Alabama |
Individual, Small and Large- Informational |
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Alaska |
Individual, Small and Large- Prior Authorization |
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Arizona |
Individual- Informational;
Small and Large- No Requirement |
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Arkansas |
Individual- Informational; Small and Large- No Requirement |
AR H 2104
|
Woods (R) |
Failed - Adjourned - House Public Health, Welfare and Labor Committee
Would authorize the Insurance Commissioner to enforce the Affordable Care Act, including to approve premium rates for individually underwritten insurance policies and health coverage contracts, to approve a schedule of premium rates or the methodology for determining premium rates for group insurance policies. |
AR H 2138 |
Hyde (D) |
Failed - Adjourned – Withdrawn
Would establish the Arkansas Health Benefits Exchange, establishing a Small Business Health Options Program, requiring insurance companies, hospital and medical service corporations, HMOs, and small employer carriers to file health premium rate tables with the Insurance Commissioner, repealing provisions concerning disapproval of individual health insurance rates and entitlement to a conversion policy upon termination of a group policy. Bill withdrawn by author. |
California |
Individual, Small and Large- File and Use |
CA A 52 |
Feuer (D) |
Pending - Senate Appropriations Committee
Would require notification by insurers before changing premium rates or coverage in a health care plan as well as approval from the Department of Managed Health Care and the Department of Insurance for increases in health care premiums, copayments, or deductibles.
Article: "Bill to regulate California health insurance rates is shelved." 9/1/11 |
Colorado |
Individual, Small and Large- Prior Authorization |
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Connecticut |
Individual, Small and Large- Prior Authorization |
CT S 15
|
Crisco (D)
|
Failed – Died
Would enhance state rate review and rate approvals for long-term care insurance policies, requiring transparency and public comment at a symposium prior to any rate approval decision for such proposed premium increases. |
CT H 5170 |
O-Brien (D) |
Failed – Died
Would expand state rate review and reduce the amount of permissible increases for health insurance premiums, ensure that health insurance premium payments are used for health care services, also would prohibit the use of health insurance policy premiums collected from residents for political activities by the insurer. |
CT H 5243
|
Zalaski (D) |
Failed – Died
Would require advance notice of health insurance premium rate increases, with health insurers to provide at least sixty days' advance notice to affected policyholders of an increase in their premium rates. |
Delaware |
Individual, Small and Large- File and Use |
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District of Columbia |
Individual, Small and Large- Prior Authorization |
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Florida |
Individual, Small and Large- Prior Authorization |
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Georgia |
Individual, Small and Large- Informational |
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Hawaii |
Individual, Small and Large- Prior Authorization |
HI S 1273 |
Tsutsui (D) |
Enacted - Act No. 15
Authorizes the state Insurance Commissioner to enforce the consumer protections and market reforms relating to health insurance, including HMOs, mutual and fraternal benefit societies, as set forth in the Affordable Care Act—including rate review. |
Idaho |
Individual- File and Use; Small and Large- No Requirement |
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Illinois |
Individual- With Form; Small and Large- No Requirement |
IL H 289
|
Flowers (D)
|
Pending - House Rules Committee
Would create the independent quasi-judicial Health Insurance Rate Review Board to ensure insurance rates are reasonable and justified. A panel would provide a list of nominees for appointment to the Board. |
IL H 1501
|
Harris (D) |
Pending - House Rules Committee
Would provide for the filing of premium rates with respect to health insurance coverage offered by an issuer and premium rate changes, also would require a company to notify the Director of Insurance whenever a policy form has been closed for sale, with provisions concerning health insurance premium rates and prior approval of the Director. |
Indiana |
Individual- Prior Authorization; Small and Large- File and Use |
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Iowa |
Individual, Small and Large- Prior Authorization |
IA S 20
|
Kibbie (D)
|
Pending - Carryover - Senate Commerce Committee
Would expand state health insurance rate review and rate increase requirements, including notice, public comment and hearing requirements, would require health insurance carriers to notify all policyholders and the public. |
IA HSB 125
|
Commerce Committee |
Pending - Carryover – HOUSE
Would authorize the Insurance Commissioner to adopt administrative rules to implement the insurance provisions of the Affordable Care Act, would require public posting of all comments regarding premium rate review "if the increase exceeds the average annual health spending growth rate." |
Kansas |
Individual, Small and Large- File and Use |
KS H 2208
|
Insurance Committee |
Pending - Carryover - House Insurance Committee
Would require any health insurer desiring to change rates on any policy form, contract, or certificate to submit electronically a rate filing request for approval with the Commissioner. No rate or change to a rate shall be used unless approved by the Commissioner, including special provisions for the Individual Market Health Insurance Rate Review Act. |
KS H 2383 |
Appropriations Committee |
Pending - Carryover - Senate Ways and Means Committee
