Section 2026.80  Prior Approval, Disapproval, or Modification of Rates

a)         When the Director approves, disapproves, or modifies an individual or small group market rate described in Section 2026.30(b), the Director, within 60 days after the close of the public comment period, will notify the health insurance issuer of the decision, make the decision available to the public by posting it on the Department's website, and include an explanation of the findings, actuarial justifications, and rationale that are the basis for the decision. Any notice of modification or disapproval will state that the health insurance issuer whose rate has been modified or disapproved may request a hearing within 10 days after the Department issues the notice to the health insurance issuer. (Section 355(f) of the Code)

b)         Within 60 days of receipt of a large group market rate filing described in Section 2026.30(c), the Director will issue a decision to approve, disapprove, or modify the filing along with the reasons and actuarial justification for the decision. Any rate filing or rates within a filing on which the Director does not issue a decision within 60 days will be automatically deemed approved. (Section 355(j)(2) of the Code) Any notice of modification or disapproval will state that the health insurance issuer whose rate or rate filing has been modified or disapproved may request a hearing within 10 days after the Department issues the notice to the health insurance issuer.

c)         Hearings will be conducted in accordance with 50 Ill. Adm. Code 2402, and costs of the hearing may be assessed against the health insurance issuer in accordance with Section 408(5) of the Code and 50 Ill. Adm. Code 2402.270.

(Source:  Amended at 49 Ill. Reg. 11309, effective August 28, 2025)