California Code of Regulations
Title 10 - Investment
Chapter 5 - Insurance Commissioner
Subchapter 2 - Policy Forms and Other Documents
Article 1.9 - Standards for Determining Whether Benefits of an Individual Hospital, Medical or Surgical Policy Are Unreasonable in Relation to the Premium Charged Pursuant to Subdivision (c) of Section 10293
Section 2222.19 - Statement of Compliance

Unless requested by the commissioner to provide more specific information on policy forms subject to the standards of reasonability in Section 2222.12, a company shall, by April 1 of each year, provide a statement from a qualified actuary that lists the policy forms to which the standards apply, the lifetime anticipated loss ratio and, if applicable, the lifetime anticipated disease management ratio for each form, and a statement that the standards of reasonability have been met, for each policy form for the preceding calendar year. For policy forms to which Section 2222.12(a) applies, a company shall also submit by April 1 of each year a schedule detailing disease management expenses for the preceding calendar year, if applicable.

1. New subsection (5) filed 4-5-78; designated effective 1-1-79 (Register 78, No. 14).
2. Amendment of section heading, repealer and new section and amendment of NOTE filed 12-29-2006; operative 3-29-2007 pursuant to Insurance Code section 10293(a) (Register 2006, No. 52).

Note: Authority cited: Sections 10293 and 10608, Insurance Code. Reference: Section 10293(a), Insurance Code.