Rule 120-2-81-.07 - Premium Rates for Standard Policies or Plans(1) Maximum premium rates are specified in Form GHIAS-R for Plans A and B, and in Form GHBAS-R for Plans C and D. All premium rates utilized by the health insurer or managed care organization for standard policies or plans must be filed for approval and shall include premium modes available. All participating health insurers and managed care organizations shall offer a monthly premium mode and may offer additional, less frequent, modes.(2) Actual premiums charged to any eligible individual may not exceed the maximum premium rates specified in Forms GHIAS-R and GHBAS-R . If premium modes that are less frequent than monthly are offered, the actual premiums charged through such modes may not exceed the maximum premium rates specified in Forms GHIAS-R and GHBAS-R discounted by the modal factors that the health insurer or managed care organization would typically apply to other policies for that premium mode.(3) If a health insurer offers standard policies with preferred provider arrangements as permitted by this Regulation Chapter, the maximum rate charged may not exceed the maximum premium rates specified in Form GHIAS-R for Plans A and B discounted by the same factor that the health insurer would typically apply to other policies with preferred provider arrangements.(4) Premium rates shall reflect, at a minimum, single male and female rating tiers and one family tier for any number of dependents. The Commissioner may prescribe additional tiers on Forms GHIAS-R and GHBAS-R if deemed necessary for the effective maintenance of the GHIAS and GHBAS.Ga. Comp. R. & Regs. R. 120-2-81-.07
O.C.G.A. Secs. 33-2-9, 33-29A-1, et seq.
ER. 120-2-81-0.8 adopted. F. Dec. 31, 1997; eff. Jan. 2, 1998, to remain in effect for a period of 120 days or until the effective date of a permanent Rule covering the same subject matter superseding the ER, is adopted, as specified by the Agency.Amended: Permanent Rule entitled "Premium Rates for Standard Policies or Plans" adopted. F. Apr. 29, 1998; eff. May 19, 1998.