The legislation instructs state exchanges to require insurance carriers seeking certification as qualified health plans to submit a justification for any premium increase prior to implementation of the increase. The exchange is then required to take the information into consideration when determining whether to allow the sale of the plan through the exchange. The legislation requires state insurance commissioners to provide data on premium trends and make recommendations to the HHS secretary about whether certain insurance carriers should be excluded from the exchange based on a pattern of excessive premium increases. In addition, the legislation requires the secretary in conjunction with the states to monitor premium increases inside and outside the exchange beginning in 2014. In considering whether to open the exchanges to large employers (more than 100 workers) in 2017, states must consider trends in premium growth outside and inside the exchanges.
Source: The Common Wealth Fund