reference Tables'!$A$17:$B$20,2))/(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(P$40,'Reference Tables'!$A$17:$A$20)),1,0)-VLOOKUP(P$40,'Reference Tables'!$A$17:$B$20,1))),1.736)))","v":1},null,null,null,{"$f":"IF(T$40<2500,1,(MIN(VLOOKUP(T$40,'Reference Tables'!$A$17:$B$20,2)+((T$40-VLOOKUP(T$40,'Reference Tables'!$A$17:$B$20,1))*(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(T$40,'Reference Tables'!$A$17:$A$20)),1,1)-VLOOKUP(T$40,'Reference Tables'!$A$17:$B$20,2))/(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(T$40,'Reference Tables'!$A$17:$A$20)),1,0)-VLOOKUP(T$40,'Reference Tables'!$A$17:$B$20,1))),1.736)))","v":1},null,null,null,{"$f":"IF(X$40<2500,1,(MIN(VLOOKUP(X$40,'Reference Tables'!$A$17:$B$20,2)+((X$40-VLOOKUP(X$40,'Reference Tables'!$A$17:$B$20,1))*(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(X$40,'Reference Tables'!$A$17:$A$20)),1,1)-VLOOKUP(X$40,'Reference Tables'!$A$17:$B$20,2))/(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(X$40,'Reference Tables'!$A$17:$A$20)),1,0)-VLOOKUP(X$40,'Reference Tables'!$A$17:$B$20,1))),1.736)))","v":1},null,null,null,{"$f":"IF(AB$40<2500,1,(MIN(VLOOKUP(AB$40,'Reference Tables'!$A$17:$B$20,2)+((AB$40-VLOOKUP(AB$40,'Reference Tables'!$A$17:$B$20,1))*(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(AB$40,'Reference Tables'!$A$17:$A$20)),1,1)-VLOOKUP(AB$40,'Reference Tables'!$A$17:$B$20,2))/(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(AB$40,'Reference Tables'!$A$17:$A$20)),1,0)-VLOOKUP(AB$40,'Reference Tables'!$A$17:$B$20,1))),1.736)))","v":1},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AN$40<2500,1,(MIN(VLOOKUP(AN$40,'Reference Tables'!$A$17:$B$20,2)+((AN$40-VLOOKUP(AN$40,'Reference Tables'!$A$17:$B$20,1))*(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(AN$40,'Reference Tables'!$A$17:$A$20)),1,1)-VLOOKUP(AN$40,'Reference Tables'!$A$17:$B$20,2))/(OFFSET(INDEX('Reference Tables'!$A$17:$A$20,MATCH(AN$40,'Reference Tables'!$A$17:$A$20)),1,0)-VLOOKUP(AN$40,'Reference Tables'!$A$17:$B$20,1))),1.736)))","v":1}]
[null,"4.5 Credibility adjustment (Lines 4.2 x 4.4 (do not round)) ",null,null,null,{"$f":"IF(OR(F$38<1000,F$38>=75000),0,F$39*F$41)","v":0},null,null,null,null,{"$f":"IF(OR(K$38<1000,K$38>=75000),0,K$39*K$41)","v":0},null,null,null,null,{"$f":"IF(OR(P$38<1000,P$38>=75000),0,P$39*P$41)","v":0},null,null,null,{"$f":"IF(OR(T$38<1000,T$38>=75000),0,T$39*T$41)","v":0},null,null,null,{"$f":"IF(OR(X$38<1000,X$38>=75000),0,X$39*X$41)","v":0},null,null,null,{"$f":"IF(OR(AB$38<1000,AB$38>=75000),0,AB$39*AB$41)","v":0},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AN$38<1000,AN$38>=75000),0,AN$39*AN$41)","v":0}]
[null,"5. MLR Calculation (for issuers with at least 1,000 life years in the Total column of Line 4.1)"]
[null,"5.1 Preliminary MLR"]
