Health insurance rate FAQs

Anytime a health insurer requests a rate change, it must back up its request with data. We create a summary for each request to help you understand why your company believes it needs a rate change. Each one-page summary includes:

• The average percentage change the company is requesting
• When the new rate would take effect
• How many people are impacted.
• Key information the company used to develop the rate
• How it plans to spend your premium
• If there are any benefit changes
• The company's annual rate request history.

To see a summary for any rate request, go to the health rate search site, find the company name, and look under documents.

The data in the summaries is supplied by the company. Part of our rate review includes double-checking and verifying the company's information. If we disagree with the company's data, we may disapprove the rate.

Once we've reviewed the rate request and made our final decision, we write a decision memo. The memo outlines:

• Our reasons behind the decision
• What we consider in our review
• Key information the company used to develop its request
• If we disagreed with the company, why and about what
• If the rate change includes any benefit changes

To see a decision memo for any rate request, go the health rate search site, find the company name, and look under documents.

Yes. You can sign up to get an e-mail whenever your health insurer wants to change your rate. Once you've signed up and selected your company, we'll send you an e-mail notification whenever:

• Your health plan requests a rate change
• The request is withdrawn
• The request is revised
• And once we've made our decision

Individual and small employer health insurance rates are community rated. This means that insurers look at the claim experience of everyone in either the individual or small group market. That's why your rate could change even if you haven't filed a claim.

Here are the other factors that determine how much you pay in monthly premium:

Individual plan (plans you buy yourself): Your age, where you live, how many family members are covered, whether you or your family members smoke and which benefits you choose.

Small group plan (plans for employers with 1- 50 employees):The employees' age,where they live, their family size, and the benefits they choose.

Executive and CEO salaries are part of the health plans' administrative costs. They grab a lot of headlines, but actually make up a tiny portion of your premium. In general, the amount of premium going to CEO salaries is less than $1 per member per month.

To see specific information about your company, take a look at the summary and decision memo associated with its rate request. The summary includes the percentage of your premium going to administrative costs and the decision memo tells you the amount in dollars.

The Affordable Care Act signed into law March 23, 2010, created several new benefits that took effect on January 1, 2011. How much these benefits impacted your rate depends on the level of benefits your plan already provided. Most of the rates filed for the new health reform benefits were less than two percent.