SB 1163 Summary

• Requires health care service plans and health insurers offering individual or group coverage to provide written denial or rate increase decisions in clear, easily understandable language, stating specific reasons for the decision.

• Increases notice period for premium rate changes from 30 days to 60 days prior to the effective date for both health care service plans and health insurers in individual and group markets.

• Requires health care service plans and health insurers to file detailed rate information with state regulatory departments at least 60 days before implementing rate changes, including information certified by an independent actuary regarding whether increases are reasonable.

• Establishes public disclosure requirements for rate filings, making most submitted information publicly available on departmental websites for 60 days before implementation, except for confidential provider and large group contracted rates.

• Deems health plans in compliance with requirements to offer all benefit designs to small employers if the design qualifies as a grandfathered health plan under the federal Patient Protection and Affordable Care Act and meets specified conditions.