Trends in Premiums in the Small Group and Individual Insurance Markets, 2008-2011. Appendix A: State-Specific Data Gathering Methodology

11/06/2012

Alabama


Alabama Individual and Small Group carriers’ (with the exception of HMO, Medicare, long-term care, and rate changes for credit) rate filings have been requested on an informational basis only. This information was considered proprietary and was not subject to public disclosure. As a result, few filings were available for download and information in the filings was limited. Filings are now available online at: http://www.aldoi.gov/Consumers/ACARateFilings.aspx# through a Health Filing Access Interface developed in response to the Affordable Care Act. Rate filings submitted since July 10, 2010, are now available for download.

Arkansas


Arkansas was added to the sample later to replace states in the original selection that had filings of insufficient quality. As it was not included in the original contract, Perr & Knight did not take steps to collect data in Arkansas. Arkansas requires prior approval on rate increases. The filings collected by the Arkansas Insurance Department are considered public and rate filings that were filed after March 21, 2008, are available online at: http://www.insurance.arkansas.gov/LH/FlgShpage/Filings.htm. Many of the rate filings that had complete information were determined to be usable in the database.

California


California poses unique challenges in the private insurance market because regulatory authority is divided among two agencies – the Department of Managed Health Care (DMHC), which is responsible for all managed care including the HMOs in the individual and small group markets, and the Department of Insurance, which regulates the rest of the market. California was a difficult state in which to find usable filings. California did not have prior approval over rate increases. Filings for carriers reporting to the DOI are filed with the Commissioner, and rates become effective 30 days after filing or if they receive written approval prior to that time. Although many filings were collected by Perr & Knight, most were found to be unusable. Usable filings were found using two separate websites. Individual rate filings starting in mid-2010 are made public on the website at: http://www.insurance.ca.gov/0250- insurers/HlthRateFilings/index.cfm. HMO filings starting in 2011 are made public on the website at: http://wpso.dmhc.ca.gov/RateReview.

Colorado


Colorado was initially under consideration to be left out of the sample due to the difficulties of pulling information, but was eventually left in the sample. As of 2009, Colorado has prior approval on rate increases. Many filings were downloaded from Perr & Knight and were usable. Other filings have been available since January 2008 and were downloaded from the state’s website. The portal at: http://www.dora.state.co.us/pls/real/Ins_RAF_Report.main contains summary information for rate filings submitted since January 1, 2008. An alternative portal to Colorado filings submitted through SERFF is at: http://healthinsurance.colorado.gov/pages/filingsSearch.aspx.

Connecticut


Connecticut has prior approval for individual plans and for small group HMOs. Many filings were downloaded from Perr & Knight, but were mostly unusable or included limited information. Many of the filings are labeled “trade secret”, but some are available to the public at: http://www.catalog.state.ct.us/cid/portalApps/RateFilingDefault.aspx.

Florida


Florida has prior approval for rate filings. Information from Florida filings is complete and easily accessible. Many usable filings were downloaded by Perr & Knight. Other information was obtained from annual rate summaries published online by the state. Individual filings are available, but must be requested from the state insurance department. The filings must be requested individually via email, and the insurance department will email a link to the filing. Many of the files are for new products or are underwriting certifications. Files may be requested using the interface at: http://www.floir.com/edms/. Summary information is also available on the public website.

Hawaii


Hawaii has prior approval on HMO plans. Not many filings were available from Perr & Knight, and no filings are available for download on the state insurance department website.

Illinois


Illinois requires Individual plans to file for information purposes. Small Group plans are file and use. Perr & Knight did not retrieve information from Illinois. A summary of products in the individual market through the end of 2010 was previously available at: http://www.insurance.illinois.gov/healthinsurance/ratefilings.asp (and does not appear to be actively updated).

Iowa


Iowa has prior approval for Individual and Small Group plans. Perr & Knight was not able to download many rate filings. The state insurance department website had a summary of rate increase history since 2005 in the individual market through September 2011, but the summary is updated sporadically and has, at times, been removed from their public website. It is available at: http://www.iid.state.ia.us/system/files/page/2012/02/15/individua... _history_s_12771.pdf.

