Current through Register No. 12, March 21, 2024
(a) Carriers shall calculate a market rate
that is representative of all of the
RSA 420-G:2, IX
health coverage plans offered to large employers as follows:
(1) Carriers shall provide the plan
relativity factors that are used to modify experience under its existing
coverages so that the coverages can be combined in the calculation of the
market rate. The plan relativity factors used to modify experience shall be the
same as those used to establish the health coverage rates when the coverages
were offered;
(2) Carriers shall
provide annualized trend information detailed to include cost, utilization,
technology and other components; and
(3) Carriers shall specify all other
assumptions used in the calculation of the market rate.
(b) A carrier shall calculate health coverage
plan rate for the coverages it will offer as follows:
(1) A carrier shall provide the plan
relativity factors used to calculate the health coverage plan rate from the
market rate. Any changes to the health coverage plan rate from the previously
approved set of factors shall be highlighted and the basis for the same shall
be documented;
(2) Variations in
the health coverage plan rate shall be attributable to variations in expected
utilization or claims severity; and
(3) Plan relativity factors shall not assume
that there are differences in the morbidity among individuals electing varied
coverages;
(c) Carriers
shall calculate premium rates for each large employer from the health coverage
plan rate through the application of factors for case characteristics that are
filed and approved by the department.
(d) Supporting documentation shall include:
(1) Recent claims for the previous 3 years
under the previously approved rates;
(2) A projection of how such experience
compares to what was expected;
(3)
A breakdown for each previous calendar year and each policy year of collected
premium, earned premium, paid claims, paid loss ratio, change in claim
liability and reserve, incurred claims, incurred loss ratio, expected incurred
claims, actual-to-expected claims, and active life reserves;
(4) Delineation of any changes in assumptions
from those used in the demonstration of the most recently approved
rates;
(5) Demonstration of
compliance with the limitations delineated above;
(6) Formulae, factors and sample calculations
demonstrating how premium rates are actually computed;
(7) Excerpts from the underwriting manual
indicating how company personnel are to apply rating variations;
(8) Indication of the range of variation
provided by the proposed factors for each allowable case
characteristic;
(9) Indication of
the expected distribution of rate factors, for each allowable case
characteristic, the carrier expects will apply as it underwrites large
employers;
(10) Indication of the
actual distribution of rate factors applied by the carrier versus the
expectation delineated in the rate filing where rates were previously
approved;
(11) A description of the
morbidity basis used for the form, including its source, any adjustments from
the source and supporting data that justifies the morbidity basis;
(12) The average monthly premium rate
anticipated per enrolled employee and per covered individual;
(13) For proposed rate adjustments, the
average percentage increase and the largest percentage increase in the monthly
premium rate anticipated per enrolled employee and per covered individual,
where the average increase is determined by comparing the aggregate premium
before and after the increase assuming no lapses for all policies affected by
the rate adjustment and where the maximum increase is the largest increase for
an in-force policy, accounting for changes due to trend, aging, and allowable
rating factors but excluding changes in the group's covered
population;
(14) The medical trend
assumption and supporting documentation for the same;
(15) Experience upon which rating assumptions
can be based, except that when there is insufficient experience within New
Hampshire upon which rating assumptions can be based, the carrier may use
nationwide experience provided that appropriate adjustments shall be made,
including adjusting premiums to New Hampshire levels and adjusting claims to
represent New Hampshire utilization and prices;
(16) Premium adjustment information, except
that no adjustment shall be made if nationwide premiums include area factors
that adjust premiums for variations in utilization and price levels provided
that these factors result in the same percentage adjustment to both premiums
and claims;
(17) A history of prior
rate adjustments, including the approval date and average percentage rate
adjustments for the past 3 years;
(18) Certification that the policy forms for
which rates are being filed are being actively marketed, and are available to
both new issues and renewing policyholders;
(19) Certification by a qualified actuary
that to the best of the actuary's knowledge and judgment, the entire rate
filing is in compliance with the applicable laws of New Hampshire and with the
rules of the department;
(20) A
description of the benefits provided via the form;
(21) A description of the expense
assumptions;
(22) Rate calculations
for at least 2 different hypothetical groups; and
(23) Sufficient documentation so that premium
rates could be calculated for any group.
(e) Carriers shall submit a complete filing
annually that includes all the documentation required by this
subsection.
(f) Carriers may make
an interim filing between the required annual filing, to propose rating
adjustments.
The amended
version of this section by
New
Hampshire Register Volume 39, Number 24, eff.6/10/2019 is not yet
available.