Section 505.18 - Health care insurance quality and costs - annual report1. Consumers deserve to know the quality and cost of their health care insurance. Health care insurance transparency provides consumers with the information necessary, and the incentive, to choose health plans based on cost and quality. Reliable cost and quality information about health care insurance empowers consumer choice and consumer choice creates incentives at all levels, and motivates the entire health care delivery system to provide better health care and health care benefits at a lower cost. It is the purpose of this section to make information regarding the costs of health care insurance readily available to consumers through the consumer advocate bureau of the insurance division.2. The commissioner in collaboration with the consumer advocate shall prepare and deliver a report to the governor and to the general assembly no later than November 15 of each year that provides findings regarding health spending costs for health insurance carriers in the state for the previous calendar year. The commissioner may contract with outside vendors or entities to assist in providing the information contained in the annual report. The report shall provide, at a minimum, the following information: a. Aggregate health insurance data concerning loss ratios of health insurance carriers licensed to do business in the state.b. Rate increase data.c. Health care expenditures in the state and the effect of such expenditures on health insurance premium rates.d. A ranking and quantification of those factors that result in higher costs and those factors that result in lower costs for each health insurance carrier in the state.e. The current capital and surplus and reserve amounts held in reserve by each health insurance carrier licensed to do business in the state.f. A listing of any apparent medical trends affecting health insurance costs in the state.g. Any additional data or analysis deemed appropriate by the commissioner to provide the general assembly with pertinent health insurance cost information.h. Recommendations made by the work group convened pursuant to section 505.8, subsection 18.