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Wisconsin – 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 Wisconsin is doing to protect you from unfair and unnecessary premium rate increases. Here’s a summary of the Wisconsin 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 Wisconsin is doing to protect you from unfair and unnecessary premium rate increases.  Here’s a summary of the Wisconsin laws that govern rate increases.

  • Wisconsin does not have prior approval authority to approve or deny rates before they go into effect. 
  • Wisconsin requires insurers to file rates “within 30 days after they become effective.”  Wis. Stat. § 625.13
  • Rates may not be “excessive, inadequate or unfairly discriminatory.”  Wis. Stat. § 625.11.
  • If, after a hearing, the Commissioner of Insurance finds that rates are “excessive, inadequate or unfairly discriminatory,” he or she shall issue an order within 30 days of the hearing, or within a reasonable timeframe, requiring the rate to be discontinued.  Wis. Stat. § 625.22.
  • Filings are open to public inspection and filings are available in a searchable database on the Office of the Insurance Commissioner’s website at https://ociaccess.oci.wi.gov/Companyfilings/jsp/rfsearch.oci.  Wis. Stat. § 625.14.
IssuesHealth