May 31, 2016
Health rate review laws among strongest in the country
Santa Fe, NM — The Office of Superintendent of Insurance (OSI) invites those who currently have a health plan purchased through the Exchange to review and comment on proposed rate increases and changes. This rate review period covers 2017 health plans submitted by a variety of insurance companies and is only open through August. During this rate review period, insurance companies first submit their proposed rate increases and/or plan changes then revise and resubmit proposals based on public comment and OSI feedback. These plans are posted and may be viewed by visiting www.osi.state.nm.us/hirr.aspx.
OSI approves the request if the carrier can show that the new rate is reasonable in relation to the benefits provided and the plan meets all other requirements. If the carrier’s data does not fully support the increase, OSI can ask for more information, approve a smaller increase, or reject an increase.
The Affordable Care Act (ACA) requires that all insurers intending to offer a health insurance plan must submit their rates to either the state or federal government for review, regardless of premium changes. The rate review process is designed to improve insurer accountability and transparency. It ensures that experts evaluate whether the proposed rates are based on reasonable cost assumptions and solid evidence, and gives consumers the chance to comment on proposed increases. The ACA also requires that a summary of rate review justifications and results be accessible to the public in an easily understandable format.