Rate Increase Reviews to Begin on Schedule

[Crabcake Johnny]

Don't forget this this gem which kicks in Sept. 1st of this year. All rate increases that exceed 10% will automatically be reviewed. And per the PPCA, if the government decides that the rate increase is not justified, it can be denied.

Just more fun coming our way.

Health Insurers Lose Push to Ease Rule on U.S. Overhaul Law

 

[stuy119]

Group, individual, or both?

 

[Crabcake Johnny]

Affordable Care Act helps fight unreasonable health insurance premium increases

"Starting September 1, 2011, the rule requires independent experts to scrutinize any proposed increase of 10-percent for most individual and small group health insurance plans."

But not to worry, a team of "independent experts" will be reviewing the cases.

We can thank Anthem for this. This clause was sparked by Anthem stating a 39% increase in CA but upon review went "ooops." Then they did it again in CT - wanted a 25% increase. The CT DOI said "prove it." Anthem said "well...umm...we can't." DOI said "then denied."

I think Anthem needs to hire my son to do their math.

 

[stuy119]

Probably why they wanted renewal to reach clients 100 days out, so that the independent reviewers can take 3 months to look it over.

 

[ActuaryGuy]

And per the PPCA, if the government decides that the rate increase is not justified, it can be denied.

Thankfully, this part is just not true. CMS can only declare that the increase is unreasonable, if they so find. Only certain states have the actual authority to flat out deny rate increases.