A proposed health insurance price change disclosure form will be going back to the drafters.
The Health Insurance and Managed Care Committee at the National Association of Insurance Commissioners, Kansas City, Mo., has decided to defer action on the form, which was developed by the Speed to Market Task Force.
The task force created the form draft to implement rate review provisions of the Affordable Care Act (ACA), the legislative package that includes the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act.
The ACA rate review provisions require the NAIC and state insurance regulators to use the tools at their disposal to get health carriers to notify them about pending rate changes and to justify any changes that appear to be “unreasonable.”
The Health Insurance and Managed Care Committee has posted a number of comments on the rate filing disclosure form draft, and the committee has asked the task force to “consider revising the forms, as appropriate, in light of the comments,” officials say.
Candy Gallagher, a vice president at America’s Health Insurance Plans, Washington, has written to the NAIC to suggest that the ambiguity of the term “unreasonable” will cause problems.
“We understand that [the U.S. Department of Health and Human Services] will be responsible for developing a definition,” Gallagher says. “However, absent clear definitions at this time, it is difficult to be sure that this form addresses that ‘test.’”
AHIP also would like to see the NAIC develop separate forms for the individual and small group markets, and to exempt large group plans from the rate change disclosure process, or at least give large groups the ability to protect the confidentiality of their information, Gallagher says.