The regulation does not apply to the large group or the association business. Steve Larsen, director for the center for consumer information and insurance oversight, said on the conference call that purchasers in the large group market "are more sophisticated and don't need assistance" in securing fair rate increases. He added that the inclusion of association business will be revisited after additional comments are collected by the department.
In a press statement challenging the rate review rule, America's Health Insurance Plans' president and CEO Karen Ignagni said, "Premium review must adequately factor in all of the components that determine premium rates, including geographic variation, the cost of new benefit mandates, and the impact of younger and healthier people dropping coverage. An arbitrary threshold for review will establish a de facto presumption of unreasonableness in what should be an objective, actuarially-based evaluation."
She agreed that states "are best suited to review premiums because they have the experience, infrastructure, and local market knowledge needed to ensure that consumers are protected and health plans are solvent. The federal government is not in a position to make these assessments."