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Rate Filing Guidance
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Information has been updated below for the 2019 Plan Year!

The following guidance provides rate filing requirements for major medical and certified SADP plans.

This guidance is not exhaustive. Health plan issuers are responsible to review and comply with all applicable state and federal law.

 

Important Notices!

Updated Filing Deadlines as of April 30, 2018

2019 EHB Compliant Health Plans and 2018/2019 Student Health Plans

Ohio Rate Filing Deadlines:

  
The rate filing deadlines for (1) student health plans, (2) both on-exchange and off-exchange major medical plans and (3) both on-exchange and off-exchange certified Stand Alone Dental Plans (SADPs) are provided below:
 
ODI will continue to monitor the policy changes being discussed in Washington and how those may impact health insurance in Ohio.  However, the revised timelines we are outlining below are likely final for submissions related to plan year 2019. 
 
Rate Filing Market Type
Ohio Filing Deadline
 
Student Health Plans
  - for the 2018/2019 School Year
 
March 28, 2018

Certified SADPs

May 21, 2018 NEW!

 
On-Exchange Individual & Small Group Major Medical Plans
 
 
June 15, 2018


Off-Exchange Only Individual & Small Group Major Medical Plans

July 25, 2018 NEW!
   

Ohio Rate Filing Requirements:

  1. Ohio ACA Rate Filing Guidance and Checklist (see link in bottom section of this page)
    This checklist is should be used in submitting all ACA compliant On-Exchange and Off-Exchange major medical products and On-Exchange and Off-Exchange Certified Stand Alone Dental Plan (SADP) products.

  2. 2019 Part 1 Unified Rate Review Template (URRT)* - Not applicable to SADPs
    The URRT is required for all single risk pool plans in the individual and small group medical markets, including single risk pool plans that experience rate increases, rate decreases, or no rate changes, as well as new single risk pool plans.

    Important! Please attach both an Excel (.xls) and a .pdf version of the completed URRT.

  3. 2019 Part III Actuarial Memorandum and Certifications
    Required for single risk pool plans in the individual and small group medical markets, Part III is an Actuarial Memorandum that includes the actuarial reasoning and assumptions, justifications and methodologies that support the entries in the Unified Rate Review Template (URRT).

    Important! Only an unredacted version of the Part III Actuarial Memorandum and Certifications is required for the Ohio rate filing submission in SERFF.
 
*Final 2019 PY Unified Rate Review instructions and the URRT have been posted by CMS on the CCIIO QHP website at: https://www.qhpcertification.cms.gov/s/Unified%20Rate%20Review
 
 

Special Note Re: 2019 PY Stand Alone Dental Plan (SADP) Rate Filing Requirements:

A rate filing with supporting actuarial documents is required for 2019 plan year recertification of all SADPs unless both of the following conditions are met:

 

a) There is no change in rates from the approved 2018 PY rates; and 

b) Trend was not used in developing the approved 2018 PY rates.
 

Certification by a credentialed Actuary that both conditions are met must be filed in SERFF in lieu of the 2019 PY rates. 

 

 

ACA Rate Filing Resources​
  

 

The State of Ohio is an Equal Opportunity Employer

Ohio Department of Insurance
50 W. Town Street, Third Floor - Suite 300
Columbus, Ohio  43215
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John Kasich, Governor | Jillian Froment, Director
General Info: 614-644-2658 | Consumer Hotline: 800-686-1526
Fraud Hotline: 800-686-1527 | OSHIIP Hotline: 800-686-1578