25-08, Health Insurance Revised Rate and Form Filings, September 11, 2025

The Missouri Department of Commerce and Insurance issued Bulletin 25-08 on September 11, 2025, directing health insurers writing coverage in Missouri to revise their Plan Year 2026 rate and form filings in response to two federal developments. First, the United States District Court for the District of Maryland in City of Columbus v. Kennedy, No. 25-cv-2114-BAH, stayed implementation of certain provisions of the Marketplace Integrity and Affordability Final Rule, 90 Fed. Reg. 27074 (June 25, 2025), including the expanded de minimis ranges for actuarial value calculations under 45 C.F.R. §§ 156.140(c), 156.200(b)(3), and 156.400. Those provisions had been scheduled to take effect August 25, 2025. Second, CMS issued guidance on September 4, 2025, outlining additional hardship exemptions expanding eligibility for catastrophic plans. Because the court's stay reinstates the pre-rule, narrower actuarial value ranges, insurers that filed QHP plans using the expanded de minimis ranges must submit revised rate filings. The Department requires that revised rate filings be received via SERFF by September 24, 2025. The expedited review process is limited to actuarial value corrections, necessary plan design changes required by the court order, changes to catastrophic plan rates from the September 4 hardship exemption guidance, and immediate downstream impacts of those changes. Revised rate filings must include a redlined actuarial memorandum, a cover letter referencing the original SERFF tracking number, an attestation that only required changes are being made, a Rate Table Template in Excel format filed in the Rate/Rule Schedule tab, and a screenshot of the Actuarial Value Calculator results. Insurers electing not to offer an affected plan in Plan Year 2026 must document that decision and reflect downstream impacts in the revised filing. For form revisions, the Department directs insurers to comply with the court order and with Public Health Service Act provisions added by the Consolidated Appropriations Act, 2021. Pursuant to Missouri statute § 376.1186, RSMo, the Department defers to CMS for completion of Change Analysis Reports and State Authorization Forms, and confirms that those forms should continue to be submitted to CMS Form Filings rather than to the Department. Form filing revisions, whether for closed or open filings, must be completed by September 16, 2025, via SERFF, with redlined forms and an attestation of no additional changes.