North Carolina Rate Review Grants Award List

Cycle I Grant Application Summary

North Carolina Grantee: North Carolina Department of Insurance
Award Date: August 16, 2010
Award Amount: $1,000,000

• Pursue Additional Legislative Authority: Currently all individual rates are subject to prior approval. North Carolina will seek legislative action to standardize data collection and to require that simplified summary information be submitted as a part of this data collection for consumers.
• Expand the Scope of the Review Process: The State will expand to prior approval of small and large group markets.
• Improve the Review Process: North Carolina has HMO and individual health insurance premium review currently. The State is seeking expanded authority and will improve the reporting and data collection.
• Increase Transparency and Accessibility: Currently all filings free of confidential information are posted on the web. North Carolina is seeking authority to require insurers to create consumer-friendly summaries. Consideration and planning for public comment and hearings will be explored.
• Develop and Upgrade Technology: North Carolina will improve its efficiency and data collection to aide in the health insurance premium review process.

Cycle II Grant Application Summary

North Carolina Grantee: North Carolina Department of Insurance
Award Date: September 20, 2011
Total Award: $3,984,080
Baseline Award: $3,000,000
Workload Award Amount: $384,080
Performance Award Amount: $600,000

• Introduce legislation: North Carolina will propose legislation to require rate filing information submitted by insurers to be considered public. North Carolina will also propose statutory and regulatory changes to create rate filing consistency and may revise statutes to meet the statutory requirements of 2014.
• Expand scope of rate review: The North Carolina Department of Insurance was recently granted prior approval authority of small group rates. Cycle II grant funds will help support this expanded authority.
• Improve rate filing requirements: North Carolina plans to make statutory and regulatory changes to create consistency across rate filings by market and product types. North Carolina will work with an actuarial firm to develop a rate review process manual.
• Improve transparency and consumer interfaces: North Carolina is currently pursuing legislative action to make rate filings public. The Department of Insurance will also develop a plan for considering consumer comments in its review of rate filings and providing consumer summaries of filings. The State will hire a Health Insurance Outreach Specialist to design, develop, implement and monitor a program to educate consumers on the rate review process. North Carolina is also evaluating the role of hearings in the rate review process.
• Hire new staff: North Carolina will create 3 new positions with Cycle II grant funding; these positions are in addition to the 6 positions created with Cycle I resources.
• Improve IT: North Carolina plans to evaluate various actuarial tools to enhance the rate review process, possibly including tools or software for performing trend analyses and assisting in assumptions validation when reviewing a rate filing.

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