Compilation of Rules and Regulations of the State of Georgia
Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER
Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE
Subject 120-2-44 - PREFERRED PROVIDER ARRANGEMENTS
Rule 120-2-44-.06 - Rates and Forms

(1) In accordance with the Rules and Regulations of the Office of Commissioner of Insurance § 120-2-25-.06(1)(g), every group policy or contract, certificate, rider, endorsement, and application to be issued, delivered, or issued for delivery in this State in connection with a health plan having a preferred provider arrangement must be submitted for approval prior to use in this State. Following an initial approval of these forms for each insurer, subsequent, substantially similar group certificates and associated forms may be treated as exempt forms pursuant to the Rules and Regulations of the Office of Commissioner of Insurance § 120-2-25-.05(3), provided the insurer files a notice and schedule of benefit changes with the Commissioner of Insurance for informational purposes at least 30 days prior to the use of such forms.

(2) Basic rates and charges shall not be excessive, inadequate, or unfairly discriminatory. A certification by a qualified actuary to the appropriateness of the basic rates, based on reasonable assumptions as to expected medical expenses, administrative expenses, and margins for contingencies, shall accompany the filing along with supporting information.