Section 2026.30  Rate Increases Subject to Review

A rate increase filed on or after January 1, 2014, or effective on or after January 1, 2014, is subject to review if, as required by 45 CFR 154.200:

a)         The rate increase is 10 percent or more and applicable to a 12-month period as calculated under subsection (b).

b)         A rate increase meets or exceeds the applicable threshold set forth in subsection (a) if the average increase for all enrollees weighted by premium volume meets or exceeds the applicable threshold.

c)         If a rate increase that does not otherwise meet or exceed the threshold under subsection (b) meets or exceeds the threshold when combined with a previous increase or increases during the 12-month period preceding the date on which the rate increase would become effective, then the rate increase must be considered to meet or exceed the threshold and is subject to review.  The review shall include a review of the aggregate rate increases during the applicable 12-month period.