TDI Finalizes CSR Rule Changes Affecting Premium Rate Calculations
On May 1, 2025, the Texas Department of Insurance adopted changes to 28 TAC §3.505 that revise the cost-sharing reduction (CSR) adjustment factor from 1.35 to 1.40 and clarify how actuarial values (AVs) must be used in setting premium rates for individual and small group plans. Following advocacy by TAHP and its members, the final rule allows issuers to continue using their own pricing tools rather than requiring the federal AV calculator, as long as pricing AVs remain within federally permitted ranges. TDI also clarified that while it will not codify specific AV ranges, filings outside federal standards will be treated as noncompliant.
