On May 19, the Department of Health and Human Services (HHS) issued a final regulation implementing section 1003 of the Patient Protection and Affordable Care Act that requires review of certain health insurance premium increases. Starting September 1, 2011, premium increases of ten percent or more for non-grandfathered individual and small group health plans must be disclosed and reviewed by relevant officials. States will primarily have the responsibility for reviewing rate increases and have already been awarded approximately $44 million in grants to obtain the necessary resources to conduct the reviews. In September 2012, the ten-percent threshold will be replaced by state-specific percentages based on state cost trends. The final rule also requires insurance companies to provide consumers with information and justifications for the rate increases in order to ensure transparency about consumer costs. The rule does not provide HHS and states with authority to approve or reject the rate increases, but instead allows officials to enhance transparency in the insurance marketplace.