[null,"5.1a  Preliminary MLR (Lines 1.8 / 2.3)",{"$f":"IF(OR(C$38<1000,C$17<=0),\"\",C$12/C$17)","v":""},{"$f":"IF(OR(D$38<1000,D$17<=0),\"\",D$12/D$17)","v":""},{"$f":"IF(OR(E$38<1000,E$17<=0),\"\",E$12/E$17)","v":""},{"$f":"IF(OR(F$38<1000,F$17<=0),\"\",F$12/F$17)","v":""},null,{"$f":"IF(OR(H$38<1000,H$17<=0),\"\",H$12/H$17)","v":""},{"$f":"IF(OR(I$38<1000,I$17<=0),\"\",I$12/I$17)","v":""},{"$f":"IF(OR(J$38<1000,J$17<=0),\"\",J$12/J$17)","v":""},{"$f":"IF(OR(K$38<1000,K$17<=0),\"\",K$12/K$17)","v":""},null,{"$f":"IF(OR(M$38<1000,M$17<=0),\"\",M$12/M$17)","v":""},{"$f":"IF(OR(N$38<1000,N$17<=0),\"\",N$12/N$17)","v":""},{"$f":"IF(OR(O$38<1000,O$17<=0),\"\",O$12/O$17)","v":""},{"$f":"IF(OR(P$38<1000,P$17<=0),\"\",P$12/P$17)","v":""}]
[null,"5.1b  Preliminary MLR: Mini-Med and Student Health  (Lines 1.9 / 2.3)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(Q$38<1000,Q$17<=0),\"\",Q$13/Q$17)","v":""},"","","","","","","","","","","",null,null,null,null,null,null,null,null,{"$f":"IF(OR(AK$38<1000,AK$17<=0),\"\",AK$13/AK$17)","v":""},{"$f":"IF(OR(AL$38<1000,AL$17<=0),\"\",AL$13/AL$17)","v":""},{"$f":"IF(OR(AM$38<1000,AM$17<=0),\"\",AM$13/AM$17)","v":""},{"$f":"IF(OR(AN$38<1000,AN$17<=0),\"\",AN$13/AN$17)","v":""}]
[null,"5.2 Credibility adjustment (Line 4.5, if applicable)",null,null,null,{"$f":"IF(F$45=\"\",\"\",F$42)","v":""},null,null,null,null,{"$f":"IF(K$45=\"\",\"\",K$42)","v":""},null,null,null,null,{"$f":"IF(P$45=\"\",\"\",P$42)","v":""},null,null,null,{"$f":"IF(T$46=\"\",\"\",T$42)","v":""},null,null,null,{"$f":"IF(X$46=\"\",\"\",X$42)","v":""},null,null,null,{"$f":"IF(AB$46=\"\",\"\",AB$42)","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AN$46=\"\",\"\",AN$42)","v":""}]
[null,"5.3 Credibility-adjusted MLR (Lines 5.1a or 5.1b + 5.2)",null,null,null,{"$f":"IF(F$45=\"\",\"\",ROUND(F$45+MAX(0,F$47),3))","v":""},null,null,null,null,{"$f":"IF(K$45=\"\",\"\",ROUND(K$45+MAX(0,K$47),3))","v":""},null,null,null,null,{"$f":"IF(P$45=\"\",\"\",ROUND(P$45+MAX(0,P$47),3))","v":""},null,null,null,{"$f":"IF(T$46=\"\",\"\",ROUND(T$46+MAX(0,T$47),3))","v":""},null,null,null,{"$f":"IF(X$46=\"\",\"\",ROUND(X$46+MAX(0,X$47),3))","v":""},null,null,null,{"$f":"IF(AB$46=\"\",\"\",ROUND(AB$46+MAX(0,AB$47),3))","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AN$46=\"\",\"\",ROUND(AN$46+MAX(0,AN$47),3))","v":""}]
[null,"6. Rebate Calculation"]
[null,"6.1 MLR standard",0.8,0.8,0.8,0.8,null,0.8,0.8,0.8,0.8,null,0.85,0.85,0.85,0.85,{"$f":"IF('Company Information'!$C$12=\"\",\"Please select a State\",IF('Company Information'!$C$12=\"Grand Total\",\"\",VLOOKUP('Company Information'!$C$12,'Reference Tables'!$D$3:$J$61,2,FALSE)))","v":"Please select a State"},{"$f":"IF('Company Information'!$C$12=\"\",\"Please select a State\",IF('Company Information'!$C$12=\"Grand Total\",\"\",VLOOKUP('Company Information'!$C$12,'Reference Tables'!$D$3:$J$61,4,FALSE)))","v":"Please select a State"},{"$f":"IF('Company Information'!