Legislation


Cal. Health & Safety Code §§ 1385.01 through 1385.13: Knox-Keene Health Care Service Plan Act of 1975 — Review of Rate Increases – California

Status: Enacted
Year Enacted: 2010
Year Amended: 2017
File: Download

All health care service plans shall file with the department all required rate information for grandfathered individual and grandfathered and nongrandfathered small group health care service plan contracts at least 120 days prior to implementing any rate change. A plan shall disclose to the department for each individual and small group rate filing: (1) amount of the projected trend attributable to the use of services, price inflation, or fees and risk for annual plan contract trends by aggregate benefit category; (2) a comparison of claims cost and rate of changes over time; (3) any changes in enrollee cost sharing over the prior year associated with the submitted rate filing. A health care service plan subject to subdivision (a) shall also disclose for all rate filings submitted under this section in the individual and small group health plan markets: (1) the plan’s average rate increase by plan year, segment type, and product type and (2) any cost containment and quality improvement efforts since the plan’s last rate filing for the same category of health benefit plan.


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