SHB 1220 -
By Representative Rolfes
ADOPTED AS AMENDED 03/04/2011
Strike everything after the enacting clause and insert the following:
"Sec. 1 RCW 48.02.120 and 1985 c 264 s 2 are each amended to read
as follows:
(1) The commissioner shall preserve in permanent form records of
his or her proceedings, hearings, investigations, and examinations, and
shall file such records in his or her office.
(2) The records of the commissioner and insurance filings in his or
her office shall be open to public inspection, except as otherwise
provided by this code.
(3) Except as provided in subsection (4) of this section, actuarial
formulas, statistics, and assumptions submitted in support of a rate or
form filing by an insurer, health care service contractor, or health
maintenance organization or submitted to the commissioner upon his or
her request shall be withheld from public inspection in order to
preserve trade secrets or prevent unfair competition.
(4)(a) Except as provided in (b) of this subsection, for a rate
filing for an individual or small group health benefit plan with an
effective date on or after January 1, 2012, subsection (3) of this
section applies only to the numeric values of each rating factor used
by a health carrier. The remainder of the rate filing shall be open to
public inspection subject to subsection (5) of this section.
(b) Subsection (3) of this section shall continue to apply for a
period of one year from the date a new individual or small group
product filing is submitted or until the next rate filing for the
product, whichever occurs earlier, if the commissioner determines that
the proposed rate filing is for a new product that is distinct and
unique from any of the carrier's currently or previously offered health
benefit plans. A carrier must make a written request for a product
classification as a new product under this subsection (4)(b) and must
receive subsequent written approval by the commissioner for this
subsection (4)(b) to apply.
(5) Unless the commissioner has determined that a filing is for a
new product pursuant to subsection (4) of this section, for individual
or small group health benefit rate filings with an effective date on or
after January 1, 2012, the commissioner shall:
(a) Make the portions of each rate filing that are open to public
inspection available for public inspection on the tenth calendar day
after the commissioner determines that the rate filing is complete and
accepts the filing for review through the electronic rate and form
filing system;
(b) Prepare a rate disclosure summary form in a standard format
that is written in plain language easily understood by the general
public. The summary must allow carriers to explain the relationship
between premium and health care cost drivers. The summary must set
forth, at a minimum, the following: (i) The rate increase, year over
year, for annual increases, including historic rate adjustments for at
least the past three years; (ii) any percent increase to current rates
attributed to mandated changes, not including changes due to
demographics; (iii) the number of members impacted by the rate; (iv)
the impact of benefit changes on the rate; (v) the products' filed
health care trend; (vi) the projected medical loss ratio for the rating
period; (vii) the top three drivers contributing to the change in
premiums; and (viii) other information added to the summary form by
rule that the commissioner, in consultation with carriers, finds
reasonably necessary to help consumers understand the reasons for
proposed and accepted rates. A carrier shall complete the disclosure
summary form and submit it electronically to the commissioner along
with each individual or small group health benefit plan rate filing;
and
(c) Prepare a standardized rate summary form to explain his or her
findings after the rate review process is completed. The
commissioner's summary form must be included as part of the rate filing
documentation available to the public electronically.
(6) The commissioner shall adopt rules to implement and administer
this section. The rules must include, but are not limited to, a
process for updating the summary form content in subsection (5)(b) of
this section. In adopting rules under this section, the commissioner
shall consult with carriers, as defined in RCW 48.43.005, and consumers
in the development of the summary forms."
Correct the title.
EFFECT: Protects the following information from public
inspection: Numeric values of each rating factor used by a health
carrier in its individual or small group health benefit plan rate
filings.
Preserves the exceptions to public inspection allowed under current
law (i.e., actuarial formulae, statistics, and assumptions associated
with the rate filing) for new products that are distinct and unique
from a carrier's currently or previously offered plans (this exception
lasts for one year or the date of the next filing, whichever occurs
first); a carrier must make a written request to the Insurance
Commissioner, which must be approved in writing in order for this
exception to apply.
Requires the Insurance Commissioner to make any publicly available
information 10 days after the Insurance Commissioner determines that
the filing is complete and accepts the filing through the electronic
rate and form filing system.
Requires the Insurance Commissioner to develop a rate disclosure
summary in language easily understood by the public that allows
carriers to explain the relationship between premium and health care
cost drivers. Requires the rate disclosure summary form to contain the
following information: (1) Annual rate increases for the past three
years, (2) rate increases attributed to mandated changes, (3) the
number of members impacted by the rate, (4) the impact of benefit
changes on the rate, (5) the filed health care trend, (6) the projected
medical loss ratio for the rating period, (7) the top three drivers
contributing to the change in premiums, and (8) other information added
to the summary form by rule that the Insurance Commissioner, in
consultation with the carriers, finds reasonably necessary to help
consumers understand the reasons for proposed and accepted rates.
Requires carriers to complete the rate disclosure summary form and
submit it electronically along with each individual or small group
health benefit plan rate filing.
Requires the Insurance Commissioner to prepare a standardized rate
summary form to explain his or her findings after the rate review
process is completed. Requires the Insurance Commissioner's rate
summary form to be included as part of the rate filing documentation
available to the public electronically.
Requires the Insurance Commissioner to adopt rules, including a
process for updating the rate disclosure summary forms. Requires the
Insurance Commissioner to consult with carriers and consumers when
developing summary forms.