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Maryland-Rate Review Law

If you buy health insurance on the individual market, without help from an employer, you may want to know what Maryland is doing to protect you from unfair and unnecessary premium rate increases.  Here’s a summary of the Maryland laws that govern rate increases.  Caution: the laws and regulations on the books don’t always reflect what actually happens in practice.  Contact your state’s insurance agency for further information.

  • Maryland requires prior-approval of individual market rates.
  • Insurers must file proposed insurance policy forms and initial rates at least 60 days before the effective date.  Rates will be deemed approved if not disapproved by the expiration of 60 days.  MD INS. CODE § 12-203.  Rates may be disapproved if benefits are unreasonable in relation to premiums.  MD INS. CODE § 12-205.  Subsequent changes to rates must be filed with supporting data at 90 days before the effective date.  Code of Maryland Regulations
  • HMOs must file proposed rate increases at least 60 days before the effective date.  HMO rates may not excessive, inadequate, or unfairly discriminatory. MD INS. CODE § 19-713; Code of Maryland Regulations
  • For nonprofits, rates may be disapproved or modified if they “appear by statistical analysis and reasonable assumptions to be excessive in relation to benefits. MD INS. CODE §14-126(b)(3).
  • Maryland currently does not publicly disclose rate filings or any portion of rate filings.

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