MO SB688

Effective July 1, 2014, health carriers must file all health insurance premium rates with the Missouri Department of Insurance at least 60 days before the rates take effect, including actuarial justification and supporting documentation.

Rate filings must include past and prospective loss experience, current and projected loss ratios, expense data, utilization trends, three-year rate increase history, and contingency reserve information.

A qualified actuary from the American Academy of Actuaries must certify that rates are not excessive, inadequate, or unfairly discriminatory; the director must approve or deny rates within 30 days of filing.

For "significant rate increases" (those exceeding federal thresholds), health carriers must notify affected enrollees and policyholders, and the director must hold a public hearing within 30 days and solicit public comments before making a determination.

Enrollees and policyholders paying all or a majority of premiums may appeal rate increases to court if the increase equals 8% or more (same coverage) or 20% or more (additional coverage), under Chapter 536 procedures.