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Code · California · Insurance Code

§ 10181.4

278 words·~1 min read·/ca/insurance-code/10181-4

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

(a)For large group health insurance policies, all health insurers shall file with the department at least 60 days prior to implementing any rate change all required rate information for unreasonable rate increases. This filing shall be concurrent with the written notice described in Section 10199.1.
(b)For large group rate filings, health insurers shall submit all information that is required by PPACA. A health insurer shall also submit any other information required pursuant to any regulation adopted by the department to comply with this article.
(c)A health insurer subject to subdivision
(a)shall also disclose the following aggregate data for all rate filings submitted under this section in the large group health insurance market:
(1)Number and percentage of rate filings reviewed by the following:
(A)Plan year.
(B)Segment type.
(C)Product type.
(D)Number of insureds.
(E)Number of covered lives affected.
(2)The insurer’s average rate increase by the following categories:
(A)Plan year.
(B)Segment type.
(C)Product type.
(3)Any cost containment and quality improvement efforts since the health insurer’s last rate filing for the same category of health insurance policy. To the extent possible, the health insurer shall describe any significant new health care cost containment and quality improvement efforts and provide an estimate of potential savings together with an estimated cost or savings for the projection period.
(d)The department may require all health insurers to submit all rate filings to the National Association of Insurance Commissioners’ System for Electronic Rate and Form Filing (SERFF). Submission of the required rate filings to SERFF shall be deemed to be filing with the department for purposes of compliance with this section.
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