What's happening
This bill amends health insurance rate review processes, setting deadlines for determinations, appeal procedures, and actuarial certification.
Why it matters
Establishes faster timelines for rate decisions. By requiring the superintendent to make an initial determination on health insurance premium changes within 30 days (down from up to 60 days), the bill speeds up the process, potentially allowing policyholders and insurers to know sooner about approved or denied rate changes.
Mandates transparency and actuarial rigor. The bill obligates the superintendent to explain in detail the actuarial assumptions and methods behind rate decisions, and requires that all final rate determinations are certified by a qualified actuary. This could increase accountability and public confidence that rate changes are based on sound, professional standards.
Creates a clear and limited appeal process. Insurers (or corporations) have 15 days to appeal an initial rate decision, with the superintendent having another 15 days to issue a revised determination. This introduces defined opportunities for challenge, but also prevents indefinite delays in finalizing rate decisions.
Shortens consumer notification period but adds flexibility. Insurers and corporations now need to give at least 30 days’ notice (rather than 60) before implementing approved rate changes, and can do so either via website posting or written notice. This could make notification more efficient but gives consumers less time to prepare for premium changes.
Albany, before your first meeting.
Every bill that moved yesterday, summarized in a sentence and ranked by impact. The Albany Scorecard follows on Sundays.
Free. Unsubscribe in one click. Want alerts on specific bills? Create an account.
Who cares
Headline styles
Speed Up Insurance Rate Decisions
Plain English, a few words. Used as the page title.
Sponsors
History
- Referred to insurance
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Speed Up Insurance Rate Reviews
In Senate Committee · Insurance · Sponsor James L. Seward
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
32
2017-2018 Regular Sessions
IN ASSEMBLY (Prefiled)
January 4, 2017
Introduced by M. of A. CAHILL, STECK, BRINDISI, SCHIMMINGER, RAIA -read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to rating of individual and small group health insurance policies
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subparagraph (A) of paragraph 1 of subdivision (e) of section 3231 of the insurance law, as amended by chapter 107 of the laws of 2010 and as further amended by section 104 of part A of chapter 62 of the laws of 2011, is amended to read as follows:
(A) An insurer desiring to increase or decrease premiums for any policy form subject to this section shall submit a rate filing or application to the superintendent.
An insurer shall send written notice of the proposed rate adjustment, [including the specific change requested,] to each policy holder and certificate holder affected by the adjustment on or before the date the rate filing or application is submitted to the superintendent. The notice shall prominently include mailing and website addresses for both the department of financial services and the insurer through which a person may, within thirty days from the date the rate filing or application is submitted to the superintendent, contact the department of financial services or insurer to receive additional information or to submit written comments to the department of financial services on the rate filing or application. The superintendent shall establish a process to post on the department's website, in a timely manner, all relevant written comments received pertaining to rate filings or applications. The insurer shall provide a copy of the notice to the superintendent with the rate filing or application. The superintendent shall immediately cause the notice to be posted on the department of financial services' website. The superintendent shall determine whether the filing
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01676-01-7
A. 32 2
or application shall become effective as filed, shall become effective as modified, or shall be disapproved. The superintendent may modify or disapprove the rate filing or application if the superintendent finds that the premiums are unreasonable, excessive, inadequate, or unfairly discriminatory, and may consider the financial condition of the insurer when approving, modifying or disapproving any premium adjustment. [The] Provided, however, any adjustment to a rate filing or application must be in accordance with generally accepted actuarial principles and practices, and must be appropriate for the population to be covered and services to be furnished under the policy. An initial determination [of] regarding the rate filing or application shall be made by the superintendent [shall be supported by sound actuarial assumptions and methods, and shall be rendered in writing between] no later than thirty [and sixty] days from the date the rate filing or application is submitted to the superintendent. The superintendent's initial determination shall be provided to an insurer in writing within the thirty day time period and shall describe in detail the actuarial assumptions and methods used in the superintendent's determination. Should the superintendent require additional information from the insurer in order to make [a] an initial determination, the superintendent shall require the insurer to furnish such information, and in such event, the [sixty] thirty days shall be tolled and shall resume as of the date the insurer furnishes the information to the superintendent. [If the superintendent requests additional information less than ten days from the expiration of the sixty days (exclusive of tolling), the superintendent may extend the sixty day period an additional twenty days to make a determination. The] Following the issuance of the initial determination, an insurer shall have fifteen days to appeal the determination in writing. If an initial rate determination is appealed, the superintendent shall have fifteen days to issue a revised determination. If the initial determination is not appealed by an insurer, it shall become final fifteen days after it is issued. All final rate determinations shall be certified by an actuary designated by the superintendent who meets the qualification standards established by the American academy of actuaries and follow the practice standards established by the actuarial standards board. Notwithstanding the foregoing, the application or rate filing will be deemed approved if a determination is not rendered within the time allotted under this section. An insurer shall not implement a rate adjustment that is approved by the superintendent unless the insurer provides at least [sixty] thirty days advance [written] notice of the [premium rate adjustment approved by the superintendent] adjustment, either through a posting on its website or by written notice to each policy holder and certificate holder affected by the rate adjustment.
