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DC – Health Insurance Premium Rate Review Law

If you buy health insurance on the individual market, without help from an employer, you may want to know what the District is doing to protect you from unfair and unnecessary premium rate increases.  Here’s a summary of the District of Columbia laws that govern rate increases.

  • District of Columbia has prior approval of individual market rate increases. D.C. Code § 31-3508 (b).
  • Nonprofit insurers must submit rate filings at least 60 days before the proposed effective data. The filing is deemed approved if not disapproved within 60 days or any extension of the review period. D.C. Code § 31-3508(b). HMOs (any company providing coverage on a prepaid basis) have a 30-day approval or deemer period. D.C. Code § 31-3415(c).
  • “Rates shall not be excessive, inadequate, or unfairly discriminatory.” D.C. Code § 31-3508 and § 31-3415(b).
  • Rate filings are not posted online. The District posts a list of all rate filings recently approved, but does not indicate the amount of the increase. Filings are public documents except for trade secrets and confidential information. D.C. Code § 31-3425.

Information is based on review of state statutes and regulations and, in some case, interviews or emails with state insurance departments.