Pennsylvania Regulators’ Rate Review Authority Gets a Boost

By | March 22, 2012

The law giving the Pennsylvania Insurance Department authority to review and disapprove rate increases in the small group health insurance market took effect on Wednesday.

The law, Act 134, was signed into law by Governor Tom Corbett late last year. It expands the department’s ability to review proposed rate increases of 10 percent or more for small group health plans issued in Pennsylvania.

“Pennsylvania now regains control over the regulation of the small group market from the federal government,” said Insurance Commissioner Mike Consedine. “This means that the U.S. Department of Health and Human Services will have no role in reviewing these rates, and will adopt our determinations.”

Previously, Pennsylvania was one of only 10 states with limited rate review authority in the commercial small group market. Rate requests outside the department’s scope were defaulting to the federal government for review. The department maintains full authority to review rates for individual products.

In January of this year, Health and Human Services agreed that the department’s authority to review individual health products was already effective, and determined that the passage of Act 134 gives the additional review authority needed for small group health plans.

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