Appropriations bill, concerning spending for fiscal years 2011 through 2016. Would authorize state spending of federal grant funds without limit, related to implement the federal Affordable care act including the HHS rate review grant. |
Kentucky |
Individual, Small and Large- File and Use |
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Louisiana |
Individual, Small and Large- File and Use |
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Maine |
Individual and Small- Prior Authorization; Large- ? |
ME H 877
|
Goode (D)
|
Pending - Carryover - Joint Committee on Insurance and Financial Services
Makes the rate review process for small group health insurance rates the same as the process for individual health insurance. Part A requires that, if a filing proposes an increase in rates in a small group health plan, the Superintendent of Insurance shall hold a hearing on the proposed rate increase at the request of the Attorney General. Part A makes it clear that in any hearings the burden of proving proposed rates are not excessive, inadequate or unfairly discriminatory is on the insurer. |
ME H 1140 |
Richardson W (R) |
Enacted - Public Law No. 2011-364
Amends the state health insurance laws to incorporate changes to implement the requirements of the federal Affordable Care Act adopted in 2010—including rate review. |
Maryland |
Individual, Small and Large- Prior Authorization |
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Massachusetts |
Individual- Prior Authorization; Small and Large- No Requirement (Act. Cert.) |
MA S 444
|
Moore M (D)
|
Pending - Joint Committee on Financial Services
Would provide that if the aggregate medical loss ratio (MLR) for all plans offered under chapter 288 Sec. 29, is less than 88%, such carrier's rate "shall be presumptively disapproved as excessive by the Commissioner," also would provide for calculations for certain refunds from out of compliance insurers. |
MA H 1181
|
Costello (D) |
Pending - Joint Committee on Health Care Financing
Would require continued reporting of premium rate review information by most health insurance companies, while exempting entities (such as employers) that do not charge or collect premiums. |
Michigan |
Individual- File and Use; Small and Large- No Requirement |
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Minnesota |
Individual, Small and Large- Prior Authorization |
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Mississippi |
Individual, Small and Large- Informational |
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Missouri |
Individual, Small and Large- No Requirement |
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Montana |
Individual, Small and Large- No Requirement |
MT H 105
|
Olson A (R)
|
Failed – Died
Would provide the state Insurance Commissioner the authority to conduct rate reviews and approve health insurance premiums. |
MT D 269
|
Driscoll (D)
|
Failed - Adjourned – Draft
Would require that rates for health insurance coverage be filed with the Commissioner of Insurance for review, provides terms for rate approval, disapproval, and withdrawal of approval. |
MT S 362
|
Economic Affairs Committee |
Failed – Died
Would require proposed health insurance rates to be filed with the state Insurance Commissioner for review. |
Nebraska |
Individual- ?; Small and Large- With Form |
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Nevada |
Individual- Prior Authorization; Small and Large- No Requirement |
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New Hampshire |
Individual and Small- Prior Authorization; Large- File and Use |
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New Jersey |
Individual- Prior Authorization; Small and Large- No Requirement (MLR) |
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New Mexico |
Individual, Small and Large- Prior Authorization |
NM S 208
|
Feldman (D)
|
Enacted - Chaptered. Chapter No. 2011-144
Amends state insurance code to provide greater transparency and new standards in rate review of applications for health insurance premium rate increases, providing for public hearings and administrative and judicial review of determinations in health insurance premium rate review matters. |
NM S 499
|
Papen (D) |
Failed - Adjourned – SENATE
Would amend insurance code to provide new rate review standards for change in classification of risks and rates, requiring hearings and administrative and judicial review of determinations in health insurance and health care plan rate and classification changes. |
New York |
Individual, Small and Large- Prior Authorization |
NY S 2800 |
Office of the Governor |
Enacted - Chapter No. 50
Makes appropriations for the support of government for services and expenses of the Department of Health for planning and implementing various healthcare and insurance reform initiatives authorized by federal legislation, including an HHS rate review grant. |
North Carolina |
Individual, Small and Large- Prior Authorization |
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North Dakota |
Individual, Small and Large- Prior Authorization |
ND H 1125 |
Keiser (R) |
Enacted - Chapter Number 211
Provides that the state administer and enforce the provisions of the Affordable Care Act that apply to insurance companies (such as premium rate review) subject to the Commissioner's jurisdiction and to the extent that the provisions are not under the exclusive jurisdiction of any federal agency. |
Ohio |
Individual, Small and Large- Prior Authorization |
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Oklahoma |
Individual, Small and Large- With Form |
OK S 643 |
Johnson C (D) |
Pending - Carryover - Senate Retirement and Insurance Committee
Relates to health insurance rate review process, would create the Oklahoma Individual Market Rate Review Act, would require insurers to submit changes in premium rates to the Insurance Commissioner, requiring the Commissioner to issue written findings and specifying that approved rates shall be guaranteed by the insurer for at least 12 months. |
