Pennsylvania Rate Review Grants Award List

Cycle I Grant Application Summary

Pennsylvania Grantee: Pennsylvania Insurance Department
Award Date: August 16, 2010
Award Amount: $1,000,000

• Additional Legislative Authority: The state intends to engage legal services to investigate current and proposed statutory premium rate review authority, current regulatory authority and future legislative authority as well as the authority to use and disclose data collected from the industry.
• Expand the Scope of Health Insurance Premium Review: The state plans to analyze current regulatory authority and develop a plan to access rates for both regulated and non-regulated products.
• Improve the Review Process: Currently the Commonwealth conducts actuarial review of individual market products. Commercial carriers are not required to file group rates. Pennsylvania intends to collect data from insurers in the individual and small group markets and will create a Health Insurance Rate Level Index database, which will be used as a resource for Department staff when reviewing rate filings and to develop comparison charts so that consumers can compare rates.
• Increase Transparency and Accessibility: Currently health insurance premium increases above 10 % are published on the web. The Commonwealth will provide health insurance premium information to the public and will develop enhanced consumer information, including premium comparisons and consumer education tools.
• Develop and Upgrade Technology: Pennsylvania will produce a web based data collection tool and database to provide information to the public.
  

Cycle II Grant Application Summary

Pennsylvania Grantee: Pennsylvania Insurance Department
Award Date: September 20, 2011
Total Award: $4,312,084
Baseline Award: $3,000,000
Workload Award Amount: $712,084
Performance Award Amount: $600,000

• Introduce legislation: Pennsylvania plans to acquire authority over commercial small group rates through legislation.
• Expand scope of rate review: Pennsylvania plans to acquire authority over commercial small group rates by modifying Act 159.
• Improve rate filing requirements: Pennsylvania proposes building the framework for an enhanced rate review process by contracting with actuarial and other expertise, and acquiring software tools to enhance internal reviews. The State will use funds to establish new rate review procedures.
• Improve transparency and consumer interfaces: Pennsylvania proposes to build upon the comparison guide on its website by developing a web-based interactive tool and data repository to allow consumers to view and compare product offerings and rates to make the best decision. The website will also include additional transparency enhancements including consumer comments, summaries of approved rate filings, and the final rate determinations.
• Hire new staff: Pennsylvania proposes training for current staff.
• Improve IT: Pennsylvania will develop a database for market analysis and consumer assistance tools.
  

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