California Insurance Companies Required to Justify Their Rates to the Public Initiative (2014)
Health insurance rates proposed after November 6, 2012, shall be approved by the commissioner prior to their use, and health insurance rates in effect on November 6, 2012, are subject to refund under this section.
2) “Rate” means the charges assessed for health insurance or anything that affects the charges associated with health insurance, including, but not limited to, benefits, premiums, base rates, underwriting relativities, discounts, co‑payments, coinsurance, deductibles, premium financing, installment fees, and any other out‑of‑pocket costs of the policyholder.
Personally, I think this is just another law and more paperwork that we don’t need. Look at Health Care Reform, we had a Supreme Court Decision calling it a Tax and now we have the courts deciding whether or not subsidies can be given in the exchange. Enough!!! Free Market…. I just created (9.19.2014) a new page, where I annotate and comment on this proposition line by line, click here to view the annotated text.
Rate Regulation – November 2014 Ballott Inititive Proposition 45 – the right for regulators to modify or reject rates before they go into effect, rather than just the 80% Medical Loss Ratio rule and current rate regulations where Insurance Companies simply file, show their work and the method must be approved. Click to view 17 page analysis by CA Health Benefit Exchange (Covered CA) Government Code §100500 et seq setting up the exchange and their authority.
Currently, the commissioner reviews every rate increase, but doesn’t have the enforcement power to reject them. This measure would change that. The bigger policy question, though, is whether or not that rate regulation enforcement power would successfully rein in rising health care costs and premiums. Calif. Health Line 6.4.2014 Opposed stop higher costs.org California Health Line – Pros – Cons Peter Lee vs Dave Jones 7.7.2014 Covered CA – Analysis 6.17.2014 Ballot Pedia Consumer Watch Dog Another website for them Calprig.org analysis of current law LA Times 5.8.2014 More info on our websites about the current rate regulation laws & procedures. Medical Loss Ratio Health Care Reform
- MLR Medical Loss Ratio Rate Regulation PPACA – Health Reform
- Role of the Agent – Broker in Health Insurance
- Medical Loss Ratio Code Federal Regulations
How about just getting out, exercise, cook your own meals and stop the obesity epidemic? Michelle Obama changed the food pyamid to make it easier to follow, ACA requires restaurants to show calories, etc. Let’s just take care of ourselves!
- December 23, 2010 OCIIO–9998–IFC: Rate Increase Disclosure and Review; Proposed Rule – Opens in a new window (PDF – 215 KB)
- May 19, 2011 CMS-9999-FC: Rate Increase Disclosure and Review; Final Rule (PDF – 282 KB)
- September 6, 2011 CMS-9999-F: Rate Increase Disclosure and Review: Definitions of Individual Market and Small Group Market – Opens in a new window (PDF – 526 KB)
- November 26, 2012 CMS-9972-P:Patient Protection and Affordable Care Act: Health Insurance Market Rules; Rate Review – Opens in a new window
- February 22, 2013 CMS-9972-F:Patient Protection and Affordable Care Act: Health Insurance Market Rules; Rate Review – Opens in a new window
- March 30, 2012 State-Specific Threshold Proposals Guidance for States (PDF – 200 KB)
Los Angeles Times Poll Proposition 45 leading with 41.6% of those queried and opposed by 29.9%. Undecideds were 28.5% latimes.com/
Blue Cross Small Group Rate Increase – Excessive – Back and Forth 80% Medical Loss Ratio
Insurers spend $12M in 5 days to defeat Prop 45 californiahealthline.org
Against: http://stophighercosts.org/ http://www.agentsofaction.org/
$88M to defeat – only $3.3M in support rate-regulation-ballot/
Covered CA to stay neutral california health line.org/
Arguments against…. .breit bart.com/
Polls seem to favor passage – I still don’t see the point with 80% mandatory loss ratio la times.com/
L.A. Times Article latimes.com