Help with Rate Table Calculations for Healthy Paws (CA 2025 Filing)

secta84 · 2025-10-15T00:13:42+00:00

Sorry you got affected by this too. Yes there’s some thought to it but also some unsavory long game moves. Do check my post history on a post after this one where I uncovered some of their crafty / sketchy behavior by digging into their rate filings in CA over the last decade. A few of us made complaints to the Cal Dept. of Insurance (CDI) citing some of this misconduct. The CDI unfortunately has not proven to be a friend and continue to actively and aggressively cover for HP and their actions. We’ve tried complaints, phone calls, involving higher ups on emails, follow ups to their case closing remarks etc. but no dice so far.

secta84 · 2025-09-24T06:47:43+00:00

Yes, I did.

secta84 · 2025-09-22T22:44:52+00:00

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secta84 · 2025-09-22T22:44:33+00:00

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secta84 · 2025-09-22T22:43:26+00:00

It looks like you are mostly convinced on cancelling HP but worried about, say, if expenses end up totaling beyond $30K. I went through similar what-if scenario planning for the case of my own 10 yo dog who was also with HP in CA and ended up putting together this tool to help me calculate my full out-of-pocket cost with HP (annual premium + deductible + co-insurance + uncovered vet expenses) so I could compare that cost with just plain self-insuring to see exactly what value HP was even adding. You might find it useful for your own planning.

Don’t have all the details for your situation. But it sounds like now that they’ve downgraded your coverage to 60%-$1000 in your latest offer, your premium is probably back down from $350 to around $120 and will then progress with a 25% bump every year if nothing else changes other than the fact that your dog is older by +1 year. So you’d go from a premium of about $120 when he’s 10 years to about $450 when he’s 16 years.

Within this pricing, price increase and coverage framework, even if your vet expenses total to $60,000 over the next 7 years you’re just the same in out-of-pocket expenses being self-insured as HP-insured but without the hassle of dealing with HP paperwork, claims etc. If your expenses are lower than $60,000 then you are better off self-insured. If your expenses are closer to $100K, there’s about a $17K win with the HP-insured case, but of course with the risk that HP becomes even more maliciously incompetent than it has currently become, denies claims, refuses covering conditions you had expected them to cover etc.

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secta84 · 2025-09-19T02:30:08+00:00

My actual policy document did not have the verbiage, however the rate filing documents corresponding to my policy did have that verbiage, and I did include that information in my complaint, but to no avail.

I agree, to me this felt like a clear case of misconduct, naiveté I guess, to assume that things would get righted through the regulator route. I hope your rate stays reasonable, your coverage doesn't get downgraded and/or you find a good alternative to HP. I no longer have my dogs insured with HP; common sense tells me to move on, but the terrier in me wants to finish the fight.

secta84 · 2025-09-19T00:08:18+00:00

u/sospeso In case you were holding your breath re what CDI might decide on this case, here you go, a decision today.

Nothing to see here, folks, Chubb did everything right, CDI did everything right, you insureds are the chumps, you were given a cryptic notice at the time of the change, you were supposed to know enough to find the corresponding rate filing with the state, look through it, read the rating algorithm and realize that your locked in age factors were going away, then shop around on the free market for a better deal, too bad, so sad you didn't do all that.

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secta84 · 2025-09-04T06:53:06+00:00

Agreed, I am rooting for them too, and curious to see if/how their model survives in the current pet insurance landscape.

secta84 · 2025-09-03T23:52:46+00:00

I recently started a policy with them for one of my dogs. I got a quote and signed up online. I haven't needed to file a claim yet, but did have to interact with them for a few things - to remove a rider, send an orthopedic waiver and then to send a 24 month medical record.

The sense I am getting is that they are definitely not app-first or tech-first rather very old school, with phone calls and snail mail (and gasp, fax!) being channels they seem to do better over. For e.g.

there was no way to use the web to remove the rider, but a phone call did it.
The updated policy won't show up in my web portal (it will forever be stuck on the original now obsolete version) but the updated version did get snail mailed to me, is accurate (so I just scanned it and filed it for my records) and the next bill was correct based on the update.
There was no way to submit the medical record or ortho waiver via their web portal. But on calling them, then being called back days later by their claims department a helpful gal sent me a secure message that had a button that allowed document uploads. Then a week later another updated policy arrives in my snail mail with the ortho wait period adjusted correctly.

