On May 23, 2011, HHS published a final rule with comment period to implement the ACA's requirements regarding disclosure and review of “unreasonable” health insurance premium increases. Under the rule, premium increases of 10% or more must be reviewed by state or federal officials, effective September 1, 2011. In addition, effective September 1, 2012, the 10% threshold will be replaced by state-specific thresholds that reflect insurance and health care cost trends in each state. The rule also requires companies to provide consumers with their justifications for unreasonable rate increases, and the public would have an opportunity to provide input during the evaluation process. In order to address varying state rules on treatment of insurance sold through associations, HHS is accepting comments on the rule’s definition of “individual market” and “small group market”; comments on those sections will be considered if submitted by July 18, 2011.