Last Updated: May 7, 2024
Comprehensive Health Rate Filing Requirements
Individual and Small Group Markets
Single Risk Pool (SRP)
| Required Document | Description | Reference Document(s) |
|---|
Individual Market Filings - Rating Level
(submit identical documents with all filings in the rating block) |
Federal Unified Rate Review Template (URRT)
| Standardized federal data collection template - must be submitted to OCI and the federal government | |
|
Wisconsin Actuarial Memorandum and Certification Template | Provides support for data submitted in the URRT; must be in the Wisconsin-specific format (which satisfies the requirements of the federal Actuarial Memorandum and Certification instructions) - must be submitted to OCI and the federal government | |
| Wisconsin Rate Pages and Service Area Template (Individual) | Standardized Wisconsin-specific collection tool for plan-level rate(s) and service area(s) in the individual market; submitted via the Health Insurer Web Application (HIWA) |
Geographic Rating Areas |
| Plan Mapping Template | Standardized Wisconsin-specific collection tool for mapping plans from the prior rate filing; submitted via HIWA |
|
Individual Market Filings – Product Level
(submit one document for each product in the filing) |
| Product Data Template - Individual Single Risk Pool | Standardized Wisconsin-specific collection tool for product-specific background, product-specific regional enrollment and rate change information; submitted via HIWA |
Geographic Regions
Product and Plan Definition |
| Required Document | Description | Reference Document(s) |
|---|
Small Group Market Filings - Rating Level
(submit identical documents with all filings in the rating block) |
| Federal Unified Rate Review Template (URRT) | Standardized federal data collection template - must be submitted to OCI and the federal government | |
|
Wisconsin Actuarial Memorandum and Certification Template | Provides support for data submitted in the URRT; must be in the Wisconsin-specific format (which is in full compliance with the federal Actuarial Memorandum and Certification instructions) - must be submitted to OCI and the federal government | |
| Wisconsin Rate Pages and Service Area Template (Small Group) | Standardized Wisconsin-specific collection tool for plan-level rate(s) and service area(s) in the small group market; submitted via the Health Insurer Web Application (HIWA) |
Geographic Rating Areas |
| Plan Mapping Template | Standardized Wisconsin-specific collection tool for mapping plans from the prior rate filing; submitted via HIWA |
|
Small Group Market Filings – Product Level
(submit one document for each product in the filing) |
| Product Data Template - Small Group Single Risk Pool | Standardized Wisconsin-specific collection tool for product-specific background, product-specific regional enrollment and rate change information; submitted via HIWA |
Geographic Regions
Product and Plan Definition
|