If you buy health insurance on the individual market, without help from an employer, you may want to know what Georgia is doing to protect you from unfair and unnecessary premium rate increases. Here’s a summary of the Georgia laws that govern rate increases.
- Rate changes are filed with the Office of Insurance and Safety Fire Commissioner. Any rate filing that results in an increase must also be filed with the Consumer Insurance Advocate within the Governor’s Office of Consumer Affairs. § 33-57-5; Bulletin No. 99-LH-2.
- Initial “basic” HMO rates are filed with policy forms and may not be “excessive, inadequate, or unfairly discriminatory.” GA INS. CODE § 33-21-13(e). The HMO forms and initial rates shall be approved or disapproved in a “reasonable” period of time; rates will be deemed approved after 90 days if no action is taken. GA INS. CODE § 33-21-13(f).
- For non-profit plans, initial rates to be charged must be approved upon an application for the plan to do business, but rate revisions need not be approved. GA INS. CODE § 33-19-14.
- Out-of-network options on health plans must be priced within statutory limits. GA INS. CODE § 33-20A-9.1.
- Notice of any individual rate increase must be given to policyholders at least 60 days before the effective date. 33-29-22.
- Rate increases and rate filings are not posted online. HMO filings are public documents. GA INS. CODE § 33-21-22.
- Georgia is one of five states that has not filed for a health reform federal grant to improve rate review.
Information is based on review of state statutes and regulations and, in some cases, interviews or emails with state insurance departments.