§ 2. Paragraph 2 of subdivision (c) of section 4308 of the insurance law, as amended by chapter 107 of the laws of 2010 and as further amended by section 104 of part A of chapter 62 of the laws of 2011, is amended to read as follows:
(2) A corporation desiring to increase or decrease premiums for any contract subject to this subsection shall submit a rate filing or application to the superintendent. A corporation shall send written notice of the proposed rate adjustment, [including the specific change requested,] to each contract holder and subscriber affected by the adjustment on or before the date the rate filing or application is submitted to the superintendent. The notice shall prominently include mailing and website addresses for both the department of financial services and the corporation through which a person may, within thirty days from the date the
A. 32 3
rate filing or application is submitted to the superintendent, contact the department of financial services or corporation to receive additional information or to submit written comments to the department of financial services on the rate filing or application. The superintendent shall establish a process to post on the department's website, in a timely manner, all relevant written comments received pertaining to rate filings or applications. The corporation shall provide a copy of the notice to the superintendent with the rate filing or application. The superintendent shall immediately cause the notice to be posted on the department of financial services' website. The superintendent shall determine whether the filing or application shall become effective as filed, shall become effective as modified, or shall be disapproved. The superintendent may modify or disapprove the rate filing or application if the superintendent finds that the premiums are unreasonable, excessive, inadequate, or unfairly discriminatory, and may consider the financial condition of the corporation in approving, modifying or disapproving any premium adjustment[. The]; provided, however, any adjustment to a rate filing or application must be in accordance with generally accepted actuarial principles and practices, and must be appropriate for the population to be covered and services to be furnished under the contract. An initial determination [of] regarding the rate of filing or application shall be made by the superintendent [shall be supported by sound actuarial assumptions and methods, and shall be rendered in writing between] no later than thirty [and sixty] days from the date the rate filing or application is submitted to the superintendent. The superintendent's initial determination shall be provided to a corporation in writing within the thirty day time period and shall describe in detail the actuarial assumptions and methods used in the superintendent's determination. Should the superintendent require additional information from the corporation in order to make [a] an initial determination, the superintendent shall require the corporation to furnish such information, and in such event, the [sixty] thirty days shall be tolled and shall resume as of the date the corporation furnishes the information to the superintendent. [If the superintendent requests additional information less than ten days from the expiration of the sixty days (exclusive of tolling), the superintendent may extend the sixty day period an additional twenty days, to make a determination. The] Following the issuance of the initial determination, a corporation shall have fifteen days to appeal the determination in writing. If an initial rate determination is appealed, the superintendent shall have fifteen days to issue a revised determination. If the initial determination is not appealed by a corporation, it shall become final fifteen days after it is issued. All final rate determinations shall be certified by an actuary designated by the superintendent who meets the qualification standards established by the American academy of actuaries and follow the practice standards established by the actuarial standards board. Notwithstanding the foregoing, the application or rate filing will be deemed approved if a determination is not rendered within the time allotted under this section. A corporation shall not implement a rate adjustment that is approved by the superintendent unless the corporation provides at least [sixty] thirty days advance [written] notice of the [premium rate adjustment approved by the superintendent] adjustment, either through a posting on its website or by written notice to each contract holder and subscriber affected by the rate adjustment.
§ 3. This act shall take effect immediately.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.