Notice of Proposed Rulemaking – Medicare Supplement Insurance

On October 16, 2015, the Department published a Notice of Rulemaking in the Arizona Register, (21 A.A.R. 2401, October 16, 2015).  The rulemaking proposes to amend Article 11 – Medicare Supplement Insurance, AAC R20-6-1101, to update the incorporation by reference of the NAIC Model Regulation to Implement the NAIC Medicare Supplement Insurance Minimum Standards Model Act which includes the Genetic Information Nondiscrimination Act of 2008 (Model Regulation).  Currently, AAC R20-6-1101 incorporates the Model Regulation published in 2008.  The amended rule will incorporate the Model Regulation published in January, 2015, which corrects some deficiencies of the 2008 version.  The proposed rulemaking also amends Section 3(A)(2) of the Model Regulation to specify that the Model Regulation applies to “All certificates issued under group Medicare supplement policies, which certificates have been delivered or issued for delivery in this state including association plans.”

Anyone who wishes to request an oral proceeding on the proposed changes to AAC R20-6-1101 should contact Mary Kosinski at [email protected] or (602) 364-3471.

Director's Message Regarding Health Insurance Premiums for 2018

Open enrollment will be available from November 1, 2017 through December 15, 2017 for health insurance coverage commencing January 1, 2018.  Here are a few things you can expect when purchasing or renewing health insurance this year.

In Arizona, the overall average Marketplace (“on-exchange”) Plan Year 2018 rates have stabilized with only slight changes from last year’s premium rates.  This is significant for our market after sustaining large premium increases in 2017.  This premium rate stabilization gives us hope that more insurers may consider entering our market for Plan Year 2019. Unfortunately, like last year, Arizonan’s health insurance plan choices are limited.  Only two insurance carriers will be issuing tax subsidized major medical policies on the exchange in 2018.  One insurer will be offering health plans in Maricopa and Pima counties, and the other insurer will be offering plans in the other 13 counties.  Additionally, we are down to a total of 4 health insurers offering individual plans off-exchange for 2018. Visit our Health insurance rate page to see a list of plans and premium averages by county. 

Additionally, you can view detailed information, compare plans, and complete the enrollment process at the federal Marketplace website at

As you may have read, the federal government announced that it will stop reimbursing insurers for Cost Share Reductions (CSR) associated with major medical policies issued to Marketplace customers that meet the federal poverty level criteria.  This announcement did not result in any changes to the 2018 Arizona Marketplace plan rates for Open Enrollment.

Families with children should be aware that the federal government made some changes to the “child” premium rate calculations which will result in higher premiums for children.  This will have the greatest impact on families that do not qualify for the premium tax credit.  For an explanation of how rates for children will be changing, please read our Frequently Asked Questions document.

Under Arizona state law, the Department of Insurance is not given the legal authority to approve or disapprove the major medical health insurance rates filed with us.  Instead, the Department’s role is to review the rate filings and confirm that valid, detailed financial and actuarial justification (as required by federal and state law) is provided and any change in the rate is found reasonable by these standards.  In order to perform that review, the Department engages independent actuaries to scrutinize the rate filings in depth to confirm compliance with the laws and regulations.  You can read the insurers’ justification of their rate increases and a narrative describing the data and assumptions that the insurer used to develop its rate (a consumer justification) by visiting   Visitors can also see a list of all rate change filings (On and Off Marketplace, Individual and Small Group) on the Department’s Health Insurance Rate Information webpage.

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Rulemaking Moratorium
Insurance Rules (Arizona Administrative Code Title 20)
DOI Regulatory Agenda for 2017
Notice of Close of Record: Reasonableness of Benefits in Relation to Premium

On August 18, 2017, the Department published a Notice of Rulemaking Docket Opening in the Arizona Register (23 A.A.R. 2209, August 18, 2017). On September 15, 2017, the Department published a Notice of Proposed Rulemaking in the Arizona Register (23 A.A.R. 2485, September 15, 2017). The rulemaking proposes to amend A.A.C. R20-6-607, Reasonableness of Benefits in Relation to Premium Charged, to correct some reference errors and to update the subsection governing the reasonableness of benefits in relation to premium charged with respect to individual disability policy forms.

The Notice of Proposed Rulemaking stated that the Department would schedule an oral proceeding on the rulemaking if, within 30 days after the published Notice of Proposed Rulemaking, anyone submitted a written request for an oral proceeding. The deadline for submitting a written request for an oral proceeding was October 13, 2017. However, to accommodate the Columbus Day holiday, the Department is extending the comment period which will now end on Monday, October 16, 2017 at 5:00 p.m. Once the record is closed, the Department will submit the rulemaking to the Governor’s Regulatory Review Council (GRRC) to finalize the rule.

Anyone having any questions should contact Mary Kosinski at [email protected] or (602) 364-3471.

Extension of Major Medical Transitional Policies through Calendar Year 2018

Phoenix - The Arizona Department of Insurance (ADOI) announced today that insurers in the individual and small group[1] major medical health insurance markets can choose to renew transitional policies for a policy year beginning on or before October 1, 2018, provided all transitional coverage ends by December 31, 2018.    Transitional policies are non-Affordable-Care-Act-compliant policies that have been continuously in effect since by or before December 31, 2013.  At least 6 health insurers have individual or small group transitional policies still in effect in Arizona.

This extension is the maximum extension permitted under the Insurance Standards Bulletin issued on February 23, 2017 by the Center for Consumer Information and Insurance Oversight (CCIIO), and gives insurers the option to continue the pre-2014 individual and small group policies covering approximately 70,000 Arizonans through the end of 2018.  Insurers that offer this extension of transitional coverage are required to send each policyholder a renewal notice that explains the offer to continue the transitional policy through the end of 2018 and includes information regarding any related price increase.  Insurers must also send a 90-day notice for the final discontinuation of the transitional plans.

The extension does not affect grandfathered policies issued prior to March 23, 2010.  These policies can remain in effect as long as they maintain grandfathered status.

For additional information on the Affordable Care Act, please visit the Arizona Department of Insurance website or call Consumer Assistance at (602) 364-2499. 


[1] Small Group refers to a policy issued to an employer who employs at least two but not more than fifty eligible employees

(ARS § 20-2301(A)(21)).


Introducing Keith Schraad

Governor Ducey appointed Keith Schraad to serve as Interim Director of the Arizona Department of Insurance (“ADOI”), starting Monday, February 12.