Premium rates, rating schedules, and supporting documentation
for a Medicare supplement policy or certificate to be used in this
state must be filed with the department and approved by the Commissioner.
Any request for an increase to rates for Medicare supplement policies
or certificates issued before or after March 1, 1992, is subject to
review by and hearing before the Commissioner if one or more of the
following conditions, as determined by an actuary for the department,
is present:
(1) The increase, exclusive of any increase occasioned
by changes in the laws regulating Medicare supplement coverages, is
not necessary to maintain an anticipated lifetime loss ratio at least
equal to the minimum that is required by statute and set out in §3.3307
of this title (relating to Loss Ratio Standards and Refund or Credit
of Premiums).
(2) An increase to premium has been effected on the
same block or blocks of business within the preceding 12 months.
(3) An increase to premium would result in unfair discrimination,
as provided in Insurance Code Chapter 544, between individuals of
the same class and of essentially the same hazard in the amount of
premium, policy fees, or rates charged for a policy or contract.
(4) An increase to premium would result in the benefits
offered under the policy form to be unreasonable in relation to the
premiums charged.
(5) An increase to premium would have the practical
effect of altering the rating structure of the policy form to which
it is applied, or would create a new set of rating criteria under
the policy form.
(6) A contemplated increase to premium has the practical
effect of resulting in a series of planned future increases to premium
rather than a one-time increase.
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| Source Note: The provisions of this §3.3323 adopted to be effective April 15, 1992, 17 TexReg 2238; amended to be effective January 1, 1997, 21 TexReg 10753; amended to be effective June 13, 2018, 43 TexReg 3787 |