$C$12=\"\",\"Please select a State\",IF('Company Information'!$C$12=\"Grand Total\",\"\",VLOOKUP('Company Information'!$C$12,'Reference Tables'!$D$3:$J$61,6,FALSE)))","v":"Please select a State"},{"$f":"S$50","v":"Please select a State"},{"$f":"IF('Company Information'!$C$12=\"\",\"Please select a State\",IF('Company Information'!$C$12=\"Grand Total\",\"\",VLOOKUP('Company Information'!$C$12,'Reference Tables'!$D$3:$J$61,3,FALSE)))","v":"Please select a State"},{"$f":"IF('Company Information'!$C$12=\"\",\"Please select a State\",IF('Company Information'!$C$12=\"Grand Total\",\"\",VLOOKUP('Company Information'!$C$12,'Reference Tables'!$D$3:$J$61,5,FALSE)))","v":"Please select a State"},{"$f":"IF('Company Information'!$C$12=\"\",\"Please select a State\",IF('Company Information'!$C$12=\"Grand Total\",\"\",VLOOKUP('Company Information'!$C$12,'Reference Tables'!$D$3:$J$61,7,FALSE)))","v":"Please select a State"},{"$f":"W$50","v":"Please select a State"},0.85,0.85,0.85,0.85,null,null,null,null,null,null,null,null,0.8,0.8,0.8,0.8]
[null,"6.2 Credibility-adjusted MLR (Line 5.3)",null,null,null,{"$f":"F$48","v":""},null,null,null,null,{"$f":"K$48","v":""},null,null,null,null,{"$f":"P$48","v":""},null,null,null,{"$f":"T$48","v":""},null,null,null,{"$f":"X$48","v":""},null,null,null,{"$f":"AB$48","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"AN$48","v":""}]
[null,"6.3 Adjusted earned premium (Lines 2.1 - 2.2 CY)",null,null,null,{"$f":"IF(F$38<1000,\"\",MAX(0,E$15-E$16))","v":""},null,null,null,null,{"$f":"IF(K$38<1000,\"\",MAX(0,J$15-J$16))","v":""},null,null,null,null,{"$f":"IF(P$38<1000,\"\",MAX(0,O$15-O$16))","v":""},null,null,null,{"$f":"IF(T$38<1000,\"\",MAX(0,S$15-S$16))","v":""},null,null,null,{"$f":"IF(X$38<1000,\"\",MAX(0,W$15-W$16))","v":""},null,null,null,{"$f":"IF(AB$38<1000,\"\",MAX(0,AA$15-AA$16))","v":""},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(AN$38<1000,\"\",MAX(0,AM$15-AM$16))","v":""}]
[null,"6.4 Rebate amount if credibility-adjusted MLR is less than MLR standard (Lines (6.1 - 6.2) x 6.3)",null,null,null,{"$f":"IF(OR(F$38<1000,F$17<=0),0,MAX(0,F$50-F$51)*F$52)","v":0},null,null,null,null,{"$f":"IF(OR(K$38<1000,K$17<=0),0,MAX(0,K$50-K$51)*K$52)","v":0},null,null,null,null,{"$f":"IF(OR(P$38<1000,P$17<=0),0,MAX(0,P$50-P$51)*P$52)","v":0},null,null,null,{"$f":"IF(OR(T$38<1000,T$17<=0),0,MAX(0,T$50-T$51)*T$52)","v":0},null,null,null,{"$f":"IF(OR(X$38<1000,X$17<=0),0,MAX(0,X$50-X$51)*X$52)","v":0},null,null,null,{"$f":"IF(OR(AB$38<1000,AB$17<=0),0,MAX(0,AB$50-AB$51)*AB$52)","v":0},null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(OR(AN$38<1000,AN$17<=0),0,MAX(0,AN$50-AN$51)*AN$52)","v":0}]
[null,"7. Temporary Adjustments"]
[null,"7.1 ACA assessments on non-calendar year policies (2013 only)"]
[null,"7.1a  Deferred portion of 2013 premium collected for 2014 ACA \n         assessments or fees."]
