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Peering Into the Black Box of Insurance Rating

Recently, the New York Times reported that private health insurers continue to seek large premium increases despite seeing lower than expected use of medical care and booking record profits. The story highlights a significant problem for health policy: the lack of good, public information about how health insurers manage health…

Who Will be the H&R Block and TurboTax for Health Insurance?

There’s been quite a bit of focus lately insofar as these issues go, anyway on health insurance agents and brokers (sometimes known in the industry as “producers”). They are pushing legislation that has been introduced in Congress and is now being studied by the National Association of Insurance Commissioners that…

Transparency and Complexity

This fall a new rule takes effect requiring all private health plans to offer a uniform, simple to read, summary of benefits and coverage (SBC).  The SBC will provide consumers with standardized information about how plans cover essential health benefits and what coverage limits and cost sharing applies. The SBC…

Pulling it Together: Last Week’s Health Reform “Shocker”

Last week we learned that health reform could cost the federal government at least a trillion dollars over ten years, and that it will be really difficult to forge bipartisan agreement on legislation and keep major interest groups on board. This obviously brought more angst to the deliberations, several Republicans…

Explaining Health Care Reform: What Is An Employer “Pay-or-Play” Requirement?

To broaden coverage, some health reform proposals would require employers to offer coverage or pay to help finance subsidies for those without access to affordable coverage. These types of reforms are often referred to as “pay-or-play” policies. The brief explains the concept and policy implications of employer pay-or-play proposals, which…

Uniform Coverage Summaries for Consumers

This brief explains the proposed federal rule that requires private health plans to provide a short, easy-to-read uniform summary of benefits and coverage to all health insurance applicants and enrollees. The rule, which implements a provision in the Affordable Care Act (ACA), is intended to make it simpler for consumers…

Health Insurance Market Reforms: Guaranteed Issue

Guaranteed issue laws require insurance companies to issue a health plan to any applicant – an individual or a group – regardless of the applicant’s health status or other factors. Currently, in most states, insurance companies can deny nongroup coverage to people based on their health status or their medical…

Quantifying the Effects of Health Insurance Rate Review

This report from the Kaiser Family Foundation analyzes the effect of government efforts to ensure that insurance premium increases are justifiable and provide value to consumers and small businesses. Rate review programs require insurers in the small group and individual markets to submit proposed rate increase requests to state or…

Health Insurance Market Reforms: Rate Review

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…

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.