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 120-2-98 - REVIEW OF HEALTH BENEFIT PLAN RATE INCREASES
Rule 120-2-98-.02 - Definitions

Current through Rules and Regulations filed through March 20, 2024

(1) "CMS" means the Centers for Medicare & Medicaid Services.

(2) "Health benefit plan" has the same meaning as O.C.G.A. § 33-24-59.5(2) as that term is modified by the provisions of O.C.G.A. § 33-1-2(1.1) but does not include coverage offered by a person not subject to the jurisdiction of the Commissioner pursuant to O.C.G.A. § 33-1-14.

(3) "Individual market" means the market for health benefit plans where the health benefit plan is issued directly to a natural person and not through coverage under a group, blanket or franchise health benefit plan.

(4) "Rate increase" means any increase of the rates for a health benefit plan offered in the individual or small group market.

(5) "Rate increase subject to review" means a rate increase that meets the criteria set forth in 120-2-98-.03.

(6) "Secretary" means the Secretary of the Department of Health and Human Services.

(7) "Small group market" means the market within which small group coverage is sold as that term is defined in O.C.G.A. § 33-30-12(a).

(8) "Unreasonable rate increase" means a rate increase subject to review that violates applicable laws, regulations, and rules.

O.C.G.A. Sections 33-2-9, 33-9-1et seq., 33-21-13, 33-21-18(a), 33-21-28.

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