Health Insurance Oversight System (HIOS) Rate Review System Technical Instructions for States and Health Insurance Issuers (Rate Review Justification)
Section 2794 of the Public Health Service Act (PHS Act), as added by the Patient Protection and Affordable Care Act (Affordable Care Act), establishes a process for the annual review of an unreasonable increase in premiums for health insurance coverage.\r\n\r\nThis Technical Instructions Manual explains how health insurance Issuers and States will use the Health Insurance Oversight System (HIOS) and Rate Review module to review and upload information related to the new rate review program. This manual provides systematic instructions for all of the issuer and state reviewer system features and functionalities available in the Rate Review System.\r\n
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 16, 2021
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.