What must be done at least 45 days prior to an effective date for insurer rates?

The requirement to file rates and plans at least 45 days prior to their effective date is crucial in maintaining regulatory oversight in the insurance industry. This process ensures that rate changes and the justification for those rates are reviewed and approved by state regulators before they can be implemented. By filing these rates in advance, insurers allow the regulatory body to assess whether the proposed rates are adequate, not discriminatory, and in compliance with state law. This protective measure aids in fostering transparency and protecting consumers from sudden or unfair rate increases.

The other options do not align with the specific requirement of the 45-day notice before an effective date. For instance, while notification of changes and public hearings may be part of the regulatory process, they do not specifically pertain to the advanced filing of rates and plans, which is what the question directly addresses. Approval from policyholders is also not a mandated step in this process; instead, it is the regulatory authority that plays a key role in evaluating the proposed rates.