Accident and sickness insurance; restrictions relating to premium rates. (SB1734)

Introduced By

Sen. Creigh Deeds (D-Bath) with support from co-patron Del. David Toscano (D-Charlottesville)


Passed Committee
Passed House
Passed Senate
Signed by Governor
Became Law


Health policies; variances in area rating factors. Requires a rate filing by a health carrier that proposes area rate factors in the individual or small group market that exceed the weighted average of the proposed area rate factors among all rating areas by more than 15 percent to include, in publicly available and unredacted form, a comparison of the area rate factor for individual and small group plans that utilize the same provider network and provider reimbursement levels of the health benefit plans that are subject to the filing. In addition, to the extent that the health carrier is deriving any area rate factor from experience data, the measure requires the health carrier to provide additional information, including aggregated incurred claims for any provider exceeding 30 percent of total claims for the rating area in that market. The measure requires the State Corporation Commission to hold a public hearing before approving such proposed rates. The measure also bars the Commission from approving such a proposed rate filing if (i) a variance in area rate factors, indexed to the same rating region for both the individual and small group markets, of 15 percent or more exists between health benefit plans a carrier intends to offer in the individual market and health benefit plans intended to be offered in the small group market, when those plans utilize the same provider networks and reimbursement levels and (ii) the methodologies used to calculate the area rate factors are different between the two markets. The measure provides that beginning for plan year 2020, a health carrier with an approved rate filing that contains at least one area rate factor that exceeds by more than 25 percent the weighted average of the area rate factors among all rating areas in a market in which the health carrier offers individual or small group health insurance coverage shall file with the Commission for each calendar quarter during that plan year a report that provides, for each rating area within the market in which the health carrier operates, the plan's enrollment, total premiums, allowed claims, incurred claims excluding anticipated or, if available, actual risk adjustment payments or receipts, incurred claims including anticipated or, if available, actual risk adjustment payments or receipts, loss ratio, and aggregate claims, for each provider exceeding 25 percent of total claims for that rating area. The measure requires the health carrier to make each such quarterly report publicly available, without redaction, not later than 45 days after the end of the calendar quarter. This bill is identical to HB 2770. Read the Bill »


Bill Has Passed


01/17/2019Presented and ordered printed 19101946D
01/17/2019Referred to Committee on Commerce and Labor
01/29/2019Impact statement from SCC (SB1734)
01/31/2019Reported from Commerce and Labor with substitute (12-Y 1-N) (see vote tally)
01/31/2019Committee substitute printed 19106216D-S1
02/01/2019Constitutional reading dispensed (40-Y 0-N) (see vote tally)
02/04/2019Floor substitute printed to LIS only 19106418D-S2 (Deeds)
02/04/2019Read second time
02/04/2019Reading of substitute waived
02/04/2019Committee substitute agreed to 19106216D-S1
02/04/2019Engrossed by Senate - committee substitute SB1734S1
02/04/2019Constitutional reading dispensed (40-Y 0-N) (see vote tally)
02/04/2019Passed Senate (40-Y 0-N) (see vote tally)
02/06/2019Placed on Calendar
02/06/2019Read first time
02/06/2019Referred to Committee on Commerce and Labor
02/11/2019Impact statement from SCC (SB1734S1)
02/12/2019House committee, floor amendments and substitutes offered
02/12/2019Reported from Commerce and Labor with substitute (22-Y 0-N) (see vote tally)
02/12/2019Committee substitute printed 19106485D-H1
02/12/2019Read second time
02/13/2019Read third time
02/13/2019Committee substitute agreed to 19106485D-H1
02/13/2019Engrossed by House - committee substitute SB1734H1
02/13/2019Passed House with substitute BLOCK VOTE (98-Y 0-N)
02/13/2019VOTE: BLOCK VOTE PASSAGE (98-Y 0-N) (see vote tally)
02/14/2019Impact statement from SCC (SB1734H1)
02/15/2019House substitute agreed to by Senate (38-Y 0-N) (see vote tally)
02/15/2019Title replaced 19106485D-H1
02/19/2019Impact statement from SCC (SB1734S2)
02/20/2019Bill text as passed Senate and House (SB1734ER)
02/20/2019Signed by President
02/20/2019Signed by Speaker
02/21/2019Impact statement from SCC (SB1734ER)
02/27/2019Enrolled Bill Communicated to Governor on February 27, 2019
02/27/2019G Governor's Action Deadline Midnight, March 26, 2019
03/18/2019G Approved by Governor-Chapter 440 (effective 7/1/19)
03/18/2019G Acts of Assembly Chapter text (CHAP0440)