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Pennsylvania-Rate Review Law

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

  • Pennsylvania does require insurers to obtain prior approval of individual market rate increases before they go into effect.
  • Insurers must file rate increase requests with the Insurance Department, and regulators have 45 days to approve or disapprove the revised rates. PA INS. CODE 3803. Rates are deemed approved if regulators do not disapprove them by the end of the 45-day period or the end of a public comment period, if such a period is established by the Commissioner.   PA INS. CODE 3804.
  • Disapproval of a rate filing shall be based only on specific provisions of applicable law, regulation or statement of policy or if insufficient information is submitted to support the filing.  PA INS. CODE 3804.
  • Requests for rate hikes must include detailed data and justifications for the increases.
  • Rate increases and rate filings are publicly available on the state’s website at http://www.insurance.state.pa.us/dsf/rf_filings.html.

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