MO HB983

Health carriers must file premium rates and risk classifications with the Department of Insurance 60 days before the effective date, beginning July 1, 2013, with plan forms and rate filings posted publicly on the department's website.

Rate filings must include the product form number, actuarial justification statement, and supporting information including all factors used in calculating premiums, explanations for each factor, and documentation sufficient for independent actuarial validation.

The director must determine within 30 days whether proposed rates are excessive, inadequate, or unfairly discriminatory, considering past and prospective losses, expenses, trend projections, loss ratios, and three-year rate increase history.

For significant rate increases, health carriers must notify affected enrollees of the proposed increase with details on rate changes and contributing factors; the director must hold a public hearing within 30 days and post public comments online before making a determination.

Enrollees or policyholders paying all or a majority of premiums may appeal the director's decision under chapter 536 if the rate increase equals or exceeds 8 percent for same coverage or 20 percent for additional coverage.