If you buy health insurance on the individual market, without help from an employer, you may want to know what Illinois is doing to protect you from unfair and unnecessary premium rate increases. Here’s a summary of the Illinois laws that govern rate increases.
- Illinois currently does not require insurers to obtain prior state approval of rate hikes before they go into effect. The Division of Insurance has no authority to approve, deny, or modify individual market rates.
- Illinois requires insurers to attach premium rates for each policy to policy forms, and submit the forms for approval to the Division of Insurance before the policy is issued. The rates and rate revisions are filed “as information” under Illinois law for the purpose of “tracking” rates in the individual market.
- Insurers may file an actuarial memorandum supporting their rates increases.
- For HMO plans, insurers must file all rates and rate increases with the Division of Insurance prior to the effective date of the increase. The Division may request actuarial documentation in support of the rate increases. The rates are considered public documents, but the actuarial documentation is deemed confidential and proprietary information. ILL. ADMIN. CODE tit. 50, § 5421.60. HMOs also must submit any changes in rating methods to the Division. ILL. REV. STAT. ch. 215, para. 125/4-12.
- Rate filings are not publicly available on the state’s websites. The Division of Insurance has published a list of rate increases since 2005 for all carriers. More information is available in the state’s application for a federal premium review grant.
Information is based on review of state statutes and regulations and in some cases, interviews or emails with state insurance departments.