The Patient Protection and Affordable Care Act ("Affordable Care Act") required the U.S. Department of Health and Human Services ("HHS") to establish a process for the review of "unreasonable" health insurance premium rate increases in the individual and small group markets. As a result, federal regulations mandating the review of all rate increases of 10 percent or more in the individual and small group markets became effective on September 1, 2011.

In the six months since the federal rate review regulations became effective, the Center for Consumer Information & Insurance Oversight ("CCIIO") in the Centers for Medicare & Medicaid Services ("CMS") has completed 22 reviews of insurance premium rate increase filings. CCIIO determined that six of the reviewed premium rate increases represented "unreasonable" increases while 16 of the rate increases were deemed "not unreasonable." It is our understanding that none of the filed rates that CCIIO deemed "unreasonable" have been rescinded or otherwise adjusted.

In promulgating its rate review regulations, HHS articulated specific goals, consistent with the objectives of health care reform, focused on empowering consumers and lowering health insurance costs. This Implementing Health and Insurance Reform alert provides a summary of CCIIO's completed rate review determinations under the federal rate review program.