Section Ins 4104.06 - Rate Filing Standards(a) Carriers shall calculate a market rate that is representative of all of the RSA 420-G:2, IX health coverage plans offered to large employers as follows: (1) Carriers shall provide the plan relativity factors that are used to modify experience under its existing coverages so that the coverages can be combined in the calculation of the market rate. The plan relativity factors used to modify experience shall be the same as those used to establish the health coverage rates when the coverages were offered;(2) Carriers shall provide annualized trend information detailed to include cost, utilization, technology and other components; and(3) Carriers shall specify all other assumptions used in the calculation of the market rate.(b) A carrier shall calculate health coverage plan rate for the coverages it will offer as follows: (1) A carrier shall provide the plan relativity factors used to calculate the health coverage plan rate from the market rate. Any changes to the health coverage plan rate from the previously approved set of factors shall be highlighted and the basis for the same shall be documented;(2) Variations in the health coverage plan rate shall be attributable to variations in expected utilization or claims severity; and(3) Plan relativity factors shall not assume that there are differences in the morbidity among individuals electing varied coverages;(c) Carriers shall calculate premium rates for each large employer from the health coverage plan rate through the application of factors for case characteristics that are filed and approved by the department.(d) Supporting documentation shall include: (1) Recent claims for the previous 3 years under the previously approved rates;(2) A projection of how such experience compares to what was expected;(3) A breakdown for each previous calendar year and each policy year of collected premium, earned premium, paid claims, paid loss ratio, change in claim liability and reserve, incurred claims, incurred loss ratio, expected incurred claims, actual-to-expected claims, and active life reserves;(4) Delineation of any changes in assumptions from those used in the demonstration of the most recently approved rates;(5) Demonstration of compliance with the limitations delineated above;(6) Formulae, factors and sample calculations demonstrating how premium rates are actually computed;(7) Excerpts from the underwriting manual indicating how company personnel are to apply rating variations;(8) Indication of the range of variation provided by the proposed factors for each allowable case characteristic;(9) Indication of the expected distribution of rate factors, for each allowable case characteristic, the carrier expects will apply as it underwrites large employers;(10) Indication of the actual distribution of rate factors applied by the carrier versus the expectation delineated in the rate filing where rates were previously approved;(11) A description of the morbidity basis used for the form, including its source, any adjustments from the source and supporting data that justifies the morbidity basis;(12) The average monthly premium rate anticipated per enrolled employee and per covered individual;(13) For proposed rate adjustments, the average percentage increase and the largest percentage increase in the monthly premium rate anticipated per enrolled employee and per covered individual, where the average increase is determined by comparing the aggregate premium before and after the increase assuming no lapses for all policies affected by the rate adjustment and where the maximum increase is the largest increase for an in-force policy, accounting for changes due to trend, aging, and allowable rating factors but excluding changes in the group's covered population;(14) The medical trend assumption and supporting documentation for the same;(15) Experience upon which rating assumptions can be based, except that when there is insufficient experience within New Hampshire upon which rating assumptions can be based, the carrier may use nationwide experience provided that appropriate adjustments shall be made, including adjusting premiums to New Hampshire levels and adjusting claims to represent New Hampshire utilization and prices;(16) Premium adjustment information, except that no adjustment shall be made if nationwide premiums include area factors that adjust premiums for variations in utilization and price levels provided that these factors result in the same percentage adjustment to both premiums and claims;(17) A history of prior rate adjustments, including the approval date and average percentage rate adjustments for the past 3 years;(18) Certification that the policy forms for which rates are being filed are being actively marketed, and are available to both new issues and renewing policyholders;(19) Certification by a qualified actuary that to the best of the actuary's knowledge and judgment, the entire rate filing is in compliance with the applicable laws of New Hampshire and with the rules of the department;(20) A description of the benefits provided via the form;(21) A description of the expense assumptions;(22) Rate calculations for at least 2 different hypothetical groups; and(23) Sufficient documentation so that premium rates could be calculated for any group.(e) Carriers shall submit a complete filing annually that includes all the documentation required by this subsection.(f) Carriers may make an interim filing between the required annual filing, to propose rating adjustments.N.H. Admin. Code § Ins 4104.06
#9690, eff 4-9-10; ss by #9938, eff 6-10-11
The amended version of this section by New Hampshire Register Volume 39, Number 24, eff.6/10/2019 is not yet available.