Wis. Admin. Code Office of the Commissioner of Insurance Ins 19.03

Current through October 28, 2024
Section Ins 19.03 - Payment parameters

The commissioner shall annually establish the payment parameters for future benefit years through an established procedure that includes all of the following components:

(1) The commissioner shall request, under s. 601.42, Stats., all eligible health carriers to submit data and information from prior and current benefit years including: compliant plan membership, premium experience at a metal and federally facilitated marketplace status level, advanced premium tax credit enrollee information, and other information as requested by the commissioner.
(2) The commissioner shall publish the preliminary payment parameters and a public hearing notice in the Wisconsin Administrative Register and to the OCI website. The commissioner shall hold a public hearing seeking public comment regarding the preliminary payment parameters for the subsequent benefit year.
(3) The commissioner shall set the final payment parameters after consultation with an actuarial firm, consideration of comments received from the public hearing, the goals established in s. 601.83(2), Stats., and any additional information as appropriate.
(4) The commissioner shall publish the final payment parameters in the Wisconsin Administrative Register and to the OCI website by May 15 of the calendar year prior to the applicable benefit year.

Wis. Admin. Code Office of the Commissioner of Insurance Ins 19.03

Adopted by, CR 19-088: cr. Register November 2021 No. 791, eff. 12-1-21; correction in (4) made under s. 35.17, Stats., Register November 2021 No. 791, eff. 12/1/2021