Insurers > Regulatory Actions>2013 Rate Factor Review

2013 Health Insurance Premium Rate Review Process

Today Health Insurance Commissioner Christopher F. Koller announced his final decision to approve significantly lower premium increases for individuals and small and large employers that purchase their coverage through Blue Cross Blue Shield of Rhode Island (BCBSRI), Neighborhood Health Plan of Rhode Island (NHPRI), Tufts Health Plan (Tufts) and United Healthcare (United).

Commissioner Koller also reviewed each health insurer's contracts to ensure plans sold in Rhode Island meet benefit, access, and member cost sharing standards required by the State and the Affordable Care Act (ACA).

The review was for products to be sold in Rhode Island for coverage commencing in 2014.

     2013 Rate Review Process Final Decision Press Release
     Requested and Approved Summary
     Rate Approval Conditions
     Benefit Relativity Factor Summary


On April 15, 2013 and May 15, 2013, Blue Cross Blue Shield of Rhode Island (BCBSRI), Neighborhood Health Plan of Rhode Island (NHPRI), Tufts Health Plan (Tufts), and United Healthcare (United) filed with the State of Rhode Island Office of the Health Insurance Commissioner (OHIC) to request approval for rates to be charged to individuals, small employers, and large employers effective in 2014.
BCBSRI and NHPRI have filed in the individual market. All four commercial health insurers have filed in the small employer market. BCBSRI, Tufts, and United have filed in the large employer market. OHIC has the responsibility of reviewing the rates with the goal of holding the insurers publicly accountable for making health insurance more affordable while ensuring their solvency.

The document below depicts the essential health benefits base rate and the key assumptions behind its development for the individual and small employer group markets.

     2013 Rate Review Process Individual and Small Employer EHB Base Rate Summary 52313 Final

The document below provides information on large employer submissions

     2013 Rate Review Process Large Employer Submission Summary 52413 Final

As a part of its review of the rates filed, OHIC is soliciting public comment on what has been submitted by the insurers. OHIC believes that public input is essential and will take all input received into account in developing its final decision. All public comments must be received by OHIC by June 12, 2013. The document below explains how to submit public comment to OHIC

     2013 Rate Review Process Public Comment Solicitation 52213 Final
     2013 Rate Review Process Public Input Meeting Agenda 52913 Final

The document below contains the draft rate approval conditions that, once finalized, insurers must agree to in order to receive approval for their submissions. Written comments may be sent for consideration to and must be received by June 20, 2013.

     2013 Rate Review Process Rate Approval Conditions 61413

The document below shows the filed and approved average premium rate increases or the individual, small group, and large group markets for 2010 through 2013.

     2013 Rate Review Process Rate Increases History 52113 Final

For information specific to the 2013 BCBSRI Direct Pay hearing process, please click here.

Please find below OHIC 2013 Stand Alone Dental Form and Rate Filing Instructions; RIHBE Guidance Documents

     Form and Rate Filing Instructions 6-17-2013 final
     2013 Stand-Alone Dental PlansRIHBE Age-Based Rating Tables
     2013 Pediatric Dental Coverage RIHBE Memo 6-17-2013 final
     2013 Stand-Alone Dental Plans RIHBE Offering Criteria 6-17-2013 final





Health Insurance Consumer Alert
Red Flags

Federal Health Care Reform 

Improving Primary Care in RI:
The CSI Project

RI's Affordability Standards for Commercial Insurers