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Washington – Health Insurance Premium Rate Review Laws

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

  • Washington requires all insurers and HMOs to file rates, and the state has prior approval authority to approve or reject rates before they go into effect.
  • The state Insurance Commissioner may disapprove any rate increase “if the benefits provided . . . are unreasonable in relation to the amount charged.”  RCW 48.44.020.  This same standard applies to HMOs.  RCW 48.46.060.  
  • Rates may not be used until 60 days after they are filed with the Insurance Commissioner.  If the Commissioner does not disapprove the rate increase within 60 days of the filing, the rate increase is deemed approved.   RCW 48.44.020.  This same standard applies to HMOs. RCW 48.46.060.
  • The Washington Office of the Insurance Commissioner (OIC) has an online search tool for insurance rate filings, however, most individual market rate filings are exempted from public disclosure under current state law.  RCW 48.02.120.  The OIC supported a 2011 bill that would open up health insurance rate filings to the public.
IssuesHealth