Pennsylvania is one of nine states that HHS believes lacks the authority to adequately review rates. In those cases, the Centers for Medicare and Medicaid Services has the authority to step in and review the reasons behind the premium increase.

After a rate increase request is deemed "unreasonable," the insurer has 10 days to either reduce their rate hikes or post a justification on their website.

"We hope that by publicizing the excessive premium hikes, we will empower consumers," HHS Secretary Kathleen Sebelius said in a statement. "By shining a light on unjustified premium increases, we will hold health insurers accountable like never before, and help keep money in the pockets of Americans."

If Everence Insurance decides to move forward with the rate increase, it will have an effective date of Oct. 1, and will affect nearly 5,000 people, according to the rate review, which was made available to the public on HealthCare.gov.

The Affordable Care Act provides $250 million over five years to states that need help in order to perform stronger reviews. Over the last year, 42 states, the District of Columbia and the five U.S. territories have used around $48 million.

While regulators have the power to stamp a rate hike as "unreasonable," most states don't have the power to reject or reduce rate increases. In fact, less than half the states require prior approval of all rate increases for both individual and small group health insurance plans, according to the Kaiser Family Foundation.

"We have called on [Everence Insurance] to immediately rescind the rate, issue refunds to consumers or publicly explain their refusal to do so," said Steve Larsen, director of the Center for Consumer Information and Insurance Oversight at the Centers for Medicare & Medicaid Services. 

In July, the Government Accountability Office released its findings of a survey of insurance departments in all 50 states on their premium rate oversight. The survey found 38 states in 2010 reviewed rate filings before the rates took effect, and that some survey respondents also reported conducting comprehensive reviews of rate filings, while others reported reviewing little information or conducting cursory reviews. Only 14 respondents reported providing consumers with opportunities to be involved in premium rate oversight, such as participation in rate review hearings or public comment periods.

HHS Secretary Sebelius says by exposing insurers to public censure, this will promote a competitive marketplace and will deter expensive premiums. Insurers will become "very reluctant" to be the most expensive option when plans are compared side-by-side, Sebelius said in a Huffington Post op-ed.

Despite the beefed up process and efforts to shame insurers over unreasonable rate hikes, critics of rate reviews say regulators need to grant the outright authority to reject premium increase requests in order to protect consumers.

"Disclosure alone will never be enough to prevent health insurers from charging unreasonable insurance premiums. To protect consumers, regulators must have the power to review and reject excessive rates," said Carmen Balber, Washington director for Consumer Watchdog. "Without at least the threat of enforcement, public complaints about unreasonable increases will continue to fall on deaf ears. It's up to the states to require approval of health insurance rates and hold down rate hikes where federal health reform has failed."