19-02 - Health Insurance Rate Filing Key Dates, February 14, 2019

INSURANCE BULLETIN 19-02 Health Insurance Rate Filing Key Dates

INSURANCE BULLETIN 19-02 Health Insurance Rate Filings – Key Filing Dates for 2019 Issued: February 14, 2019

The following Bulletin is issued by the Missouri Department of Insurance, Financial Institutions and Professional Registration (“Department”) to inform and educate the reader on the specified issue. It does not have the force and effect of law, is not an evaluation of any specific facts or circumstances, shall not be considered a statement of general applicability and is not binding on the Department. See § 374.015, RSMo (2016).

To: All health carriers writing health insurance or health benefit plan coverage in Missouri

From: Director Chlora Lindley-Myers

Re: Health Insurance Rate Filing Key Dates (2019)

This Bulletin provides notice to health carriers of key filing dates for health benefit plans that will be offered during 2020, as required by §376.465, RSMo (2016)1, and 20 CSR 400-13.100.

1 All statutory references herein are to RSMo (2016) unless otherwise noted. Applicability

This Bulletin is intended to announce key rate filing dates for health benefit plans that are: • “Health benefit plans” as defined in §376.465 (excluding plans sold in the large employer group market); and • Individual and small employer group plans subject to the requirements of the single risk pool and transitional plans; and • Subject to a determination of “reasonableness” pursuant to §376.465.7.

For ease, this Bulletin will hereinafter refer to such plans as “Subsection 7 Plans.” Section 376.465 specifies the timeframes applicable to rate filings for all other health benefit plans.

File Rates for Subsection 7 Plans No Later than July 19, 2019

The Centers for Medicare and Medicaid Services (CMS), Center for Consumer Information and Insurance Oversight (CCIIO) designated Missouri as an “Effective Rate Review” state in 2017. To retain that status, the Department must ensure rate filings meet federal guidelines. This Bulletin serves to indicate that the Department intends to follow federal filing and posting guidelines to the extent possible under Missouri law.

Current federal guidelines require rates to be filed for single risk pool and transitional plans issued or renewed on or after January 1, 2020. Rates for Subsection 7 Plans must be submitted to the Department no later than July 19, 2019, with the exception of student health plans.

With regard to student health plans, federal law exempts such plans from the filing deadlines applicable to single risk pool and transitional plans. However, pursuant to §376.465, rates for student health plans should be filed with the Department at least 60 days prior to the proposed effective date.

File Rates for Subsection 7 Plans No Earlier than June 22, 2019

If a rate filing is submitted prior to June 22, 2019, the health carrier should include a request to extend the review timeframe to July 19, 2019. This extension of time is necessary for the Department to accommodate the review and posting of proposed rates and the public comment period required by 20 CSR 400-13.100 within the overall timeframes established by CCIIO.

Post Proposed Rates for Subsection 7 Plans - August 1, 2019

Current federal guidelines require “Effective Rate Review” states to post proposed rates for single risk pool and transitional plans no later than August 1, 2019. The Department does not intend to post proposed rates earlier than this date. Optional Filing of Quarterly Rates for Subsection 7 Plans in the Small Group Market

Current federal law permits single risk pool and transitional plans in the small group market to adjust rates as often as quarterly. As Missouri law does not limit the frequency of rate filings, health carriers may submit quarterly rate filings for small group market plans.

• 2020 Plans: Health carriers should submit rate filings by July 19, 2019, or at least 60 days prior to the proposed effective date, per §376.465. o Health carriers should remember the 30 day public comment period specified in 20 CSR 400-13.100. This requirement applies to small group quarterly rate filings. Health carriers should plan for filing and implementation of rates accordingly. o The Department notes federal filing deadlines for quarterly filings in prior years have been approximately 105 days before the effective date of the quarterly rates.

Transitional Plan Rate Filings

Missouri law doesn’t differentiate between transitional plans and other Subsection 7 Plans. Therefore, transitional plan rates must be filed at least 60 days prior to implementation, and are subject to the same standards of review, as other Subsection 7 Plans. However, while current federal guidance for transitional health plans only requires rate submissions where the proposed rate increase exceeds the federally identified rate review threshold, under Missouri law, all transitional plan rate changes must be filed with the Department regardless of the magnitude or direction of the rate change.

Please note, for transitional plan rate changes that are less than the federal threshold, the Department will not require companies to also file concurrently with CMS per 20 CSR 400- 13.100(8).

For Additional Rate Filing Guidance

General Instructions available via the System for Electronic Rate and Form Filing (SERFF) for Missouri will be updated. Additional filing guidelines will be posted on the Department’s website and updated as necessary.

Rate Filings for other Health Benefit Plans

For filing requirements applicable to grandfathered and excepted benefit plans that are not Subsection 7 Plans, please see §376.465. For dental plans that a health carrier or licensed pre- paid dental plan intends to make available on the exchange, rates must be filed in accordance with §376.465, or thirty (30) days prior to the intended effective date.

Any questions or comments regarding this Bulletin should be directed to Molly White at 573- 526-4106 or via email to Molly.White@insurance.mo.gov.

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