The price for health insurance is known as a rate or a premium rate. A premium rate is the specific amount a policyholder pays for insurance coverage. A premium rate is usually paid on a monthly basis. The premium rate is separate and apart from any co-pay, co-insurance or deductible that may have to be paid for services being rendered. The premium rate typically depends upon the type of policy and the factors listed below.

Individual or Family Policies (for those who don't receive health insurance through work)

Premium rates for individual or family policies may depend upon the following factors:

• Age of each person covered by the policy
• How much of the cost of care is covered by the policy. For example, a high deductible means you pay more out of pocket for your care
• Number of dependents (family members) in the policy
• Where you live in California
• Network of providers (doctors and hospitals) offered by the plan you choose

Small Group Policies (for employers who provide benefits to their employees when the employer has between 2 and 50 employees)

Premium rates for small groups may depend upon the following factors:

• Ages of enrolled employees and dependents
• Benefits your employer chooses
• Number of dependents an employee has that are covered by the policy
• Where your employer is located
• Network of providers (doctors and hospitals) for the plan your employer chooses

When you buy your own insurance as an individual, you pay the premium rate. When you get covered through your job, your employer pays the premium rate or you and your employer share the premium rate.

California law requires insurers to file and justify any proposed health insurance rate change for individual or small group (50 or fewer employees) health insurance policies. The law requires the California Department of Insurance (CDI) to review those rate changes and publish them on the CDI web site. The purpose of the review and publication is to protect consumers and promote accountability in the health insurance industry. While the Commissioner can request that the insurer amend the rate change or make an official determination that the proposed rate change is unreasonable, the Commissioner does not have the authority to deny or approve proposed rate changes.

• An insurer submits documentation about its proposed health insurance rate change to the California Department of Insurance (CDI) and, under certain circumstances, to the federal government.
• Insurers must notify policyholders at least 60 days prior to the effective date of the change.
• CDI posts the insurer's proposed rate change to this web site and the public may comment on the rate filing.
• CDI's actuaries, who specialize in the mathematics of calculating insurance premium rates, review the insurer's rate filing and the insurer's justification for the rate change.
• After the actuaries review the insurer's justification, the Insurance Commissioner determines if the insurer's data supports their proposed change.
• If the data does not support the rate change, the Commissioner can either request that the insurer amend the rate change or make an official determination that the proposed rate change is unreasonable.

While the Commissioner can request that the insurer amend the rate change or make an official determination that the proposed rate change is unreasonable, the Commissioner does not have the authority to deny or approve proposed rate changes.

Small group employers purchase insurance policies for their employees and dependents in the small group market. If you don't get your insurance from your employer, or if you are a sole proprietor, you can purchase insurance for yourself and/or your family in the individual market. There are different rules that govern each market.