HHS Proposed Rule on "Unreasonable" Health Insurance Premium Increases
HHS published a proposed rule on December 23, 2010 regarding the disclosure and review of “unreasonable” health insurance premium increases under the ACA. The proposed rule would establish a rate review program to ensure that all rate increases that meet or exceed an established threshold are publicly disclosed and reviewed by a state or HHS to determine whether the rate increases are unreasonable. An unreasonable rate increase would be defined as one that is excessive (that is, it causes insurance premiums to be unreasonably high in relation to the benefits provided under the coverage), unjustified, or unfairly discriminatory. For rate increases filed in a state on or after July 1, 2011 (or effective on or after July 1, 2011 in a state that does not require a rate increase to be filed), the threshold for whether rates are subject to review would be whether the average weighted increase in the rate filing (alone or in combination with prior increases in the preceding 12 month period) is 10% or more. After 2011, state-specific thresholds for review would be established. Additional background information is posted here.
