Current through Register Vol. 46, No. 39, September 25, 2024
(a) All product
or system group policy and certificate forms shall be subject to the approval
requirements of Insurance Law, section 2307(a), and shall comply with
applicable Insurance Law, article 23 standards.
(b)
(1)
Except as provided in paragraph (3) of this subdivision, all product or system
group policy rates, including rating plans, rating rules, and rating
classifications and territories shall be submitted to the superintendent
pursuant to the applicable provisions of Insurance Law, article 23.
(2) Except as provided in paragraph (3) of
this subdivision, rates and rating plans and rules for a product or system
group policy written as inland marine insurance shall not be exempt from filing
requirements.
(3)
(i) Notwithstanding any other provision of
this section, in accordance with the provisions of section
2311 of the
Insurance Law, individual rate filings for 'a' rated risks shall not be
required to be filed with the superintendent.
(ii) The insurer shall maintain all rating
information used to support the rate in an individual underwriting file for
each policy issued, in accordance with the records retention requirements of
Part 243 of this Title (Regulation 52).
(iii) As used in this section, an 'a' rated
risk means any insurance coverage for which rates are individually determined
based upon judgment because the insurer has not established a manual rate based
upon experience, except that if the insurer acquires sufficient experience to
establish, or the insurer itself has, a manual rate for such coverage, then
such coverage shall no longer be considered an 'a' rated risk for such
insurer.
(c)
A product or system group policy shall not qualify as a special risk pursuant
to Insurance Law, article 63 and Part 16 of this Title (Regulation
86).
(d) The insurer must treat in
like manner all eligible group members of the same class.
(e) Product or system group policy rates
shall comply with applicable Insurance Law, article 23 standards, subject to
the following factors:
(1) Premium reductions
may be considered, based on actual or reasonably anticipated loss and expense
experience of the group or where such expenses and experience can be fairly
demonstrated.
(2) Rates shall not
be deemed unfairly discriminatory in the event different premiums result for
different groups with like loss exposure but different expense factors, or like
expense factors but different loss exposures, where such differences can be
fairly demonstrated.
(3) Rates,
rating plans or rating rules recognizing loss or expense experience differences
on a group basis, in comparison to like risks not in the group, shall be deemed
rating classifications subject to the superintendent's approval pursuant to
Insurance Law, section 2307.
(f) An insurer shall maintain separate loss
and expense statistics applicable to business underwritten and transacted under
Insurance Law, section 3446.
