CurrentAetnaPolicy N/A

California large group rate change review request (CIC §10181.31)

Describes criteria and form fields for large group contractholders to request the California Department of Insurance review a proposed rate change under California Insurance Code Section 10181.31; applies to large-group Aetna plan contractholders in California seeking CDI review.

Policy Summary

PayerAetna

PolicyCalifornia large group rate change review request (CIC §10181.31)

Policy CodePolicy N/A

Change TypeAdministrative — form and submission requirements

Effective DateJuly 1, 2021

Next Review DateN/A

Key ActionSubmit the completed CDI rate change review form and required insurer documentation to HealthRateReview@insurance.ca.gov.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

2,000+contractholder threshold to request CDI review

500 charsconcerns/comments limit

1/22/2021form version

Submission and Coverage Criteria

Submission form requirements

Form fields and required documentation to submit a request for CDI review of a proposed large-group rate change.

Required organization information

Organization Name (Organization Name *)

Primary contact (required)

First Name (First Name *)
Last Name (Last Name *)
Title (Title *)

Policy Summary

PayerAetna

PolicyCalifornia large group rate change review request (CIC §10181.31)

Policy CodePolicy N/A

Change TypeAdministrative — form and submission requirements

Effective DateJuly 1, 2021

Next Review DateN/A

Key ActionSubmit the completed CDI rate change review form and required insurer documentation to HealthRateReview@insurance.ca.gov.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Phone Number (Phone Number *)

Email Address (Email Address *)

Secondary contact (required)

First Name (First Name *)
Last Name (Last Name *)
Title (Title *)
Phone Number (Phone Number *)
Email Address (Email Address *)

Policy and rate details (required)

Insurer/Policy to be reviewed / Provide the insurer this rate change filing review is covered (if multiple policies submit separately)
Coverage Effective Date (Example: MM/DD/YYYY)
Group Number
Product
Proposed Rate Change
Date contractholder received notice of rate change (MM/DD/YYYY)
Group Size (employees plus dependents total)

Documentation (required)

Attach all documentation provided by health insurer to satisfy Section 10181.10
Include any documentation provided by health insurer or agent to the contractholder detailing the proposed rate change for upcoming plan year

Optional comments and submission

Concerns/Comments (optional; 500 character limit)
Submit request to HealthRateReview@insurance.ca.gov

Eligibility note

Request may be submitted if the contractholder has more than 2,000 total enrollees (employees plus dependents)
Or if the insurer fails to provide any information required by Art. 4.5 or Section 10181.10 of the California Insurance Code

Form version

Version Date: 1/22/2021

Statutory reference

California Insurance Code Section 10181.31 (Effective July 1, 2021)

Eligibility Threshold

Contractholder size threshold

ThresholdMore than 2,000 total enrollees (employees plus dependents)

Applies toLarge group contractholders with experience-rated coverage (in whole or blended)

ReferenceCalifornia Insurance Code §10181.31 — Effective July 1, 2021

How to Request CDI Rate Change Review

Prior Authorization

Request CDI review of a large‑group rate change (CIC §10181.31)

Large-group contractholders may request the California Department of Insurance (CDI) to review a proposed rate change when either (1) the contractholder has more than 2,000 total enrollees (employees plus dependents), or (2) the insurer fails to provide information required by Article 4.5 (commencing with Section 10181) or Section 10181.10 of the California Insurance Code. To apply, complete the CDI Rate Change Review Request form and provide all required fields and documentation (organization and primary/secondary contact details, insurer/policy to be reviewed, coverage effective date, group number, product, proposed rate change, date contractholder received notice, group size) and attach all documentation provided by the insurer per Section 10181.10. Submit the completed form and attachments to HealthRateReview@insurance.ca.gov.

Eligibility: contractholder >2,000 total enrollees (employees + dependents) — or insurer failure to provide information required by CIC Art. 4.5 or §10181.10. [CIC §10181.31]
Required form fields: Organization Name; Primary and Secondary Contact (name, title, phone, email); Insurer/Policy to be reviewed; Coverage Effective Date; Group Number; Product; Proposed Rate Change; Date contractholder received notice; Group Size.
Attach: all documentation provided by the health insurer to satisfy Section 10181.10, including any documentation or agent communications detailing the proposed rate change.
Optional: Briefly describe concerns/comments (500 character limit).
Submit to: HealthRateReview@insurance.ca.gov

Key Definitions

Large group contractholder

DefinitionA contractholder with more than 2,000 total enrollees (employees plus dependents)

ContextEligible to request CDI review of a proposed rate change when coverage is experience rated (in whole or blended)

Effective dateEffective July 1, 2021 per CIC §10181.31

Grounds for review

Grounds for CDI review — insurer failure to provide informationWhen a health insurer fails to provide any information required by Article 4.5 (commencing with Section 10181) or Section 10181.10 of the California Insurance Code

Alternative groundContractholder size exceeds 2,000 total enrollees (employees plus dependents)

Statutory authorityCalifornia Insurance Code §10181.31