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calculating this loss-ratio percentage, any savings offset | | payments paid pursuant to section 6913 must be treated as | | incurred claims. The excess premium is the amount of premium | | above that amount necessary to achieve a 78% loss ratio for | | all of the carrier's small group policies during the same 36- | | month period.__The refund must be distributed to policyholders | | in an amount reasonably calculated to correspond to the | | aggregate experience of all policyholders holding policies | | having similar benefits. The total of all refunds must equal | | the excess premiums. |
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| | | (1)__For determination of loss-ratio percentages in | | 2005, actual aggregate incurred claims expenses include | | expenses incurred in 2005 and projected expenses for | | 2006 and 2007.__For determination of loss-ratio | | percentages in 2006, actual incurred claims expenses | | include expenses in 2005 and 2006 and projected | | expenses for 2007. |
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| | | (2)__The superintendent may waive the requirement for | | refunds during the first 3 years after the effective | | date of this subsection. |
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| | | 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. |
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| | | 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. |
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| | | Sec. E-17. 24-A MRSA §2839-B is enacted to read: |
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| | | §2839-B.__Large group rates |
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| | | 1.__Application.__This section applies to group health | | insurance offered in the large group market as defined in section | | 2850-B, except insurance covering only accidental injury, | | specified disease, hospital indemnity, dental, vision, disability | | income, long-term care, Medicare supplement or other limited | | benefit health insurance. |
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| | | 2.__Annual filing.__Every carrier offering group health | | insurance specified in subsection 1 shall annually file with the | | superintendent on or before April 30th a certification signed by | | a member in good standing of the American Academy of Actuaries or | | a successor organization that the carrier's rating methods and |
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