Indiana


Indiana has prior approval for individual plans and for small group HMO plans. Other Small Group plans are file and use. Perr & Knight was successful in downloading many usable rate filings. Filings filed after May 1, 2010, are available for download from the website at: http://www.in.gov/IDOI/RateWatch/Default.aspx.

Idaho


Idaho did not have prior approval, but requires filing for informational purposes. Perr & Knight was successful in retrieving usable filings, but Idaho filings are not made public on the insurance department website.

Kansas


Kansas has prior approval in the Individual and Small Group markets. Perr & Knight was successful in retrieving usable rate filings. Filings submitted since June 10, 2010, are available on the website at: http://www.ksinsurance.org/consumers/hfai.php# in response to the Affordable Care Act.

Kentucky


Kentucky was added to the sample to replace Tennessee due to the difficulties of information retrieval. Kentucky has prior approval on both individual and small group policies for rate increases. Group health policies are not required to be filed with the exception of Long-Term Disability, Medicare Supplement, or Large Group policies. Perr & Knight was able to download several filings, but many were unusable. Rate filings since August 2011 are available at: http://insurance.ky.gov/RateFil/default.aspx.

Massachusetts


Massachusetts has prior approval on individual and small group policies as of 2010. Perr & Knight downloaded many rate filings, but most were unusable. Filings are also not available on the department website.

Maine


Maine has prior approval on individual and small group policies unless a carrier elects a 78% guaranteed MLR option. Maine was added to the sample later because of the lack of information in some of the sample states. Perr & Knight was not very successful in finding rate filings. Filings from the top insurers in the state are available on the website at: http://www.maine.gov/pfr/insurance/filings/filings.htm. Only four filings were available at this location, but Maine’s filings were eventually found through a SERFFFbased portal, accessible at: http://www.maine.gov/pfr/insurance/PPACA/HFAI.htm. Rate increase summaries are available at: http://www.maine.gov/pfr/insurance/employer/snapshot_individual.htm and http://www.maine.gov/pfr /insurance/employer/snapshot_small_group.htm.

Maryland


Maryland has prior approval on Individual and Small Group policies. Rate changes must be filed 90 days prior to the effective date. Filings were not investigated by Perr & Knight due to difficulties in pulling information, but were instead retrieved directly from the state Department of Insurance. Filings are not for public viewing on the insurance department website.

Michigan


Michigan has prior approval for HMO plans and all BCBS plans for Small Group and requests filings Individual policies. Perr & Knight retrieved numerous filings, but almost all of them were unusable. The filings lacked vital information as well. There are no filings available for download from the state website (http://www7.dleg.state.mi.us/SerffPortal/) from Blue Cross/Blue Shield which accounts for more than 50 percent of the market share in both individual and small group markets.

Minnesota


Minnesota has prior approval on Individual and Small Group policies. Perr & Knight was able to download many files, but few were usable. More filings were requested from the Department of Commerce, which provided most of Minnesota’s filing information. Many filings submitted since June 10, 2010 are available through the department’s website (http://mn.gov/commerce/insurance/topics/medical/Access-Filings.jsp), although some have been made unavailable.

Nebraska


Nebraska was added to the sample to replace Mississippi due to lack of responsiveness on the part of the Insurance Department. Nebraska has prior approval on Individual policies. Small Group policies are required to file for informational purposes only. Not many filing were available, but Perr & Knight was able to provide some that were usable. Limited filings are available on the department website at: https://doi-ratechanges.ne.gov/DOIRateChange/faces/welcome.xhtml. Summaries, in spreadsheet form, of filings submitted since June 2011 are also available at: http://www.doi.ne.gov/lh/filings/filing_index.htm.

New Jersey


New Jersey has prior approval on Individual and Small Group policies. New Jersey has an 80% MLR requirement. Filings provided by Perr & Knight were unusable. As a result, filings were requested directly from the state Department of Insurance, which provided many filings with good information. No filings are available on the insurance department website, although some information on current premium rates in the individual market is available at: http://www.state.nj.us/dobi/division_insurance/ihcseh/ihcrates.htm.

