Rate review is the process by which insurance regulators review health plans’ new or renewed rates for insurance policies in order to ensure that the rates charged are based on accurate, verifiable data and realistic projections of health costs. Historically, state insurance departments have conducted rate review, but under the Affordable Care Act (ACA), federal regulators may review rate increases in some cases.
This fact sheet explains how rate review works and how the ACA has affected it. The document also provides an overview of how states are handling rate review in the individual and small group markets.
Fact Sheet (.pdf)