The New Hampshire Insurance Department released an RFP for program management to "enhance the quality and depth of the NHID rate review of health insurance rate increases, and improve the consumer understanding of health insurance rates and rate change."

Here is a link to the new Commonwealth Fund issue brief on state by state growth rates 2003-2010 in employer-based health plan premiums, deductibles and employee contributions, and how the provisions of the ACA will lower growth rates in premiums by 2020. There is also a podcast featuring Sandy Praeger, Insurance Commissioner of Kansas, Cathy Schoen, and myself.
http://www.commonwealthfund.org/Publications/Issue-Briefs/2011/Nov/State...

Alabama was one of the 10 states that CCIIO found to not have an 'effective rate review process'. We are statutorially precluded from the approval of health rates (this goes back to laws created in 1945). We introduced a prior rate review and approval bill in our latest Legislative session--which ended in early June--but it did not pass. We plan to pre-file this bill in November for our upcoming January 2012 Legislative session.

Our thoughts are to be as general as possible in the wording of the law while still complying with the requirements of 45 CRF Part 154 (so as to limit any needed future legislative changes) and combine this law with very specific details in the accompanying regulation (which will be much easier to revise if needed).

Robert Turner
Alabama

Maine's process for health insurance rate review was recently modified. Originally, carriers were required to file all rates, risk formulas, and modifications to the Superintendent of Insurance no less than 60 days before the effective date. The Superintendent could then suspend such rate changes if they were determined to be “excessive, inadequate, or discriminatory.”

This year, the law was amended to permit carriers in the individual market to file rates for informational purposes without prior approval of the Superintendent if a carrier maintains a minimum medical loss ratio of 80% (unless rate review is required by the ACA). Additional changes in Maine law may be considered next session to conform to federal law and regulations. I have attached a short overview on this subject prepared by the Legislature's Office of Policy and Legal Analysis and used some of their summary language.

Seeing as we may soon revisit this issue, I am curious to hear how policymakers and stakeholders in other states would respond to the following question: in hindsight, what change would most strengthen your state's rate review law and/or process? Thank you in advance for any insights.

On July 1, 2011 CMS determined that Massachusetts met the standards established by their May 19, 2011 rate review regulations and reported that our state has an effective state process to review proposed insurance rate increases.

Read more including the fill list of state determinations at: http://cciio.cms.gov/resources/factsheets/rate_review_fact_sheet.html

Rhode Island has adopted a systematic annual rate factor review process for large and small group markets (and a separate hearing process for individual market direct pay rate requests). The information we require the carriers to submit is documented in the attached letter to each commercial health plan in Rhode Island. We require the health plans to complete a rate factor filing template and surveys of provider contracts, administrative costs, and health systems improvements.