Michigan Rate Review Grants Award List

Cycle I Grant Application Summary

Michigan Grantee: Michigan Office of Financial Insurance Regulation

Award Date: August 16, 2010

Award Amount: $1,000,000

• Improve the Review Process: Currently Michigan reviews Blue Cross Blue Shield health premiums prospectively and consults with contracted actuaries as needed; however a more limited review process is in place for all other products. Michigan will contract with consulting actuaries to both perform targeted, in-depth analysis and review of health insurance premium filings made by HMOs and commercial carriers and to build processes and procedures for a more general review program for these areas.
• Increase Transparency and Accessibility: Michigan currently provides access to health insurance premium filings upon request. The State will conduct a feasibility study on posting health insurance rate information to a proposed website, and will also look to other States for rate transparency models. Michigan will also move towards creating a public portal that will provide consumer friendly information to the public.
• Develop and Upgrade Technology: Michigan will improve efficiency and leverage existing technologies.

Cycle II Grant Application Summary

Michigan Grantee: Michigan Office of Financial Insurance Regulation

Award Date: September 20, 2011

Total Award: $3,994,728

Baseline Award: $3,000,000

Workload Award Amount: $394,728

Performance Award Amount: $600,000

• Expand scope of rate review: A recent bulletin issued by Michigan requires all markets to submit rate increases for review (previously only HMOs, Blue Cross Blue Shield, and individual commercial carriers were required to submit rates). New and existing staff will review filings from commercial carriers beginning 9/1/11, and the State will educate and train the commercial market on how to submit rate filings to the State.
• Improve rate filing requirements: Michigan will hire analysts to support new reviews in the commercial market.
• Improve transparency and consumer interfaces: Michigan plans to evaluate other States’ transparency models to determine which model will work best in Michigan, what information regarding rate increases should be public, and the best method for publicizing rate increases.
• Hire new staff: Michigan will create 6 new positions with the Cycle II grant funding.
• Improve IT: Michigan will use technology enhancements to increase the efficiency of filing financial and other data, to provide transparency to the public, and to provide support as needed to the industry. Michigan also will use technology to assist with the compilation of data for market trend analysis and reporting requirements under the Affordable Care Act.

Cycle III Grant Application Summary

Grantee: Michigan Office of Financial Insurance Regulation

Award Date: September 23, 2013

Total Award: $3,370,813

Baseline Award: $2,000,000

Workload Award Amount: $970,813

Performance Award Amount: $400,000

• Data Center Establishment: Michigan proposes to use Cycle III funds to establish a Data Center to provide health care pricing data in a user-friendly way for consumers, businesses, researchers, and the general public.
• Expand and Improve Data Analysis: Using Cycle III funds, Michigan will analyze and describe the variation in provider prices and per member utilization as well as its association with health insurance premiums.
• Data Dissemination and Transparency: Michigan will study current rate and pricing data transparency models from other states to identify, adapt, and implement best practices for data dissemination and pricing transparency.
• Improve Quality of Rate Review: Michigan proposes to train staff to enhance their analysis of actuarial submissions contained in health insurance rate filings. Michigan also plans to use grant funds to contract with actuaries to perform targeted, rigorous analysis of specific rate filings.

Cycle IV Grant Application Summary

Michigan Grantee: Michigan Department of Insurance and Financial Services
Award Date: September 19, 2014
Total Award: $1,179,000

• Expanding Scope of Rate Review: Michigan will explore ways to review rate filings against the market as a whole, and will study the impact of moving groups from 51-100 into the small group market beginning in 2016.  They will also study the impact of expanding the SHOP to include large groups beginning in 2017.
• Improve Quality/Efficiency of Rate Review: Michigan will continue to seek regular training for staff that will focus on enhancing staff’s ability to analyze and interpret actuarial certifications contained in health insurance rate filings and performing the requisite analysis that will accompany the rate development and medical loss ratio requirements under the Affordable Care Act.
• Health Pricing Transparency: Michigan will evaluate the viability of a Data Center in Michigan. Any proposed Data Center would enhance health care pricing transparency for consumers, businesses, providers, and other stakeholders. These efforts would help the public better understand the comparative price of procedures in a given region or for a specific hospital, insurer, or other provider of health care services.

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