The Center for Consumer Information & Insurance Oversight
District of Columbia Rate Review Grants Award List
Cycle I Grant Application Summary
The District of Columbia Grantee: The Department of Insurance, Securities and Banking
Award Date: August 16, 2010
Award Amount: $1,000,000
- Pursue Additional Legislative Authority: The District currently has prior approval authority for health insurance premium filings in the individual insurance market and for HMOs. The District will review its existing legal framework and those of other States and will propose changes to the law and regulations that reflect best practices and will make health insurance premium filing requirements consistent for all types of insurance products.
- Expand the Scope of the Review Process: The District will begin to require all insurers to file premium changes, previously only Blue Cross Blue Shield and HMOs were required to file premiums.
- Improve the Review Process: The District will adopt regulations establishing a standard format for submitting health insurance premium filings. The District will also analyze data from health insurance premium filings to identify trends and develop statistical information.
- Increase Transparency and Accessibility: Currently, information about health insurance premium filings is only provided to the public after the filing has been approved and only in response to a Freedom of Information Act request. The District will develop a web site providing consumers with plain language information. It will also do outreach to inform the public about the information that is available and the opportunity for input into the rate review process that exists.
- Develop and Upgrade Technology: The District will develop a more sophisticated analysis of the health insurance rate filings and establish a data center to compile and publish fee schedule information.
Cycle II Grant Application Summary
The District of Columbia Grantee: Department of Insurance, Securities and Banking
Award Date: September 20, 2011
Total Award: $3,803,324
Baseline Award: $3,000,000
Workload Award Amount: $203,324
Performance Award Amount: $600,000
- Introduce legislation: The District will engage legal and technical experts to identify potential gaps in its authority and recommend legislative enhancements, as needed.
- Expand scope of rate review: After review of existing authority, the District, if needed, will seek to expand the scope of its rate review process through legislation.
- Improve rate filing requirements: The District will consult with legal and technical experts to develop a standardized rate filing template. The District will also engage consultants to develop improved methods for financial analysis. New staff will analyze the potential impact of Exchanges on submitted rates and rate filings. A Financial Analyst will review historical rates and provide additional information to consider when reviewing rates.
- Improve transparency and consumer interfaces: A web consultant will develop a website devoted to consumer information regarding rate review that will link to the District Department of Insurance Securities and Banking website and the District's health reform website. The District will also engage academic consultants to develop consumer brochures. A Consumer Specialist will work to enhance the Department of Insurance Securities and Banking’s website with information on rate filings and will conduct outreach to DC residents regarding rates. The District is also planning to contribute for enhancements to the System for Electronic Rate and Form Filing.
- Hire new staff: The District will create 5 new positions with Cycle II funding; these positions are in addition to the 2 positions created with Cycle I resources. The District will also establish a paid internship program.
- Improve IT: The District will purchase software to examine rating methodologies and expose trends. A consumer Specialist will continue to work with the Office of Information Technology on website updates.
- November 5, 2019 FAQ: Quality Rating Information Bulletin’s (Quality Bulletin’s) Display Guidelines for Direct Enrollment (DE) Entities
- November 1, 2019 Enhanced Direct Enrollment Approved Partners (Updated)
- September 11, 2019 FAQ: Enhanced Direct Enrollment Participation Requirements for Non-Issuer of a Primary EDE Entity Environment
- August 15, 2019 Quality Rating Information Bulletin for Plan Year 2020 Health Insurance Exchanges Quality Rating System (QRS) for Plan Year (PY) 2019: Results at a Glance
- April 18, 2019 CMS-9926-F: Final HHS Notice of Benefit and Payment Parameters for 2020 Final 2020 Letter to Issuers on Federally-facilitated Exchanges Key Dates for Calendar Year 2019: QHP Certification in the FFEs; Rate Review; Risk Adjustment
- April 4, 2019 Guidance on Unified Rate Review Timeline: Timing of Submission of Rate Filing Justifications for the 2019 Filing Year for Single Risk Pool Coverage Effective on or after January 1, 2020
- March 19, 2019 2020 Final Actuarial Value Calculator 2020 Final Actuarial Value Calculator Methodology
- March 6, 2019 CMS-9921-NC: Request for Information Regarding the Sale of Individual Health Insurance Coverage Across State Lines Through Health Care Choice Compacts
- February 28, 2019 Section 1332 Pass-through Funding Tools and Resources