The Patient Protection and Affordable Care Act (ACA) provides states the opportunity to enhance their health insurance premium rate review and reporting methods. Legislators in many states are considering laws to give regulators the ability to reject health insurance rate hikes that seem excessive. NovaRest Founder Donna Novak, just returned from New Jersey, where she met with stakeholders in order to gather input on the revised NJ rate filing process.
The New Jersey Department of Banking and Insurance (DOBI) currently regulates and reviews rates for fully insured health insurance products including those sold in the individual, small and medium group markets. In these markets, DOBI is responsible for reviewing premium rates to ensure they are appropriate given regulatory guidelines. NovaRest and Hay Consulting were hired to help examine its rate review procedures and recommend possible enhancements.
During the session, Donna says there was a very healthy discussion and stakeholders asked important questions about the rate filing process. “In general, stakeholders favored a process that would keep insurance rates down in NJ,” said Donna. “They were interested in which information could be provided by insurance companies to identify drivers of raising health care costs.”
Those who attended were very interested in what information DOBI should have access to when reviewing plans. They wanted to know if the certain, currently proprietary information, in rate filings could be made public, such as such as average rate increases and medical loss ratios. Stakeholders thought that it would be helpful to see how changes to specific benefits might increase or decrease the premium rates, especially the added cost of each benefit mandate.
The meetings had a high level of participation from all stakeholders. The report from Hay-NovaRest is due to be finalized this fall. Changes will then be implemented in NJ that will make the rate filing review process more efficient and somewhat more transparent.