Md. Code Regs. 31.10.05.09

Current through Register Vol. 51, No. 18, September 6, 2024

Section 31.10.05.09 - Loss Ratio Standards

As soon as practicable, but before the effective date of Medicare benefit changes, each insurer issuing or delivering Medicare supplement policies or subscriber contracts in this State shall file with the Commissioner, in accordance with applicable filing procedures:

A. Appropriate premium adjustments necessary to produce loss ratios as originally anticipated for the applicable policies or certificates. Supporting documents necessary to justify the proposed adjustments shall be included with the filing. The following apply:

(1) Each insurer subject to the Medicare Supplement Act of Insurance Article, Annotated Code of Maryland, issuing or delivering Medicare supplement policies or contracts to residents of this State, shall make those premium adjustments which are necessary to produce an expected loss ratio under the policies or contracts which will conform with the 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 for the Medicare supplement policies or contracts. Premium adjustments shall be calculated for the period beginning with Medicare benefit changes.

(2) Premium adjustments which would modify the loss ratio under the policies and contracts other than the adjustments described in this section may be made only on the renewal date or anniversary date of the policy or contract.

B. Appropriate riders, endorsements, or policy forms, which shall be drafted to:

(1) Accomplish Medicare supplement insurance modifications necessary to:

(a) Eliminate benefit duplications with Medicare, and

(b) Provide any additional benefits necessary to comply with State or federal statutes, rules, and regulations modifying minimum benefit requirements under Medicare supplement policies and contracts;

(2) Provide a clear description of the Medicare supplement benefits to be provided by the policies or contracts.

Md. Code Regs. 31.10.05.09

Regulations .09, Appendixes A_C adopted as an emergency provision effective July 1, 1982 (9:13 Md. R. 1340); adopted permanently effective October 1, 1982 (9:17 Md. R. 1707)
Regulations .09 and Appendices A_C adopted as an emergency provision effective July 25, 1989 (16:16 Md. R. 1738); emergency status extended at 16:26 Md. R. 2782 and 17:5 Md. R. 633; emergency status expired July 20, 1990
Regulations .09 and Appendices A_C repealed, and new Regulations .09 adopted effective July 23, 1990 (17:14 Md. R. 1757)
Regulation .09 amended effective January 1, 2006 (32:18 Md. R. 1522)