WOO-HOO! Illinois legislature passes bill to crack down on excessive rate hikes & provide rate transparency!

Back in February, I wrote about a bill introduced into the Illinois State Senate by Sen. Laura Fine (SD-09) which made my heart sing:

  • Amends the Department of Insurance Law.
  • Provides that the Department of Insurance shall establish the Office of the Healthcare Advocate.
  • Provides that the Office shall be administered by the Chief Health Care Advocate, who shall report to the Director of Insurance.
  • Amends the Illinois Insurance Code and the Health Maintenance Organization Act.
  • Provides that all individual and small group accident and health policies written subject to certain federal standards must file rates with the Department for approval.
  • Provides that unreasonable rate increases or inadequate rates shall be modified or disapproved.
  • Provides that when an insurer files a schedule or table of premium rates for individual or small group health benefit plans, the insurer shall post notice of the premium rate filings and a filing summary in plain language on the insurer's website.
  • Provides that the Department shall post all insurers' rate filings and summaries on the Department's website.
  • Provides that the Department shall open a 30-day public comment period on the date that a rate filing is posted on the website.
  • Provides that the Department shall hold a public hearing during the 30-day comment period.
  • Provides that the Director shall adopt affordability standards that must be considered in any decision to approve, disapprove, or modify rate filings.
  • Provides that after the close of the public comment period, the Department shall issue a decision to approve, disapprove, or modify a rate filing, and post the decision on the Department's website.
  • Provides that the Department shall adopt rules implementing specified procedures.
  • Defines "inadequate rate", "plain language", and "unreasonable rate increase".

As I noted in my 2023 annual rate change post for Illinois (which, sadly, is mirrored in far too many other states as well):

Unfortuantely, Illinois is another state which doesn't make it easy to analyze annual health insurance premium rate filings.

There's no details on their insurance department website, their SERFF listings don't seem to include the actuarial memos or URRT forms, and even the federal Rate Review listings only include the average requested rate changes; the actuarial memos there are mostly heavily redacted.

Every summer/fall a big part of my job has been to analyze the rate filings for the individual and small group health insurance markets for all 50 states + DC. Every summer/fall this rate analysis project is made extremely difficult for states which redact, bury or otherwise make it extremely difficult if not impossible to view the actual rate filings and the associated actuarial data needed to calculate the average premium changes and reasoning behind it.

Well, I'm not 100% sure whether this is a "companion bill" (it originated in the House, not the Senate), but it certainly looks like it--both the IL House & Senate just passed HB2296 last week, which does the following:

  • Amends the Department of Insurance Law.
  • Provides that beginning before or on May 1, 2026, and each May 1 thereafter, the Department of Insurance shall report to the Governor and the General Assembly on health insurance coverage, affordability, and cost trends.
  • Amends the Illinois Insurance Code.
  • Provides that any forms and rates filed for large employer group accident and health insurance shall be automatically deemed approved after 90 days after filing.
  • Provides that beginning plan year 2026, rate increases for all individual and small group accident and health insurance policies must be filed with the Department for approval.
  • Provides that unreasonable rate increases or inadequate rates shall be modified or disapproved.
  • Provides that beginning plan year 2025, the Department shall post all insurers' rate filings and summaries on the Department's website.
  • Provides that the Department shall open a 30-day public comment period on the date that a rate filing is posted on the website.
  • Provides that after the close of the public comment period, the Department shall issue a decision to approve, disapprove, or modify a rate filing within 60 days, and post the decision on the Department's website.
  • Provides that the Department shall adopt rules implementing specified procedures.
  • Defines terms.
  • Makes conforming changes in the Health Maintenance Organization Act and the Limited Health Service Organization Act.

As noted by Mike Miletich at the WAND website:

...lawmakers also want to crack down on insurance rate increases with a new consumer protection plan.

"It provides the Department of Insurance the authority to approve, modify, or disapprove health premium rates that it determines to be unreasonable or inadequate in the individual and small group market," Gabel explained.

This plan will require insurance companies to provide specific information and be more transparent about how they set their rates. Sponsors said this could help consumers and small businesses know the reason why they pay higher prices.

...Illinois will join 41 other states protecting consumers from unfair premium rate hikes if the measure is signed into law.

...Pritzker said the plans will help Illinois take historic action to provide affordable, quality health insurance to people across the state.

"We're holding health insurance companies accountable, preventing unnecessary rate hikes, and ensuring residents who are eligible to receive health insurance get connected to the plan they deserve," Pritzker said.

The governor said he looks forward to signing both bills into law.

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