Mass. Gen. Laws ch. 176J § 7

Current through Chapters 1 to 249 and Chapters 253 to 255 of the 2024 Legislative Session

Section 176J:7 - Disclosure by carriers

Every carrier shall make reasonable disclosure to prospective small business insureds, as part of its solicitation and sales material of:

(a) between April first, nineteen hundred and ninety-two and December thirty-first, nineteen hundred and ninety-four, inclusive, the extent, if any, to which premium rates are established or adjusted in part based upon the actual or expected variation in claim costs, the actual or expected variation in health conditions of employees or dependents of small businesses, or the time elapsed since initial enrollment in a health benefit plan; and

(b) the surcharge, if any, which shall be applied to a group's premium if one or more members are covered in the plan set forth in section eight of this chapter; and,

(c) the participation requirements or participation rate adjustments of the carrier with regard to each health benefit plan.

Every carrier, as a condition of doing business under the jurisdiction of this chapter, shall file with the commissioner an actuarial opinion that the carrier's rating methodologies and rates comply with the requirements of this chapter and any regulations promulgated under the authority of this chapter and a statement of the number of eligible employees and eligible dependents, as of the close of the preceding calendar year, enrolled in a health benefit plan offered by the carrier. Every carrier shall maintain at its principal place of business a complete and detailed description of its rating practices including information and documentation which demonstrates that its rating methods and practices are based upon commonly accepted actuarial assumptions, are in accordance with sound actuarial principles, and comply with the provisions of this chapter. Such information shall be made available to the commissioner upon request, but shall remain confidential.

If the commissioner determines that a carrier is not complying with the provisions of this chapter, the commissioner may disapprove the rating methodologies and the rates which the carrier uses.

Mass. Gen. Laws ch. 176J, § 7

Amended by Acts 2006, c. 450,§ 6, eff. 4/12/2006.

Amended by Acts 2006, c. 58,§ 87, eff. 1/1/2007