Current through August, 2024
Section 1 Purpose
The purpose of this regulation is to set forth rules for the
hiring of independent experts to analyze proposed rate increases in Medicare
supplement health insurance policies pursuant to Title
33 V.S.A. §
6706.
Section 2 Authority
This regulation is issued pursuant to the authority vested in
the Commissioner of Banking, Insurance and Securities ("Commissioner") by Title
33 V.S.A. §
6706.
Section 3 Review by the Commissioner
(a) Proposed rate increases in Medicare
supplement rates shall be reviewed by the Commissioner to determine if the best
interests of the policyholders or certificate-holders will be served by having
an analysis of the proposed increase performed by an independent expert. In
determining whether such analysis would serve the policyholders' or
certificate-holders' best interests the Commissioner:
(1) shall consider the premium volume and the
amount of the proposed increase;
(2) shall weigh the cost of such analysis to
each policyholder or certificate-holder against the amount of the proposed rate
increase; and
(3) may consider
amendments to Medicare law, inflation, and other factors that impact Medicare
supplement rates.
(b)
When the Commissioner determines that independent analysis is in the best
interest of the policyholders or certificate-holders, he shall notify the
insurer of such determination no later than thirty (30) days after the filing
is received by the Department. Once such notification is given, the
Commissioner shall submit the filing to an expert for independent analysis. The
filing will not be deemed approved until thirty (30) days after it is returned
to the Department by the expert.
(c) The Commissioner's determination under
this section shall become part of the Department's rate filing records and
shall be made at least five (5) days prior to the granting of the rate increase
or any portion thereof.
Section
4 Information Required of Insurers
To enable the Commissioner to adequately review Medicare
supplement rates pursuant to Section
3 of this
regulation, insurers are required to provide with each rate filing --
(a) the proposed rate increase, expressed as
both:
(1) the total dollar amount;
and
(2) a percentage of written
premiums; and
(b) for the
most recent period of experience, the following Vermont data:
(1) the number of individual policyholders or
certificate-holders to be affected by the rate increase; and
(2) the average premium per policyholder or
certificate-holder both before and after the filing, assuming the filing is
approved; and
(c) for the
preceding five-year period of sale of the certificates or policies in Vermont,
the following Vermont data for each calendar year:
(1) the amount of written premiums;
(2) the amount of earned premiums;
and
(3) the incurred claims
associated with Vermont insureds.
Section 5 Independent Analysis
(a) The Commissioner shall periodically
solicit proposals from and enter into agreements with qualified experts to
conduct the required independent analysis.
(b) The Commissioner may set reasonable
limits on the expert's fees and costs. Such fees and costs shall be submitted
to the Department and the insurer and paid directly by the insurer. The insurer
may assess the affected policyholders or certificate-holders.
(c) The independent expert shall submit a
report, containing findings, analysis and a summary statement, to the
Department within thirty (30) days of the rate filing being submitted to such
expert for analysis. The summary shall become part of the Department's rate
filing records.
Section 6
Severability
Should a court hold any provision of this regulation invalid
in any circumstance, the invalidity shall not affect any other provisions or
circumstances.
Section 7
Effective Date
This regulation shall become effective January 1,
1992.
Statutory Authority:
33 V.S.A. §
6706