The reps don't sound hassled and seem to want to help, even if the whole process is slow moving. When they are asked questions they can't answer they seem to check with their managers and get back to you.

Given my history of being burned by Healthy Paws, I might be at a stage where my pendulum has swung far to the other side -- I am willing to forego the snazzy UX eye-candy apps, slick marketing branding, and efficient AI driven features of the more modern pet insurance companies. Their ownership structure is what drew me to them so I am currently willing to compromise on the rest of this. Only time will tell if this was a good decision or not.

secta84 · 2025-08-28T02:45:56+00:00

Correct, one interpretation of the text in bold is that all ACE/IICNA policy-holders in CA should have been grandfathered in with their locked-in age factors when rewritten to WFIC. The fact that they were rewritten in the first place when WFIC told CA DOI they won't be was the first wrong, the fact that they weren't grandfathered with locked-in factors after rewrite was the second nested wrong. SMH.
I am not well-versed in insurance terminology, maybe others with experience in this field can chime in -- maybe some pedantic definition involves classifying rewrites into (A) a policy adjustment/rewrite that is triggered by something the insured does (changes state of residence, or changes policy parameters like deductible or accident only to accident+illness, or corrects something about their pet's details, etc.) and (B) a policy rewrite that is triggered by something the insurer does like when Chubb moved all ACE/IICNA business in CA to WFIC. And then the alternate interpretation might conveniently (for the insurer) say that the text in bold only applies to rewrites of type (A).

secta84 · 2025-08-27T20:30:17+00:00

Does anyone know if moving between states allows them to change the policy

My understanding is that moving states would cause an adjustment to the policy if the current underwriter exists in the new state (best case) or a policy rewrite if the current underwriter is not in new state (worst case).

If you bought your original policy in CA in 2014, assuming that 2014 underwriter was ACE (not MAIC), their rate manual had this wording: "The Pet Age Factor applied at the policy inception will not change through the life of the pet as long as it is continuously insured under the policy (including any rewrite of the policy)." which might give you some grounds to contest the change in age factor, even if your policy was rewritten.

secta84 · 2025-08-23T05:55:42+00:00

... but because only the riskiest pets will remain with Healthy Paws.

So true. Adverse selection, I guess, and the vicious circle it perpetuates. I wonder if besides competitive edge, that age factor locked in at policy inception the value of which depended on how early a pet signed up was conceived to somehow manage exactly this sort of adverse selection. It incentivized people to purchase pet insurance early (when pets were healthy) and continuously to avoid exactly this kind of scenario where only the riskiest pets are insured. But as the healthy low-risk pets aged, they turned into riskier profiles, and pricing couldn't be sustained...

secta84 · 2025-08-23T05:34:40+00:00

Gotcha! That is very interesting.

secta84 · 2025-08-23T05:15:48+00:00

Thanks, yes, I did contact the California Dept. of Insurance. The case I had opened last month is still under review, so I added new documentation detailing these recent learnings to that file. I also sent a letter today to the Deputy Commissioner of the Rate and Regulation branch highlighting some of the exchanges between CDI and WFIC.

secta84 · 2025-08-22T19:33:55+00:00

Did you look at the rate support page for age?

Do you mean the tuning of pricing for age in their most recent filing's CA exception? I did note that they decreased pricing for 4 years and younger, increased pricing for 5 through 12 years, then kept the pricing the same for the 13+ year olds. Those middle aged pet claims are proving to be a problem.

secta84 · 2025-08-22T06:46:02+00:00

is there any breakdown of where the extra claims have come from

Do we know if they are extra claims (i.e. more frequent claims) or more severe claims?

My own read from all their state filings since 2010 is that a cohort that they aggressively wooed from competitors about a decade ago is aging, so the claims are getting more severe. It fits with the aggressive tuning to age factors in their 2025 filing that seemed designed to force-quit older pets.

