Texas Individual Health Rate / Rate Increase Filing Requirements Checklist

• Category: Texas Workers Compensation - Self Insurance Regulation
• State: Texas
• Control #: TX-AH021-WC
• Format: PDF

Description

Individual Health Rate / Rate Increase Filing Requirements Checklist The Texas Department of Insurance (TDI) requires health insurance companies to submit a Texas Individual Health Rate / Rate Increase Filing Requirements Checklist for rate increases on individual health insurance plans. This checklist outlines the specific requirements insurers must meet when submitting an individual health insurance rate increase filing. The checklist includes two types of requirements: 1) those that are applicable to all filings, and 2) those that are specific to rate increase filings. The general filing requirements are applicable to all filings, regardless of the filing type, and include the following: • Company Name, Address, and Contact Information • Policy Number and Name • Current Effective Date • New Effective Date • Description of Proposed Rate Changes • Data Used to Support Proposed Rates • Explanation of Any Changes to Benefits • Explanation of Any Changes to Eligibility Requirements • Signature of Company Representative In addition to the general filing requirements, rate increase filings must also include the following specific requirements: • Explanation of the Reasons for the Proposed Rate Increase • Proof of Rate Increase Requests/Approvals from the Texas Department of Insurance • Detailed Analysis of the Proposed Rates • Description of any Rate Differentials • Description of any Discounts or Subsidies • Description of any Quality Assurance Measures • Copy of Policy Form • Copy of Rate Table • Copy of Actuarial Certification • Copy of Consumer Disclosure • Copy of Rate Increase Justification • Copy of Rate Increase Summary These requirements are designed to ensure that individual health insurance rate increases in Texas are reasonable and necessary. Health insurers must submit their rate filings to the TDI for review and approval before any rate increases can take effect.

The Texas Department of Insurance (TDI) requires health insurance companies to submit a Texas Individual Health Rate / Rate Increase Filing Requirements Checklist for rate increases on individual health insurance plans. This checklist outlines the specific requirements insurers must meet when submitting an individual health insurance rate increase filing. The checklist includes two types of requirements: 1) those that are applicable to all filings, and 2) those that are specific to rate increase filings. The general filing requirements are applicable to all filings, regardless of the filing type, and include the following: • Company Name, Address, and Contact Information • Policy Number and Name • Current Effective Date • New Effective Date • Description of Proposed Rate Changes • Data Used to Support Proposed Rates • Explanation of Any Changes to Benefits • Explanation of Any Changes to Eligibility Requirements • Signature of Company Representative In addition to the general filing requirements, rate increase filings must also include the following specific requirements: • Explanation of the Reasons for the Proposed Rate Increase • Proof of Rate Increase Requests/Approvals from the Texas Department of Insurance • Detailed Analysis of the Proposed Rates • Description of any Rate Differentials • Description of any Discounts or Subsidies • Description of any Quality Assurance Measures • Copy of Policy Form • Copy of Rate Table • Copy of Actuarial Certification • Copy of Consumer Disclosure • Copy of Rate Increase Justification • Copy of Rate Increase Summary These requirements are designed to ensure that individual health insurance rate increases in Texas are reasonable and necessary. Health insurers must submit their rate filings to the TDI for review and approval before any rate increases can take effect.