Source: http://www.maine.gov/pfr/insurance/review_checklists/Rate_filing_large_group.htm
Timestamp: 2014-07-29 18:09:10
Document Index: 350204191

Matched Legal Cases: ['§ 2839', '§2808', '§ 2839', '§ 2839', '§6913', '§6917']

Group Health Policies : Form & Rate Filing Review Checklists : Bureau of Insurance
> Company Services > Review Checklists > Group Health Policies
Group Health Policies Subject to Title 24-A M.R.S.A. § 2839:
H02G, H03G, H04, H07G, H08G, H09G, H10G, H11G, H12, H13G, H14G, H15G.002, H16G.002A, H16G.002B, H16G.002C, H16G.004, H17G, H18G, H19G, H20G, HOrg02G.003B
[Not Applicable to “Small Group Health Plans” Subject to Title 24-A §2808-B]
Title 24-A, § 2839
A rate filing for informational purposes must be submitted whenever a new policy, rider, or endorsement form that affects benefits is submitted for approval and whenever there is a change in the rates applicable to a previously approved form. Rates must be filed with the form filing rather than separately.
See http://www.serff.com If the filing is found to be in compliance with the applicable requirements, the SERFF record will show the rates to be “Filed for Information” and the record will be closed.
The name and address of the carrier, and the name, title, email address, and direct phone number of the person responsible for the filing must be provided in the SERFF “Filing Contact Information” section.
Include a brief description of the benefits provided by each policy form and any attached riders or endorsements.
4. In-Force Business:
Specify the number of group policies, the number of covered employees, the number of covered insureds, and the annualized premium for the Maine policies which will be affected by the proposed rate revision.
The filing may be prepared in a manner that protects the confidentially of proprietary information by following the confidentiality protocol, available on the Bureau of Insurance website.
7. Rates Filed:
A policy of group health insurance may not be delivered in this State until a copy of the group rates to be used in calculating the premium for these policies has been filed for informational purposes with the superintendent. The filing must include the base rates and a description of any procedures to be used to adjust the base rates to reflect factors including but not limited to age, gender, health status, claims experience, group size and coverage of dependents.
8. Notice of Rate Increase:
Title 24-A, § 2839-A
An insurer offering group health insurance, except for accidental injury, specified disease, hospital indemnity, disability income, Medicare supplement, long-term care or other limited benefit group health insurance, must provide written notice by first class mail of a rate increase to all affected policyholders or others who are directly billed for group coverage at least 60 days before the effective date of any increase in premium rates. An increase in premium rates may not be implemented until 60 days after the notice is provided.
9. Actuarial Certification, HMO Rate Filings:
10. Access Payments or Savings Offset Payments:
Any savings offset payments or access payments paid or anticipated to be paid pursuant to Title 24-A. §6913 or §6917 must be treated as incurred claims.
11. Stand Alone Dental QHP’s
Please provide the Actuarial Value of the plan and the methodology of its calculation. The AV and the methodology for calculating it must be certified by a qualified actuary. “Qualified actuary,” as used herein, means a member in good standing of the American Academy of Actuaries.