[null,"7.1b  Total Federal and State taxes associated with the deferred premium \n         on Line 7.1a."]
[null,"7.2 Risk Corridors claims liabilities/reserves true-up (Lines 7.2b - 7.2a)",null,null,null,null,{"$f":"G60-G59","v":0},null,null,null,null,{"$f":"L60-L59","v":0}]
[null,"7.2a  Adjusted incurred claims as reported on MLR Form for the prior benefit year"]
[null,"7.2b  Adjusted incurred claims from the prior year, restated as of 3/31 of the year following the benefit year"]
[null,"7.2c  Reserved for future use"]
[null,"7.2d  Reserved for future use"]
[null,"7.2e  Reserved for future use"]
[null,"7.2f  Reserved for future use"]

{"sheet":"Pt 4 Rebate Disbursement","index":6,"n_rows":24,"n_cols":11,"rows_kept":24,"cut":false,"hidden":false,"merged":[[22,2,22,10],[23,2,23,10]]}
[null,"Part 4 Rebate Disbursement"]
[]
[null,"Line Description","1\nHealth Insurance Coverage\nINDIVIDUAL","2\nHealth Insurance Coverage\nSMALL GROUP","3\nHealth Insurance Coverage\nLARGE GROUP","4\nMini-Med Plans\nINDIVIDUAL","5\nMini-Med Plans\nSMALL GROUP","6\nMini-Med Plans\nLARGE GROUP","7\nExpatriate Plans\nSMALL GROUP","8\nExpatriate Plans\nLARGE GROUP","9\nStudent Health Plans\nINDIVIDUAL"]
[null,"1. Number of policies / certificates  (from Part 1, Line 7.1)",{"$f":"'Pt 1 Summary of Data'!$E$56+'Pt 1 Summary of Data'!$G$56-'Pt 1 Summary of Data'!$H$56","v":0},{"$f":"'Pt 1 Summary of Data'!$K$56+'Pt 1 Summary of Data'!$M$56-'Pt 1 Summary of Data'!$N$56","v":0},{"$f":"'Pt 1 Summary of Data'!$Q$56+'Pt 1 Summary of Data'!$S$56-'Pt 1 Summary of Data'!$T$56","v":0},{"$f":"'Pt 1 Summary of Data'!$V$56","v":0},{"$f":"'Pt 1 Summary of Data'!$Y$56","v":0},{"$f":"'Pt 1 Summary of Data'!$AB$56","v":0},null,null,{"$f":"'Pt 1 Summary of Data'!$AO$56+'Pt 1 Summary of Data'!$AQ$56-'Pt 1 Summary of Data'!$AR$56","v":0}]
[null,"2. Number of policyholders/subscribers owed rebates"]
[null,"2.a Number of group policyholders being paid a rebate"]
[null,"2.b Number of subscribers being paid a rebate"]
[null,"2.c Number of group policyholders whose rebate is de minimis"]
[null,"2.d Number of subscribers whose rebate is de minimis"]
[null,"3. Total amount of rebates"]
[null,"3.a Total amount of rebates (from Part 3, Line 6.4)",{"$f":"'Pt 3 MLR and Rebate Calculation'!$F$53","v":0},{"$f":"'Pt 3 MLR and Rebate Calculation'!$K$53","v":0},{"$f":"'Pt 3 MLR and Rebate Calculation'!$P$53","v":0},{"$f":"'Pt 3 MLR and Rebate Calculation'!$T$53","v":0},{"$f":"'Pt 3 MLR and Rebate Calculation'!$X$53","v":0},{"$f":"'Pt 3 MLR and Rebate Calculation'!$AB$53","v":0},null,null,{"$f":"'Pt 3 MLR and Rebate Calculation'!$AN$53","v":0}]
[null,"3.b Amount of de minimis rebates"]
[null,"3.c Amount of rebates being paid by premium credit"]
[null,"3.d Amount of rebates being paid by lump-sum reimbursement"]
[null,"4. Prior MLR year rebates"]
[null,"4.a Total amount of rebates paid for the previous MLR reporting year"]
[null,"4.b Total amount of rebates still owed for the previous MLR reporting year"]
[null,"4.c Percentage of notices sent timely to individual policy subscribers or group policyholders owed a rebate"]
[null,"4.d Percentage of notices sent timely to subscribers of group policies owed a rebate"]
[null,"4.e Percentage of rebates paid timely to individual policy subscribers or group policyholders owed a rebate"]