New York


New York has prior approval on Individual and Small Group policies as of 2010. Filings from Perr & Knight were unusable and thus New York was eliminated from the sample. Summaries of filings are available at: http://www.dfs.ny.gov/insurance/health/prior_app/prior_app.htm and https://myportal.dfs.ny.gov/web/prior-approval/rate-applications-by-company.

North Carolina


North Carolina has prior approval on Individual and Small Group policies. Perr & Knight was able to provide a significant number of filings, many of which were usable. Filings are also available online at: http://infoportal.ncdoi.net/filelookup.jsp?divtype=3 via SERFF interface system.

Ohio


Ohio has prior approval on Individual policies. Filings gathered by Perr & Knight provided a large number of usable filings. Most Small Group policies are required to file for informational purposes only, but some groups and associations require prior approval. Filings are not available to the public on the department website.

Oklahoma


Oklahoma was added to the sample as a replacement for South Carolina due to difficulties in retrieving information. Oklahoma has prior approval for Individual HMO policies and Small Group policies. Perr & Knight provided a substantial number of usable filings for the database. Filings from June 2010 on are available online as a response to the Affordable Care Act and the Oklahoma Open Records Act through a SERFF interface at: http://www.ok.gov/oid/Regulated_Entities/Rate_and_Form_Filing/HFAI_Searc.... Proprietary information is not subject to public disclosure.

Oregon


Oregon has prior approval for Individual and Small Group policies. Perr & Knight provided a large number of usable filings for the database. Additional filings were downloaded from the insurance department website. Oregon filings and rate summaries are available at: http://www.oregonhealthrates.org/#search_form.

Pennsylvania


Pennsylvania has prior approval on Individual policies. For Small Group policies, prior approval is required only for HMOs and nonprofit BCBS plans. Perr & Knight provided a very small number of usable filings for the database, and additional filings were downloaded from the department website. Filings are available at: http://www.insurance.state.pa.us/dsf/rf_filings.html for filings since April 1, 2008. Some archived filings for 2004 – 2008 as well as other reports on the health insurance market are available at: http://www.portal.state.pa.us/portal/server.pt/community/industry_activi....

Rhode Island


Rhode Island has prior approval for Individual and Small Group policies. Perr & Knight provided a few filings, most of which were usable. Filings related to regulatory action, including several filings from Blue Cross & Blue Shield of Rhode Island in the individual market are available on the insurance department website at: http://www.ohic.ri.gov/Insurers_RegulatoryActions.php.

South Dakota


South Dakota has prior approval for Individual policies and requires Small Group policies to file for informational purposes only. Perr & Knight provided a small number of usable filings. No filings are available on the state webpage.

Texas


Texas requires Individual and Small Group policies to file for informational policies only. Texas was originally considered for exclusion from the sample due to difficulties in retrieving information, but was ultimately included to provide better results based on the total number of covered lives. It was later revealed that Texas labels all filings proprietary, the filings that were downloaded were unusable, and Texas was removed from the sample. No filings are available on the department website.

Virginia


Virginia has prior approval for Individual policies, and requires Small Group policies to file for informational purposes only. A large number of usable filings were provided by Perr & Knight. Many, but not all filings submitted since June 10, 2010 are available at: http://www.scc.virginia.gov/boi/SERFFInquiry/LHAccessPage.aspx, under search option 2. Search option 1, on the same page, also appears to provide some summary information on filings submitted after January 1, 2011.

Washington


Washington has prior approval for Individual and Small Group policies. Perr & Knight provided a large number of filings, most of which were large group filings. Additional filings were downloaded from the state website. Filings are available for download at: https://fortress.wa.gov/oic/onlinefilingsearch/. Rate summaries are available at: http://www.insurance.wa.gov/health-rates.shtml.

Wisconsin


Wisconsin is a file and use state for both Individual and Small Group policies. Perr & Knight provided a large number of usable filings. Additional filings were then downloaded from the department webpage. Filings are available at: https://ociaccess.oci.wi.gov/ratereview/pub/webSearch through a SERFF interface. There is also a summary document available.

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