Hawaii-Rate Review Law

  • Hawaii has prior approval for managed care plans. 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.
  • Rates 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 case, interviews with state insurance departments.