[null,"4.f Percentage of rebates paid timely to subscribers of group policies owed a rebate"]
[null,"4.g Amount of unclaimed rebates from prior MLR reporting years"]
[null,"4.h Describe methods used to locate policyholders/subscribers for prior MLR reporting year's unclaimed rebates:"]
[null,"4.i Describe disbursement of prior MLR reporting year's unclaimed rebates:"]

{"sheet":"Pt 5 Additional Responses","index":7,"n_rows":61,"n_cols":3,"rows_kept":61,"cut":false,"hidden":false,"merged":[]}
[null,"Part 5 Additional Responses"]
[]
[null,"Line Description","Tax Rate"]
[null,"1. If an amount is reported in Part 1 Line 3.2c, Community benefit expenditures, provide the state premium tax rate used to determine the reported amount:"]
[]
[null,"2. If the issuer reported amounts in Part 2 Line 2.15 Blended rate adjustment provide the affiliate(s) name(s) with whom blended rate adjustments were made. "]
[null,"Name of Affiliate"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"3. If the issuer reported amounts in the Dual Contract 3/31 Columns provide the affiliate(s) name(s) with whom experience is being reported. "]
[null,"Name of Affiliate"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"4. If the issuer entered into any 100% assumptive reinsurance agreements with a novation during the MLR reporting year, provide the name(s) of the entity(ies) with whom the agreement was (were) made and the effective date of the novation. "]
[null,"Name of Entity with whom Agreement was made","Effective Date of Novation"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"5. If the Issuer novated any business in the MLR reporting year effective during the reporting year provide the name of the entity to whom the business was sold or transferred and the date of the sale or transfer."]
[null,"Name of Entity to whom business was sold or transferred","Effective Date of sale or transfer"]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[null,"6. If the issuer has any 100% indemnity reinsurance and administrative agreements effective prior to March 23, 2010, for which the assuming entity is responsible for 100% of the ceding entity's financial risk and takes on all of the administration of the block, report the name(s) of the entity(ies) that is (are) reporting the experience related to such business."]

{"sheet":"Attestation","index":8,"n_rows":9,"n_cols":1,"rows_kept":9,"cut":false,"hidden":false,"merged":[]}
["Attestation Statement"]
[]
["The officers of this reporting issuer being duly sworn, each attest that he/she is the described officer of the reporting issuer, and that this MLR Reporting Form, the Company/Issuer Associations, and any supplemental submission that the issuer includes are full and true statements of all the elements included therein for the MLR reporting year stated above, and that the MLR Reporting Form has been completed in accordance with the Department of Health and Human Services’ reporting instructions, according to the best of his/her information, knowledge and belief.  Furthermore, the scope of this attestation by the described officer includes any related electronic filings and postings for the MLR reporting year stated above and which are required by Department of Health and Human Services under section 2718 of the Public Health Service Act and implementing regulation."]
