📌 Regulatory Requirement to File Plans

Health insurance companies selling ACA-compliant individual or small-group health plans, whether on-exchange or off-exchange, must file their plans, rates, and forms with the state insurance regulator (State DOI).

• These filings include:

  • Rates and Premiums

  • Benefit Summaries

  • Network Information

  • Actuarial Justifications

• Purpose:
  Ensuring consumer protection, compliance, transparency, and rate reasonableness.

• Who Files:
  Any carrier offering ACA-compliant coverage, including those not participating in Health Insurance Exchanges.

🗂️ Where to Access Raw Data

You can generally access filings through:

① State Department of Insurance (DOI) Websites

• Many states publicly post filings and approvals on their DOI website.

• Example websites:

  • Utah DOI: insurance.utah.gov

  • California DOI: insurance.ca.gov

  • New York DFS: dfs.ny.gov

Tip: Search your state’s DOI site for “Rate Filings,” “Health Insurance Filings,” or “Insurance Product Filings.”

② CMS Healthcare.gov Data Portal

• Federally facilitated exchanges (FFEs) data also includes off-exchange ACA-compliant plan filings:

• data.healthcare.gov

• Look for datasets on:

  • Plan attributes and rates

  • Premium information and justifications

③ System for Electronic Rates and Forms Filing (SERFF)

• The National Association of Insurance Commissioners (NAIC) provides the SERFF Filing Access:

  • filingaccess.serff.com

• SERFF is the most comprehensive, detailed source.

• May require creating a free account for full access in certain states.

🧩 Example of Data You Can Access:

• Premium rates by plan

• Rate increase requests and state approvals

• Benefit coverage details (Summary of Benefits and Coverage documents)

• Form templates and actuarial justifications

📚 How Consumers Can Use This Data

• Comparison shopping: Evaluate rates and benefits directly.

• Understand premium changes: See approved increases or reductions year-over-year.

• Research network differences: Verify which providers participate.

• Transparency: Hold insurers accountable for their filed rates and plans.

🎯 Summary & Next Steps:

• Yes, filings are required by all states.

• Access via State DOI, CMS (Healthcare.gov), or SERFF.

• Best for raw, detailed filings: SERFF Filing Access.

For specific guidance or a particular state, let me know and I can provide exact resources!