UT| Bulletin 2025-7, issued by the Utah Insurance Department, provides guidance on Cost Share Reduction (CSR) reporting requirements for insurers offering individual health benefit plans in Utah for the 2026 plan year. The bulletin instructs insurers on the necessary inclusions for their rate filings, estimation options, and contingency planning tied to potential federal funding changes.
Key Points:
- Insurers must report both the actual (or reasonably estimated) CSR amounts paid for enrollees in 2024 and the specific CSR load amount included in premiums, with a clear explanation of the methodology in their 2026 rate filings.
- Filings must explain how the additional revenue from the CSR load compares to expected CSR costs for the 2026 plan year.
- Insurers are required to include in their Actuarial Memorandum a single adjustment factor showing how rates would change if federal CSR funding is restored, fully documenting all methodology and assumptions.