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OAC 365:10

INSURANCE DEPARTMENT

(1) An issuer of Medicare supplement policies and certificates issued before or after the

effective

date

of

Part

13,

365:10-5-120

schedule and supporting documentation by policy duration for approval by requirements and procedures prescribed

et seq. in this state shall file annually its rates, rating including ratios of incurred losses to earned premiums the Commissioner in accordance with the filing by the Commissioner. The supporting documentation

shall

also

demonstrate

in

accordance

with

actuarial

standards

of

practice

using

reasonable

assumptions

that

the

appropriate

loss

ratio

standards

can

be

expected

to

be

met

over

the

entire

period for which rates are computed. Such demonstration shall An expected third-year loss ratio which is greater than or equal

exclude active life reserves. to the applicable percentage

shall

be

demonstrated

for

policies

or

certificates

in

force

less

than

three

(3)

years.

(2) As soon as practicable, but prior to the effective benefits, every issuer of Medicare supplement policies

date of enhancements in Medicare or certificates in this state shall file

(d)

with

Public

the Commissioner, in accordance with the applicable filing procedures of this state: (A) Appropriate premium adjustments necessary to produce loss ratios as anticipated for the current premium for the applicable policies or certificates. Such supporting documents as necessary to justify the adjustment shall accompany the filing. (B) An issuer shall make such premium adjustments as are necessary to produce an expected loss ratio under such policy or certificate as will conform with minimum loss ratio standards for Medicare supplement policies and which are expected to result in a loss ratio at least as great as that originally anticipated in the rates used to produce current premiums by the issuer for such Medicare supplement policies or certificates. No premium adjustment which would modify the loss ratio experience under the policy other than the adjustments described herein shall be made with respect to a policy at any time other than upon its renewal date or anniversary date. (C) If an issuer fails to make premium adjustments acceptable to the Commissioner, the Commissioner may order premium adjustments, refunds or premium credits deemed necessary to achieve the loss ratio required by this section. (D) Any appropriate riders, endorsements or policy forms needed to accomplish the Medicare supplement policy or certificate modifications necessary to eliminate benefit duplications with Medicare. Such riders, endorsements or policy forms shall provide a clear description of the Medicare supplement benefits provided by the policy or certificate. hearings. The Commissioner may conduct a public hearing to gather information

concerning a request by an issuer for an increase in a rate for a policy before or after the effective date of Part 13, 365:10-5-120 et seq., if

form or certificate form issued the experience of the form for

the previous reporting period determination of compliance is period. Public notice of such Commissioner.

is not in compliance with the applicable loss ratio standard. The made without consideration of any refund or credit for such reporting hearing shall be furnished in a manner deemed appropriate by the

[Source: Added at 9 Ok Reg 549, eff 12-13-91 (emergency); Added at 9 Ok Reg 2499, eff 6-26-92; Amended at 9 Ok Reg 3899, eff 8-24-92 (emergency); Amended at 10 Ok Reg 1475, eff 5-1-93; Amended at 15 Ok Reg 3569, eff 5-29-98 (emergency); Amended at 16 Ok Reg 1088, eff 4-26-99; Amended at 22 Ok Reg 1954, eff 7-14-05]

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