Rates; Approval

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Sec. 1. The rates to be used by a health maintenance organization, including the actuarial assumptions underlying those rates, must be filed with the commissioner for approval and:

(1) must be established in accordance with actuarial principles for various categories of enrollees and, in the case of a group contract, shall not be individually determined based on the status of an enrollee's health;

(2) must be developed by an actuary or other qualified person acceptable to the commissioner; and

(3) may not be excessive, inadequate, or unfairly discriminatory.

As added by P.L.26-1994, SEC.25.


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