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Hawaii – 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 Hawaii is doing to protect you from unfair and unnecessary premium rate increases. Here’s a summary of the Hawaii laws that govern rate increases.

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

  • Hawaii requires managed care plans to obtain prior approval of individual market rates before they go into effect.  HRS Section 431, Art. 14G.  Managed care plans are defined to include HMOs and any health plan offered by a healthcare insurer, except disability insurers. HRS § 431:14G-102.
  • Rates for insurance offered by managed care plans shall not be excessive, inadequate, or unfairly discriminatory and shall be reasonable in relation to the costs of the benefits provided. HRS § 431:14G-103.
  • The Commissioner has 60 days to disapprove proposed managed care rates, or rates will be deemed approved. HRS § 431:14G-105.
  • The Commissioner may hold a hearing upon request of a policyholder aggrieved by any rate change in effect. HRS § 431:14G-107.
  • Rate filings are open to public inspection, except for confidential and proprietary information. HRS § 431:14G-105(d).

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

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