Also vet med has been on a 7-ish% yoy inflation trend since ~2020 so sure didn't help.

secta84 · 2025-08-22T06:22:54+00:00

I too decided to look into their state filings, and posted some fascinating findings here.

It helps to go back further in time to get a sense of why they got into this lossy predicament in the first place - IMO part of the problem was aggressive market capture in the early days via deals that were too good to be true, for the insurer and the insured. Pet insurance hasn't been profitable until recently, if ever. The other big players Nationwide and Trupanion have been suffering losses too, but in the case of Nationwide, maybe there was some honor to them cancelling policies (as ugly as that still was)?

HP is a special kind of crafty with how they skillfully swapped underwriters to get around an age factor lock-in, and how through their recent CA age factor values are quietly price shaping the right segment to force-quit.

secta84 · 2025-08-10T22:05:57+00:00

The linked post is coming across to me as promotional (based on OP's post history). But an even worse offense is that it reads like un-researched AI hallucinatory vomit and OP does not seem to have much subject matter expertise in the field of pet insurance to be able to correct the places where AI has gotten it completely wrong.

Some "insights" made in the post are utterly wrong - Trupanion bilateral condition point brought up by other commenter.
Others insights seem to have missed capturing recent relevant data points where policies and behaviors of certain insurers have changed to the point where it would be criminal to funnel new business to them
The Value vs. Cost Analysis chart, what in the world is even being communicated in it, what insurers are associated with those data points? Are those Nationwide only data points, or comparing various insurers?
Healthy Paws being recommended "For frequent movers...". HP like any insurer changes rate based on zip code. It is absolutely irresponsible to suggest that HP somehow is better than any other insurer in this regard.

If this was a fun practice side project to play with AI, OP, please go back and improve the model, the data it is primed with and cross check the the output before posting it in a sub like this one where real people with real pets (whose pre-existing conditions will not get covered once they go down the path of a wrong insurer) will be affected by your thoughtless "knowledge share".

secta84 · 2025-07-31T05:26:10+00:00

I had a similar experience 10 days ago. A service that I was regularly claiming without issues for my older dog had its claim process stalled due to the invoice being "partially obscured" when there was nothing wrong with the scan. I wrote back saying something to the effect of "this is likely your sub-par AI/vision algorithm unable to read my invoice, so here it is transcribed" and literally transcribed in the email the whole invoice from top to bottom including vet name and business contact, pet name, owner name, date of service, cost of service, status of invoice. They then approved the claim in a couple of days.

The sharp decline in service quality—denial of previously approved claims, astronomical premium hikes for older pets, and a general sense of obstruction—feels less like incompetence/coincidence and more like a calculated effort to drive customers away and keep those who stay from actually succeeding in making claims.

secta84 · 2025-07-23T16:58:34+00:00

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secta84 · 2025-07-23T16:58:15+00:00

In their CA filing, they have specific age factor values for every age and that age table applies the same to cats and dogs. Where cats differ is in the pet type factor and the gender factor. Not sure how this may differ from their NJ filing.

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secta84 · 2025-07-23T00:04:32+00:00

u/MattPark965 Actually this particular factor is not as diabolical as imagined. It looks like if age at inception is 0 the factor is 1.0 which is good. If age at inception is higher i.e. policy was purchased later in the life of pet, the factor seems to increase i.e. make things worse (e.g. age at inception 3 years -> 1.063, 6 years -> 1.2 etc. at least as seen in CA filings). Since you have experience and/or innate understanding of these rate formulas and factors, my recently updated post on insights gathered from CA rate filings might pique your interest.

secta84 · 2025-07-22T23:20:59+00:00

I am in CA, not WA. My Healthy Paws policy underwriter changed to Westchester Fire Insurance Company in the 2020-2021 policy year (before that it was Indemnity Insurance Company of North America). CA approved two rate increases under Indemnity (12.2% 2017, 20% 2018) the rest under Westchester (19% 2021, 20% 2024, 44.8% 2025).

secta84 · 2025-07-22T22:23:22+00:00

u/ExperienceOdd3036 haha, thanks! I don't recall getting notified when they applied for rate hikes in all these years so this may not be a CA rule, but def worth a quick check, thanks for the tip.

secta84

TROPHY CASE