California large group rate change review request (CIC §10181.31)
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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.
No material clinical or coverage changes in this revision.
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 *)
- 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
How to Request CDI Rate Change Review
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
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