§ 10-18-105 — Loss ratio standards and filing requirements

(1) Every insurer
providing group or individual medicare supplement insurance benefits to a resident
of this state pursuant to section 10-18-102 shall file a copy of the group master
policy or individual policy and any certificate used in this state in accordance with
the filing requirements and procedures of sections 10-16-107.2 and 10-16-406;
except that no insurer shall be required to make a filing earlier than thirty days
after insurance was provided to a resident of this state under a group master policy
issued for delivery outside this state.

(2) Group and individual medicare supplement policies shall return to
policyholders benefits which are reasonable in relation to the premium charged.
The commissioner shall issue reasonable regulations to establish minimum
standards for loss ratios of medicare supplement policies on the basis of incurred
claims experience or incurred health-care expenses where coverage is provided by
a health maintenance organization on a service rather than reimbursement basis
and on the basis of earned premiums in accordance with accepted actuarial
principles and practices. Every entity providing medicare supplement policies or
certificates in this state shall file annually its rates, rating schedule, and supporting
documentation demonstrating that it is in compliance with the applicable loss ratio
standards of this state. All filings of rates and rating schedules shall demonstrate
that the actual and expected losses in relation to premiums comply with the
requirements of this article.

(3) No entity shall provide compensation to its agents or other producers
which is greater than the renewal compensation which would have been paid on an
existing policy if the existing policy had been replaced by another policy with the
same company and the new policy benefits had been substantially similar to the
benefits under the old policy and the old policy had been issued by the same insurer
or insurer group.

Legislative History

Source: L. 89: Entire article R&RE, p. 500, � 1, effective July 1. L. 92: (1) amended, p. 1725, � 10, effective July 1. L. 2013: (1) amended, (HB 13-1266), ch. 217, p. 990, � 55, effective May 13.