Who recommends/approves benefit changes or premium changes?
The insurance companies reserve the right to change rates. They usually report “plan experience” (or the number and size of claims made) twice a year and, if applicable, rate action recommendations. Using this information, the program Administrator works with ASME to evaluate the recommendations and decide what, if any, action (i.e. a rate action, a change in benefits, or even a change in insurance companies) is appropriate to maintain each plan’s financial stability and competitive status. ASME ultimately approves the action, and insured members are advised of their decision prior to implementation.
