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{"sheet":"SEH","index":0,"n_rows":47,"n_cols":9,"rows_kept":47,"cut":false,"hidden":false,"merged":[[25,0,25,1],[26,0,26,1],[27,0,27,1],[30,0,30,1],[31,0,31,1],[28,0,28,1],[36,0,36,1],[37,0,37,1],[38,0,38,1],[39,0,39,1],[40,0,40,1],[34,0,34,1],[35,0,35,1],[32,0,32,1],[29,0,29,1],[33,0,33,1],[23,0,23,1],[24,0,24,1],[19,0,19,1],[20,0,20,1],[21,0,21,1],[22,0,22,1],[0,2,0,5],[1,2,1,5],[2,2,2,5],[11,2,11,5],[0,0,0,1],[1,0,1,1],[2,0,2,1],[11,0,11,1]]}
["[XXXX] SEH Rate Chart *",null,"Quarterly Base Rates(4)"]
["[Entity Name]",null,"(Prior to Application of Territory(5) & Age(6) Rating Factors)"]
["[Entity Name]",null,"((Quarterly Base Rate(4) x Territory Rating Factor(5)) x Age Rating Factor(6) = Premium per person)"]
["Plan Name(1)(2)","Metal Tier(3)","1Q20XX","2Q20XX","3Q20XX","4Q20XX","Current HIOS Plan ID#","Previous HIOS Plan ID#","Plan Count (by Entity)"]
[]
[]
[]
[]
[]
[]
[]
["Territory Rating Factors(5)",null,"SEH Age Curve (for contracts issued 01/01/2018 or later)"]
["1) Essex, Hudson, Union                                                                                ",1,"Ages"," Age Rating Factors(6)","Ages"," Age Rating Factors(6)"]
["2) Bergen, Passaic                                                                                         ",1,"0-14",0.76500000000000001,40,1.393]
["3) Monmouth, Morris, Sussex, Warren                                                          ",1,15,0.83299999999999996,41,1.41]
["4) Hunterdon, Middlesex, Somerset                                                               ",1,16,0.85899999999999999,42,1.427]
["5) Burlington, Camden, Mercer                                                                      ",1,17,0.88500000000000001,43,1.45]
["6) Atlantic, Cape May, Ocean, Salem, Cumberland, Gloucester                    ",1,18,0.91300000000000003,44,1.478]
[null,null,19,0.94099999999999995,45,1.5109999999999999]
["Footnotes",null,20,0.97,46,1.55]
["(1)  Plan Names were supplied by the Carrier. Please contact the Carrier ",null,21,1.25,47,1.593]
["    for explanations of the abbreviations used in the plan names.",null,22,1.25,48,1.641]
["(2)  Employers, that qualify as “religious employers” under Federal law, may have ",null,23,1.25,49,1.6879999999999999]
["    the option to purchase plans with certain exclusion provisions.  ",null,24,1.25,50,1.7410000000000001]
["    Contact the Carrier for information about the exclusion provisions, if any.",null,25,1.25,51,1.792]
["(3) Metal Level indicates the actuarial value of the plan.  ",null,26,1.25,52,1.847]
["   Each metal level is designed to cover an expected percentage of the covered charges:",null,27,1.25,53,1.9019999999999999]
["   Bronze 60%, Silver 70%, Gold 80%,  and Platinum 90%.   ",null,28,1.25,54,1.9610000000000001]
["(4)  Base Rate applies to plans newly issued or renewed during the quarter.  ",null,29,1.2749999999999999,55,2.0190000000000001]
["    Multiply the Base Rate by the Territory Rating Factor and the Age Rating Factor.",null,30,1.2869999999999999,56,2.08]
["(5)  Territory Rating Factor is based on the employer’s principal place of business.",null,31,1.3049999999999999,57,2.1419999999999999]
["(6) Age Rating Factor is used to calculate the premium for each person to be covered.",null,32,1.323,58,2.206]
["(7) These are high deductible health plans and are compatible with Health Savings",null,33,1.3340000000000001,59,2.2799999999999998]
["     Accounts (HSA). Contact the Carrier for additional information.",null,34,1.3460000000000001,60,2.2799999999999998]
["(8)  These plans are not available in all counties.  ",null,35,1.3520000000000001,61,2.2799999999999998]
["     Contact the Carrier, or your broker, for additional information.",null,36,1.3580000000000001,62,2.2799999999999998]
["    *For details about plans and coverage options, e.g. HSA, ",null,37,1.363,63,2.2799999999999998]
["     please contact the Carrier or your broker directly.",null,38,1.369,"64 and older",2.2799999999999998]
["Premium Calculation",null,39,1.381]
["    Premium per person (whether employee or employee's dependents) = "]
["    ((Base Rate(4) x Territory Rating Factor(5)) x Age Rating Factor (6))"]
["    Premium per each employee’s family = sum of the premiums for the employee "]
["    and the employee’s dependents."]
["    Note:  For dependent children under age 21 the premium is capped at the "]
["    sum of the premiums for the three oldest children."]
["    Premium per small employer group = sum of the premiums for all employees "]
["    and dependents to be covered."]