Politics & policy

Insight into federal and state health care legislation & CMS regulation

Kentucky OKs Health-Adjusted Individual Rates

Health insurers in Kentucky can now set rates for individuals that take health status into account. Under the new law, an individual's health insurance premium can vary up to 35 percent from a state-set index rate. The system is expected to lead to lower rates for healthy adults and higher rates for sicker individuals.

So far, nine insurers have requested rates for 47 product lines, including indemnity plans, preferred-provider organizations, point-of-service plans and HMOs. Two insurers — Humana and Anthem Blue Cross and Blue Shield — will offer service in all counties.

The new law also established a "file-and-use" rate approval process that lets companies begin using rates as soon as they are filed and determined to be complete, even before receiving the approval of the commissioner of insurance. The commissioner may call a hearing to determine if the rates are reasonable.

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