Oregon |
Individual and Small- Prior Authorization; Large- File and Use |
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Pennsylvania |
Individual, Small and Large- Prior Authorization |
PA H 318 |
Deluca (D) |
Pending - House Insurance Committee
Would require that rates shall not be excessive, inadequate or unfairly discriminatory, with added rate review and prior approval by the Department within a 45-day period. |
Rhode Island |
Individual, Small and Large- Prior Authorization |
RI S 771
|
Sheehan (D)
|
Pending - Senate Health and Human Services Committee
Would provide for changes to the existing insurance rate review process, would require written approval from the Insurance Commissioner for a proposed insurance rate or rating formula. Rate increases would also be subject to a standard review process including the use of public meetings for consumers and the opportunity for insurers to challenge the Insurance Commissioner's decision. |
RI H 5733
|
Keable (D) |
Pending - House Health, Education and Welfare Committee
Would require the Health Insurance Commissioner to give prior written approval to a proposed change in a rate or rating formula to be used by any health insurer. Would also expand and give greater transparency to the process by which a health insurer may seek such a change in rate or a rating formula including required hearings in contested cases, to be held by the Health Insurance Commissioner. |
South Carolina |
Individual- Prior Authorization; Small and Large- No Requirement |
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South Dakota |
Individual- File and Use; Small and Large- No Requirement |
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Tennessee |
Individual, Small and Large- Prior Authorization |
TN S 1539
|
Norris (R)
|
Enacted - Public Chaptered. Chapter No. 344
Requires rate review, with medical service corporations and hospitals to submit premium rates and risk classifications to the Commissioner of Commerce and Insurance prior to any group policies being issued. |
TN H 2005
|
McCormick (R) |
Pending - Carryover – HOUSE
Would require rate review, with medical service corporations and hospitals to submit premium rates and risk classifications to the Commissioner of Commerce and Insurance prior to any group policies being issued. |
Texas |
Individual, Small and Large- File and Use |
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Utah |
Individual, Small and Large- File and Use |
UT H 291
|
Harper (R) |
Failed - Enacting Clause Struck
Would transfer all activities within the Utah Department of Insurance to the Department of Commerce, including insurance reform regulatory powers such as rate review, would create a replacement Division of Insurance. |
UT H 128 |
Dunnigan (R) |
Enacted - Chaptered. Chapter No. 400
Gives the Insurance Department the responsibility to conduct an actuarial review of rates established for the health benefit plan market. Authorizes the Department to establish a fee for the actuarial review. Removes language from the Risk Adjuster Board chapter of the Insurance Code related to the actuarial review of rates. |
Vermont |
Individual, Small and Large- Prior Authorization |
VT S 56
|
Pollina (D)
|
Pending - Carryover - Senate Finance Committee
Would clarify Vermont's health insurance rate review process, requiring all rate and form filings made by a health insurer to be filed electronically, provides to make available an e-mail alert system in which members of the public may sign up on the Department's website to receive notice of a proposed rate increase for a selected health insurer with distribution of e-mail alerts within three business days after receiving a rate filing proposing a rate change. |
VT H 65
|
Appropriations Committee |
Enacted - Act No. 3
Adjusts state insurance rate review to be consistent with the Affordable Care Act by deleting the specific provision that required "maintaining the premiums at levels due on June 15, 2008." |
Virginia |
Individual- Prior Authorization; Small and Large- Informational |
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Washington |
Individual, Small and Large- Prior Authorization |
WA H 1220
|
Rolfes (D)
|
Enacted - Chapter No. 312
Provides that all individual or small group market health benefit plan rate filing be open to public inspection, except for the numeric values of each rate factor used by the health carrier, requires health insurers in those markets to submit rate disclosure summary information along with their rate filings, requires the Insurance Commissioner to submit a publicly-available rate summary form once the rate review process is completed. Eliminates the Insurance Commissioner's authority to review and disapprove rates for individual products. |
WA S 5120
|
Keiser (D)
|
Pending - Carryover – SENATE
Would extend state regulation of insurance rate review by authorizing transparency and disclosure of the reasons for rates and decisions. |
WA S 5398
|
Keiser (D) |
Pending - Carryover – SENATE
Would continue the Insurance Commissioner's authority to review and disapprove rates for certain insurance products, by deleting a 2012 sunset date. |
West Virginia |
Individual, Small and Large- Prior Authorization |
WV SCR 75
|
Stollings (D)
|
Failed - Adjourned – HOUSE
Would request Joint Committee on Government and Finance to authorize a study of rate review process established by the Health Care Authority. |
WV H 3091
|
Frazier (D) |
Failed - Adjourned - House Banking and Insurance Committee
Would expand and clarify rate review of health insurer rate changes. |
Wisconsin |
Individual, Small and Large- Use and File |
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Wyoming |
Individual, Small and Large- No Requirement |
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