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

  • Wyoming has prior approval authority to approve or deny rates before they go into effect for HMO rates only.
  • Health insurance is considered a competitive market in Wyoming, and therefore nonprofit and commercial insurers can raise their rates by “file and use,” meaning they may file rates and implement them at anytime without approval.  Wyo. Stat. § 26-14-107 (requiring insurers in competitive markets to make rate information “available to the commissioner upon his request”).
  • HMO rates may not be “excessive, inadequate, or unfairly discriminatory.”  The rate filing must include a certification by a qualified actuary, or other qualified person, as to the appropriateness of the methodology underlying the rate request. Wyo. Stat. § 26-34-109.
  • The Insurance Commissioner must approve or disapprove the HMO rate request “within a reasonable period.”  Wyo. Stat. § 26-34-109.
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