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08/03/2021 11:05 AM
Pennsylvania House of Representatives
https://www.legis.state.pa.us/cfdocs/Legis/CSM/showMemoPublic.cfm?chamber=H&SPick=20190&cosponId=30310
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House Co-Sponsorship Memoranda

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House of Representatives
Session of 2019 - 2020 Regular Session

MEMORANDUM

Posted: September 16, 2019 11:44 AM
From: Representative David H. Zimmerman
To: All House members
Subject: Insurance Renewal Rate for Small Businesses (50-99 employees)
 
In the near future, I will be introducing legislation which will ensure employers with 50-99 employees have access to aggregate claims data for their company. Currently, they are not receiving claims data or other details to support double-digit increases by insurers at rate renewal. The Affordable Care Act requires small groups (under 50) to be community rated, and insurers readily provide claims details to fully insured groups over 100, but the 50-99 groups seem to be unique with no clear rationale for different treatment. These small business employers have explained that when asking for claims data, insurers say it is industry standard and they are not required to provide the information.

Based on the Pennsylvania legislative and regulatory landscape, there are no provisions in state law affirmatively allowing this practice and there is nothing in state law which prohibits this practice. The PA Insurance Department does not have the authority to require that insurers turn over the information at the request of an small business employer.

Eight states haves passed similar legislation, ensuring their small businesses have aggregate claims data, to make fully informed decisions on which insurer’s proposal to accept at rate renewal.

Please join me in co-sponsoring this legislation to assist the small businesses of Pennsylvania. Thank you for your consideration.



Introduced as HB2582