[]
["____________________________ "]
["Chief Executive Officer/President"]
[]
["____________________________  "]
["Chief Financial Officer"]

{"sheet":"Reference Tables","index":9,"n_rows":61,"n_cols":16,"rows_kept":61,"cut":false,"hidden":false,"merged":[]}
[null,null,null,"Table 3 - State and Territory Names and MLR Standards"]
["Table 1 - Base Credibility Adjustment Factors",null,null,"State or Territory Name","2012\nIndividual","2012\nSmall Group","2013\nIndividual","2013\nSmall Group","2014\nIndividual","2014\nSmall Group","2015\nIndividual","2015\nSmall Group",null,"Table 4 - Reporting Years",null,"Table 5 - Yes/No"]
["Life Years","Base credibility factor",null,"Alaska",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2011,null,"Yes"]
[0,0,null,"Alabama",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2012,null,"No"]
[1000,8.3000000000000004E-2,null,"Arkansas",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2013]
[2500,5.1999999999999998E-2,null,"American Samoa",0.8,0.8,0.8,0.8,null,null,null,null,null,2014]
[5000,3.6999999999999998E-2,null,"Arizona",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2015]
[10000,2.5999999999999999E-2,null,"California",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2016]
[25000,1.6E-2,null,"Canada",null,null,null,null,null,null,null,null,null,2017]
[50000,1.2E-2,null,"Colorado",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2018]
[75000,0,null,"Connecticut",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2019]
[null,null,null,"District of Columbia",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2020]
[null,null,null,"Delaware",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2021]
[null,null,null,"Florida",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2022]
["Table 2 - Deductible Factors",null,null,"Georgia",0.75,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2023]
["Average Health Plan Deductible","Deductible factor",null,"Grand Total",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2024]
[0,1,null,"Guam",0.8,0.8,0.8,0.8,null,null,null,null,null,2025]
[2500,1.1639999999999999,null,"Hawaii",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2026]
[5000,1.4019999999999999,null,"Iowa",0.75,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2027]
[10000,1.736,null,"Idaho",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2028]
[null,null,null,"Illinois",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2029]
[null,null,null,"Indiana",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2030]
[null,null,null,"Kansas",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2031]
[null,null,null,"Kentucky",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2032]
[null,null,null,"Louisiana",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2033]
[null,null,null,"Massachusetts",0.9,0.9,0.9,0.9,0.89,0.89,0.88,0.88,null,2034]
[null,null,null,"Maryland",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2035]
[null,null,null,"Maine",0.65,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2036]
[null,null,null,"Michigan",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2037]
[null,null,null,"Minnesota",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2038]
[null,null,null,"Missouri",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2039]
[null,null,null,"MP (Northern Mariana)",0.8,0.8,0.8,0.8,null,null,null,null,null,2040]
[null,null,null,"Mississippi",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2041]
[null,null,null,"Montana",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2042]
[null,null,null,"North Carolina",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2043]
[null,null,null,"North Dakota",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2044]
[null,null,null,"Nebraska",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2045]
[null,null,null,"New Hampshire",0.75,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2046]
[null,null,null,"New Jersey",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2047]
[null,null,null,"New Mexico",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.85,null,2048]
[null,null,null,"Nevada",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2049]
[null,null,null,"New York",0.82,0.82,0.82,0.82,0.82,0.82,0.82,0.82,null,2050]
[null,null,null,"Ohio",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2051]
[null,null,null,"Oklahoma",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2052]
[null,null,null,"Oregon",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2053]
[null,null,null,"Other Territories",null,null,null,null,null,null,null,null,null,2054]
[null,null,null,"Pennsylvania",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2055]
[null,null,null,"Puerto Rico",0.8,0.8,0.8,0.8,null,null,null,null,null,2056]
[null,null,null,"Rhode Island",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2057]
[null,null,null,"South Carolina",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2058]
[null,null,null,"South Dakota",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2059]
[null,null,null,"Tennessee",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8,null,2060]
[null,null,null,"Texas",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8]
[null,null,null,"Utah",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8]
[null,null,null,"Virginia",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8]
[null,null,null,"Virgin Islands",0.8,0.8,0.8,0.8]
[null,null,null,"Vermont",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8]
[null,null,null,"Washington",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8]
[null,null,null,"Wisconsin",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8]
[null,null,null,"West Virginia",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8]
[null,null,null,"Wyoming",0.8,0.8,0.8,0.8,0.8,0.8,0.8,0.8]