Charges to enrollees--Fairness--Actuary's certificate.

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58-41-44. Charges to enrollees--Fairness--Actuary's certificate.

Charges for comprehensive health maintenance services may be established in accordance with actuarial principles for various categories of enrollees, provided that such charges applicable to an enrollee shall not be individually determined based on the status of his health. However, the charges shall not be excessive, inadequate, or unfairly discriminatory. A certification, by a qualified actuary, to the appropriateness of the charges, based on reasonable assumptions, shall accompany the filing along with adequate supporting information.

Source: SL 1974, ch 321, §23 (1).


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