New Jersey Rate Review Grants Award List

Cycle I Grant Application Summary

New Jersey Grantee: New Jersey Banking and Insurance
Award Date: August 16, 2010
Award Amount: $1,000,000

• Improve the Review Process: Currently, individual and small group health insurance premiums are reviewed by a credentialed actuary. New Jersey will contract with an actuarial firm for a comprehensive study and suggested redesign of the health insurance premium filing and review process to include standardization of formats, electronic filing, analytical tests, economic analysis, and potentially other analyses. The grant will also increase staff dedicated to health insurance premium review, allowing for in-depth review, systems improvements, and establishing analytical tests and economic analysis.
• Increase Transparency and Accessibility: New Jersey provides access to health insurance premium filings upon request. The grant will enable New Jersey to establish a web site populated with rate filing information and to consult with Rutgers University on how best to provide information to the public and obtain meaningful consumer input.
• Develop and Upgrade Technology: New Jersey will capture information for reporting and analysis, with the ability to generate required reports and support economic analysis of the basis for rates.

Cycle II Grant Application Summary

New Jersey Grantee: New Jersey Banking and Insurance
Award Date: September 20, 2011
Total Award: $4,146,261
Baseline Award: $3,000,000
Workload Award Amount: $546,261
Performance Award Amount: $600,000

• Introduce legislation: New Jersey will work with partners to review rate filing statutes and regulations and introduce legislation if necessary.
• Improve rate filing requirements: New Jersey will work with an actuarial consultant to develop analytical tools and benchmarking tool, advise on the expansion of claims data requirement, make recommendations for standardization, and make recommendations on peer review of rate filings. Another actuarial consultant will make recommendations on standardizing filings for dental plans.
• Improve transparency and consumer interfaces: New Jersey will conduct three annual rate forums and will prepare a report on the effectiveness of its rate review process, training, and outreach efforts to stakeholders.
• Hire new staff: New Jersey plans to create 5 new positions from the Cycle II grant funding.
• Improve IT: New Jersey will fund the System for Electronic Rate and Form Filing (SERFF) enhancements and other insurer reporting IT systems for enhanced claims reporting.
  

Cycle IV Grant Application Summary

New Jersey Grantee: Department of Banking and Insurance, State of New Jersey
Award Date: September 19, 2014
Total Award: $1,179,000

• Improve the Quality/Efficiency of Rate Review: New Jersey will improve on the efficiency of the submission and tracking of rates.
• IT and Other Technology Based Improvements: New Jersey will track the number of consumer inquiries and complaints and will post additional consumer information to its website.
• Expand Scope of Rate Review: New Jersey plans to study specific rate review related elements that arise from the Affordable Care Act, including the Unified Rate Review Template, single risk pool, actuarial value, meaningful difference and the impact of risk mitigation programs such as risk adjustment, transitional reinsurance, and risk corridors

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