This is the second Rate Review Annual Report issued by HHS. The first was issued in September 2012 and was based on data submitted by rate review grantee states from September 2011, when reporting from grantee states began, through July 2012. This Annual Report is based on the data for requested and approved rate increases submitted by grantee states for CY 2012. This report analyzes both the rate review process and rate review grant activities, which are programs initiated by the Affordable Care Act to ensure that consumers get value for their premium dollars. Due to limitations of the data submitted by certain states, this report extrapolates from an analysis of data from 39 states in the individual market and 35 states in the small group market to estimate national savings on premiums in the individual and small group markets.