Monday, August 15, 2011


Commissioner Issues Rate Review Bulletin

Final step completed to qualify for HHS effective rate review status

(DES MOINES) August 15, 2011– Iowa’s Insurance Commissioner Susan Voss was notified today by the Department of Health and Human Services (HHS) that a bulletin issued by the Insurance Division today, along with other statutory and administrative language provided in an earlier letter to HHS, will suffice to gain Iowa Effective Rate Review status for small employer group health insurance. This is a reversal of the federal determination in July that Iowa’s rate review process was determined to be effective for individual health insurance, but not for small employer groups. Had this revised determination not been made, Iowa’s small group rates would have been reviewed at the federal level.

The bulletin states that insurance carriers are now required to file small employer group health insurance rate increases with the Division prior to the effective date of the proposed change.  This requirement makes it necessary that the Division, as well as an external actuary under contract for additional review, make a determination approving the request before it can be effective. As with all such requests in the future, accepted Medical Loss Ratio standards have to be met.

This determination completes a set of HHS approvals that the Division had sought, including approval of Iowa’s Rate Review process for individual and small group health insurance, a waiver on certain Medical Loss Ratio percentages to be applied during a transition period and the approval of Iowa’s Medical External Review process.

The complete bulletin, Commissioner’s Bulletin 11-06, as posted today on the Division’s website, can be found here.