Section 26-A2214. ANNUAL FILING OF PREMIUM RATES

 

2214.1An issuer of Medicare supplement policies and certificates issued in the District before or after the effective date of this chapter shall file annually its rates, rating schedule and supporting documentation, including ratios of incurred losses to earned premiums by policy duration, for approval by the Commissioner of the Department of Insurance and Securities Regulation in accordance with the filing requirements and procedures prescribed by the Commissioner.

 

2214.2The supporting documentation shall also demonstrate, in accordance with actuarial standards of practice using reasonable assumptions, that the appropriate loss ratio standards can be expected to be met over the entire period for which rates are computed and such demonstration shall exclude active life reserves.

 

2214.3An expected third-year loss ratio which is greater than or equal to the applicable percentage shall be demonstrated for policies or certificates in force less than three (3) years.

 

2214.4As soon as practicable, but prior to the effective date of enhancements in Medicare benefits, every issuer of Medicare supplement policies or certificates in the District shall file with the Commissioner:

 

(a)Appropriate premium adjustments necessary, to produce loss ratios as anticipated for the current premium for the applicable policies or certificates; and

 

(b)Supporting documents as necessary to justify the adjustment.

 

2214.5An issuer shall make premium adjustments as are necessary to produce an expected loss ratio under such policy or certificate as will conform with minimum loss ratio standards for Medicare supplement policies and which are expected to result in a loss ratio at least as great as that originally anticipated in the rates used to produce current premiums by the issuer for such Medicare supplement policies and certificates.

 

2214.6No premium adjustment which would modify the loss ratio experience under the policy other than the adjustments described herein shall be made with respect to a policy at any time other than upon its renewal date or anniversary date.

 

2214.7If an issuer fails to make acceptable premium adjustments, the Commissioner may order premium adjustments, refunds or premium credits deemed necessary to achieve the loss ratio required by section 2212.

 

2214.8Any appropriate riders, endorsements or policy forms needed to accomplish the Medicare supplement policy or certificate modifications necessary to eliminate benefit duplications with Medicare and the riders, endorsements or policy forms. shall provide a clear description of the Medicare supplement benefits provided by the policy or certificate.

 

source

Final Rulemaking published at 46 DCR 10175 (December 17, 1999); as amended by Final Rulemaking published at 50 DCR 4166 (May 30, 2003); as amended by Final Rulemaking published at 50 DCR 5882 (July 25, 2003); as amended by Final Rulemaking published at 53 DCR 2955(April 14, 2006).