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PPACA: States Grapple with Rate Rules

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Washington state has already started posting information about individual and small group rate change requests, and Wisconsin is giving insurers advice about how to comply with its new rate change disclosure requirements.

Washington state started posting health insurance rate requests for individual policies and plans for employers with 1 to 50 employees this month, officials say.

Washington state insurance regulators are providing the complete filings along with a summary of each filing.

Regulators also are posting some rate requests that were filed before July 1 by carriers that agreed voluntarily to make their filings public ahead of schedule. Those carriers include Asuris Northwest Health, Kaiser Foundation Health Plan and Regence BlueShield, officials say.

The department hopes to create a mechanism that members of the public can use to post comments on rate filings this fall.

The federal Patient Protection and Affordable Care Act of 2010 (PPACA) requires states to start health insurance rate disclosure and review programs or else let federal regulators handle rate disclosure and review efforts for their market.

Mike Kreidler, the Washington state insurance commissioner, proposed the bill that created the rules for his state’s new disclosure system.

“The public deserves to see what’s behind their increasing health insurance costs,” Kreidler says in a statement. “For too long, they’ve had to simply take our word when rates are justified. Now the public can see the same information we see.”

Meanwhile, Wisconsin Insurance Commissioner Theodore Nickel has posted a bulletin advising health insurers in Wisconsin that the PPACA rate disclosure rules will change rate filing rules in Wisconsin Sept. 1.

Starting Sept. 1, health insurers in the individual and small group markets must submit all rate change filings at least 30 days before the new rates are supposed to take effect, include an actuarial memorandu, and explain any increases that exceed 10%.

An insurer must “look back 12 months from the effective date of any rate increase to determine whether the 10% threshold has been met,” Nickel says in the bulletin. “This means that a rate increase effective on or after Sept. 1, 2011, that does not meet the 10% threshold may still be considered subject to review if rate increases filed 12 months prior to the current rate increase are combined with current rate increases resulting in a combined rate increase of 10% or more.”

- Allison Bell

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