We understand consumers' growing concerns over
How do we review rates?
the cost of care. We continually try to balance
the consumer’s desire for lower rates against the
long-term solvency of insurance companies.
The department enforces insurance laws to ensure
that rates are not excessive, inadequate
or unfairly discriminatory and insurance companies
remain financially sound.
If a health insurance company wants to increase
individual or small group health insurance rates,
those rate increase requests generally must be
filed with the department.
. When the filing request is submitted, the department will perform an independent actuarial review of the company’s rate filing request. Before we approve any rate increase, we take into consideration things like:
In the small group market, the department has the authority to review and disapprove all rate increases in the small group market that are greater than 10 percent
· Detailed claims data
· Claim trends
· Information on deductibles, copays and co-insurance
· Utilization data
The department will approve a rate increase when it is clear that the increase is supported and actuarially justified. Any premium increase which cannot be actuarially substantiated is disapproved.
Does my company want a rate increase?
If the department has the regulatory authority to reveiw and approve a rate, the rate request must be filed with us. There are a few ways to see if your company is asking for a rate increase.
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