| | | (1)__The rate increase for any group or subgroup does | | not exceed the index of inflation multiplied by 1.5, | | excluding any approved rate differential based on age.__ | | For the purposes of this subsection, "index of | | inflation" means the rate of increase in medical costs | | for a section of the United States selected by the | | superintendent that includes this State for the most | | recent 12-month period immediately preceding the date | | of the filing for which data are available; and |
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| | | (2)__The carrier demonstrates in accordance with | | generally accepted actuarial principles and practices | | consistently applied that, as of a date no more than | | 210 days prior to the filing, the ratio of benefits | | incurred to premiums earned averages no less than 87.5% | | for the previous 12-month period. |
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| | | F.__Any rate hearing conducted with respect to filings that | | meet the criteria in paragraph E is subject to this | | paragraph. |
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| | | (1)__Any person requesting a hearing shall provide the | | superintendent with a written statement detailing the | | circumstances that justify a hearing, notwithstanding | | the satisfaction of the criteria in paragraph E. |
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| | | (2)__If the superintendent decides to hold a hearing, | | the superintendent shall issue a written statement | | detailing the circumstances that justify a hearing, | | notwithstanding the satisfaction of the criteria in | | paragraph E. |
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| | | (3)__In any hearing conducted under this subsection, | | the bureau and any party asserting that the rates are | | excessive have the burden of establishing that the | | rates are excessive.__The burden of proving that rates | | are adequate and not unfairly discriminatory remains | | with the carrier. |
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| | | 2-C.__Optional guaranteed loss ratio.__At the carrier's | | option, rate filings for a credible block of small group health | | plans may be filed in accordance with this subsection instead of | | subsection 2-B.__Rates filed in accordance with this subsection | | are filed for informational purposes. |
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| | | A.__A block of small group health plans is deemed credible | | if the anticipated number of member months for which the | | rates will be in effect is at least 1,000 or if it meets | | credibility standards adopted by the superintendent by rule.__ | | The rate filing must state the anticipated number of |
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