AB 359

This bill changes the filing requirements for health insurance premium rates

and adds some publication and notice requirements related to increases in those

rates.

Under current law, insurers must file with the Office of the Commissioner of

Insurance (OCI) premium rates, and changes to premium rates, for all types of

insurance within 30 days after the rates or rate changes become effective. Current

law prohibits premium rates from being excessive, inadequate, or unfairly

discriminatory and provides guidelines for determining whether rates comply with

those standards. The commissioner of insurance may order that a rate be

discontinued for any policy issued or renewed after a date specified in the order if,

after a hearing, the commissioner determines that the rate does not comply with

those standards.

Under the bill, an insurer that writes health insurance must file with OCI

premium rates, and changes to premium rates, for health insurance before those

rates or changes to rates become effective and may not use a new or changed rate for

health insurance without approval of the rate by the commissioner. Unless the

commissioner holds a hearing on a rate or change to a rate, the rate or changed rate

is approved if the commissioner does not disapprove the rate or changed rate within

30 days after it was filed with OCI. The bill specifically authorizes the commissioner

to disapprove any proposed rate or rate change that is not justified based on

underlying medical costs.

The bill requires the commissioner to publish on OCI's Internet site all health

insurance rate increases that the commissioner approves and requires an insurer of

a health benefit plan for which a rate increase has been approved to provide at least

60 days' notice of the rate increase to each insured under the health benefit plan.

Under the bill, the commissioner must hold a public hearing before approving or

disapproving any health insurance rate change that increases an existing rate by

more than 10 percent. In addition, if the commissioner approves a health insurance

rate increase of more than 10 percent after holding a hearing and the insurer

justified the rate increase based on increased medical costs, the commissioner must

publish on OCI's Internet site the discounted payment rates negotiated by the

insurer with the insurer's provider networks.