Insurance Dept Provides Health Rate Filing Fact Sheet

HARTFORD — In response to questions from reporters and the public on the annual health care rate review process, the Connecticut Insurance Department is providing the following information:

The Federal Government sets the annual health rate deadline which is why the Connecticut Insurance Department (CID) cannot delay their actuarial rate review and process.

The timeline and deadlines associated with the annual health rate filings and review is not in the exclusive control of CID but instead is within the purview of the federal government through the Centers for Medicare & Medicaid Services’ (CMS) and the Center for Consumer Information and Insurance Oversight (CCIIO), part of the Department of Health & Human Services (DHHS). CMS/CCIIO provides national leadership in setting and enforcing standards for health insurance that promote fair and reasonable practices to ensure that affordable, quality health coverage is available to all Americans.

On and Off Exchange health plans are annual plans that are rated and expire on an annual basis, primarily during a calendar year, but some Small Group annual plans are not held to the calendar year. Connecticut’s On Exchange health plan marketplace is Access Health CT (AHCT).

The Annual Filing, Review and Rate Setting Process Runs from January to January.

January — CID publishes a bulletin in January of each year with instructions to the carriers on their rate filings effective for the following calendar year. See Bulletin HC-81-22 Health Insurance Rate Filing Submission Guidelines.

Spring — During the spring months the carriers gather data from the prior years’ experience to use in their filing for the following plan year.

July — At the beginning of July, the carriers submit their health rate filings with CID for the next year. As such, CID’s Life & Health (L&H) unit and L&H actuaries review the filings during the summer months and correspond with the carriers regarding any questions they have about the filings. All of the filings and correspondences are publicly available and posted on the CID website.

August — CID hosts a public informational meeting with the carriers concerning the filings. The public is invited to participate and submit any comments and testimony.

Following the public meeting, CID continues its actuarial review.

September — The Commissioner makes a final decision on the rate filings either approving, modifying, or denying the rate requests.

The determined rates need to be submitted to CMS and AHCT no later than mid-September.

The rates are then posted by CMS and Access Health CT no later than November 1st, the beginning of open enrollment.

November — AHCT anticipates having rates and plans posted on its website at least two weeks before the beginning of open enrollment that begins November 1. That schedule provides consumers with ample time to review the plan options, and to make a more informed decision on which plan best fits their needs.

December – Before the end of open enrollment on December 15, consumers make their decision in order to have a health care plan in place by the January 1 effective date of the following calendar year.

January – The new plan goes into effect for the calendar year.

Any disruption or delay in this process or timeline puts in jeopardy whether plans will be filed and made available by the deadlines set by CMS, the result of which could potentially make certain plans not available for the next calendar year, reducing consumer options, or alternatively resulting in consumers not having coverage for the following year.

The annual health care rate review filings and process are unlike most other rate setting procedures in the state of Connecticut. These health plans are issued on an annual basis, and filings of the carriers and the actuarial review process of the Insurance Department must fit within a yearly time frame and the deadlines set by CMS. As such, any analogy to other insurance plan rate reviews and other state agency rate reviews is unreasonable.

To view the recorded 2023 health care rate request informational meeting from August 15 online, visit CT-N here: ct-n.com/ondemand.asp?ID=19945.

The Department continues to seek public comment on the health insurance rate proposals filed by CIGNA Health & Life, CTCare Inc, CTCare Benefits Inc, and the ConnectiCare Insurance Company, Inc Aetna, Anthem Health Plans, and United Healthcare/Oxford for 2023 plans both on and off Access Health CT, the state’s federal Affordable Care Act exchange.

The Department expects to announce the 2023 health care insurance rates in early September.

The health insurance rate requests are available for viewing and open to public comment on the Department’s website at portal.ct.gov/cid