LD 1611
pg. 41
Page 40 of 47 An Act To Provide Affordable Health Insurance to Small Businesses and Individua... Page 42 of 47
Download Bill Text
LR 2137
Item 1

 
carrier satisfactorily responds to any reasonable discovery
requests.

 
B.__The superintendent shall disapprove any premium rates
filed by any carrier, whether initial or revised, for a
small group health plan unless it is anticipated that the
aggregate benefits estimated to be paid under all the small
group health plans maintained in force by the carrier for
the period for which coverage is to be provided will return
to policyholders at least 75% of the aggregate premiums
collected for those policies, as determined in accordance
with accepted actuarial principles and practices and on the
basis of incurred claims experience and earned premiums.

 
C.__When a filing is not accompanied by the information upon
which the carrier supports such filing, or the
superintendent does not have sufficient information to
determine whether such filing meets the requirements that
rates not be excessive, inadequate or unfairly
discriminatory, the superintendent shall require the carrier
to furnish the information upon which it supports the
filing.__A filing and supporting information are public
records except as provided by Title 1, section 402,
subsection 3 and become part of the official record of any
hearing held pursuant to paragraph D.

 
D.__If at any time the superintendent has reason to believe
that a filing does not meet the requirements that rates not
be excessive, inadequate or unfairly discriminatory or that
the filing violates any of the provisions of chapter 23, the
superintendent shall cause a hearing to be held.__Hearings
held under this section must conform to the procedural
requirements set forth in Title 5, chapter 375, subchapter
4.__The superintendent shall issue an order or decision
within 30 days after the close of the hearing or of any
rehearing or reargument or within such other period as the
superintendent for good cause may require, but not to exceed
an additional 30 days.__In the order or decision, the
superintendent shall either approve or disapprove the rate
filing.__If the superintendent disapproves the rate filing,
the superintendent shall establish the date on which the
filing is no longer effective, specify the filing the
superintendent would approve and authorize the insurer to
submit a new filing in accordance with the terms of the
order or decision.

 
E.__Any filing of rates, rating formulas and modifications
that satisfies the criteria set forth in this paragraph is
subject to the provisions of paragraph F:


Page 40 of 47 Top of Page Page 42 of 47