Georgia-Rate Review Law

  • Georgia has prior approval for HMO individual market rates only. § 33-21-13(e)(1).
  • “Basic” HMO rates may not be “excessive, inadequate, or unfairly discriminatory” § 33-21-13(e)(2).
  • The Commissioner shall approve or disapprove HMO rates in a “reasonable” period of time; rates will be deemed approved after 90 days if no action is taken. § 33-21-13(f).
  • Out-of-network options on health plans must be priced within statutory limits. §33-20A-9.1.
  • 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.
  • Notice of any individual rate increase must be given to policyholders at least 60 days before the effective date. 33-29-22.

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