If you buy health insurance on the individual market, without help from an employer, you may want to know what Colorado is doing to protect you from unfair and unnecessary premium rate increases. Here’s a summary of the Colorado laws that govern rate increases.
- Colorado has authority to pre-approve premium rate increases for all individual market products before they go into effect.
- Insurers must file rate increase requests with the Department of Regulatory Agencies, Division of Insurance, and regulators have 60 days to approve or disapprove the revised rates. Rates increases are deemed approved if regulators do not act with the 60-day period. COL. REV. STAT. § 10-16-107
- Rates may not be excessive, inadequate, or unfairly discriminatory. These terms are defined in the statute.
- Colorado law allows regulators to consider insurers’ profits, income investment, surplus, and other factors when deciding whether to approve a rate request. COL. REV. STAT. § 10-16-107.
- If medical loss ratios are at least 65% for individual market products, the Division may “expedite the approval process.” COL. REV. STAT. § 10-16-107(1.6)(b).
- Colorado has consumer information about rates and rate review at http://www.dora.state.co.us/insurance/consumer/HealthRateFAQs.htm.
- The Division of Insurance has an online database for searching rate increases, which includes the maximum and minimum increase for any policyholder. Actual rate filings are not available online.
- The Division is required to publish a consumer summary on health insurance costs, derived from information filed with the Division, except any information not open to the public under the state’s public records act. COL. REV. STAT. § 10-16-133.
- Each year, carriers must submit to the Division a list of average provider reimbursement rates to be posted on the Division’s website. COL. REV. STAT. § 10-16-134.