Idaho Bulletin 26-16 mandates a comprehensive health care cost drivers data call applicable to every insurer that reported Idaho comprehensive major medical business in the Health Insurance columns of its MLR Annual Reporting Form for any year from 2022 through 2025. The data call covers individual, small group, large group, and self-funded plans, and requires submission of five detailed exhibits: statewide premium/claims/expenses/enrollment (Exhibit A), enrollment and billed premium by ZIP code and county (Exhibit B), claims by service category by geography (Exhibit C), medical claims by primary diagnosis code (Exhibit D), and pharmacy claims by National Drug Code (Exhibit E). Claims must be reported on an incurred basis with payments through at least July 31, 2026. The reporting deadline is November 16, 2026, making this the most time-critical item. The DOI intends to publish aggregated results in a public report. Non-compliance with a mandatory data call can result in regulatory action.
Source: https://doi.idaho.gov/wp-content/uploads/ID/B26-16.pdf