LD 1611
pg. 43
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LR 2137
Item 1

 
member months for which the rates will be in effect and the
basis for the estimate.__If the superintendent determines
that the number of member months is likely to be less than
1,000 and the block does not satisfy any alternative
credibility standards adopted by rule, the filing is subject
to subsection 2-B.

 
B.__Within 7 months after the end of the period for which
rates are in effect, the carrier shall file a report with
the superintendent showing aggregate earned premiums and
incurred claims for the period the rates were in effect.__
Incurred claims must include claims paid to a date 6 months
after the end of the period for which rates were in effect
and an estimate of unpaid claims.__The report must state how
the unpaid claims estimate was determined.

 
C.__If incurred claims were less than 80% of earned
premiums, the carrier shall refund a percentage of the
premium to an entity or person that paid the premium.__The
percentage must be the same for all groups and subgroups and
must be calculated as the ratio of excess premiums to
aggregate earned premiums.__Excess premiums must be
calculated by dividing the aggregate incurred claims by 0.8
and subtracting the result from aggregate earned premiums.__
The total of all refunds must equal the excess premiums.

 
D.__The superintendent may require further support for the
unpaid claims estimate and may require refunds to be
recalculated if the estimate is found to be unreasonably
large.

 
E.__The superintendent may adopt rules setting forth
appropriate methodologies regarding reports, refunds and
credibility standards pursuant to this subsection.__Rules
adopted pursuant to this subsection are routine technical
rules as defined in Title 5, chapter 375, subchapter 2-A.

 
Sec. D-9. 24-A MRSA §2839, as amended by PL 1985, c. 648, §11, is
further amended to read:

 
§2839. Rates filed

 
No policy of group health insurance may be delivered in this
State until a copy of the group manual rates to be used in
calculating the premium for these policies has been filed for
informational purposes with the superintendent. Notwithstanding
this section, rates for group Medicare supplement, nursing home
care or long-term care insurance contracts must be filed in
accordance with section 2736 and rates for small group health


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