New rules require insurers to justify rate increases over 10%

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Federal rules mandate that companies explain the hikes and submit them to regulators. Also, HHS announced that association health plans must meet the same rate scrutiny as other types of insurance.

Los Angeles Times: U.S. Requires Health Insurers To Publicly Justify Big Rate Hikes
Health insurers will have to start publicly justifying big rate hikes, according to a new requirement of the federal health care law that is meant to put pressure on insurance companies to hold down skyrocketing premiums. The new rule, which went into effect Thursday, will mandate that insurers post on their websites explanations of premium increases exceeding 10 percent and submit the hikes to state and federal regulators, who also will post them starting this year (Levey, 9/2).

Modern Healthcare: Double-Digit Insurance Hikes To Face Review
Starting today, insurers that propose to increase their rates by 10 percent or more must submit their request to state or federal reviewers, who will determine if those hikes are reasonable, according to HHS. As part of this process, independent experts will study information about underlying costs trends in health care and will indicate when insurance companies raise their costs unjustly. Consumers in every state will be able to view disclosure information that explains increases of 10 percent or more -; compared with last year's rates -; beginning in mid-September. And consumers will also be able to provide their own comments about the proposed increases (Zigmond, 9/1).

The Associated Press: New Rate Reviews Begin For Health Insurers
Some big health insurance rate hikes will receive an extra layer of scrutiny starting Thursday, when a new review process begins as part of the health care overhaul. Whenever an insurer seeks a rate hike of 10 percent or more for individual and small-employer group coverage, it now must submit the plan for either a state or federal review of whether it's reasonable. Government officials will not have the authority to reject rate increases. But any increases will be posted along with an explanation for them on the website www.healthcare.gov (9/1).

Kaiser Health News:  Capsules: Trade Group, Other 'Association' Health Plans To Face Rate Hike Scrutiny
Insurers who offer "association health plans," which are often sold through trade groups or other organizations of affiliated members, will face the same scrutiny of premium rate hikes as other types of insurance, federal officials said Thursday (Appleby, 9/1).

Politico Pro: Rate Review Rule Targets Association Plans
Individual and small group health plans sold through associations will have to comply with new rate review regulations, according to a new HHS rule issued Thursday morning. How to regulate insurance rate increases for association plans -; special coverage that organizations like chambers of commerce or trade groups sell to their members -; had been one the biggest outstanding issues in a new rule requiring large rate increases to get heightened scrutiny. Association plans face less stringent regulations in many states, and consumer advocates warned that the looser rules could undermine health reform's new consumer protections for the individual and small group insurance markets. The new HHS rule makes it clear that association plans will face the same scrutiny over rate hikes as the rest of the small group and individual market (Millman, 9/1).

Kansas Health Institute News: Health Insurance Premium Increases Face New Reviews
But the law likely will have little immediate consequence for policyholders in Kansas, where state insurance regulators said many companies already had filed their rates for the 2012 plan year, some probably earlier than usual in order to beat the new law's start date. ... Kansas rate reviews will still be done by the state insurance department because the agency was deemed by HHS to have a strong enough review process in place. In some states, federal regulators will prevail (Shields, 9/1).


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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