Rule 120-2-81-.17 - Maintenance(1) As deemed necessary, the Commissioner may survey all insurers and managed care organizations issuing or renewing accident and sickness coverage in this state to determine the health insurers and managed care organizations eligible to participate in GHIAS and GHBAS, the pro-rata volume of business in the individual health insurance market issued by each health insurer and managed care organization for the purpose of making fair and equitable assignments, and for any other purpose necessary for the continued implementation and maintenance of GHIAS and GHBAS. The Commissioner may use all authority granted to him or her by law to enforce disclosure of information solicited by this survey. The survey may require disclosure of information pertaining to the following:(a) Premium volume under individual health insurance coverage issued in this state;(b) Premium rates charged;(c) Information regarding the marketing activity of insurers and managed care organizations in the individual health insurance market in this state;(d) Policy form, benefit, and enrollment data for individual health insurance coverage sold or renewed in this state; and(e) Any other information deemed appropriate by the Commissioner for the continued implementation and maintenance of O.C.G.A. § 33-29A-1et seq.(2) In lieu of a survey, the Commissioner may require all insurers and managed care organizations issuing or renewing accident and sickness insurance coverage (pursuant to annual reporting data formally collected by the Commissioner) to submit to the Commissioner a supplement to the annual report, designed by the Commissioner, which requires disclosure of certain information for purposes of determining participation in the assignment system.(3) The Commissioner may periodically revise and update the standardized policy forms, benefit schedules, and rate tables used for the assignment system based on data collected from insurers and managed care organizations issuing or renewing individual health insurance coverage in this state. The Commissioner shall have discretion in determining fair and equitable methodologies for such revisions in compliance with O.C.G.A. § 33-29A-1et seq. Additionally, the Commissioner may establish periods for which revisions shall take place and notify participating health insurers and managed care organizations of such revisions.(4) The assignment selection methodology for assigning qualifying eligible individuals to the GHIAS and GHBAS shall be determined by the Commissioner, shall provide for a reasonable randomized order of assignments based on market share, and shall be revised periodically to assure fair and equitable distribution of assignments among participating health insurers or managed care organizations based on data collected pursuant to this Rule.Ga. Comp. R. & Regs. R. 120-2-81-.17
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 "Maintenance" adopted. F. Apr. 29, 1998; eff. May 19, 1998.