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§ 15-911. Minimum standards for loss ratios

West's Annotated Code of MarylandInsurance

West's Annotated Code of Maryland
Insurance (Refs & Annos)
Title 15. Health Insurance
Subtitle 9. Medicare Supplement Act (Refs & Annos)
MD Code, Insurance, § 15-911
§ 15-911. Minimum standards for loss ratios
Loss ratio defined
(a) In this section, “loss ratio” means the ratio of losses incurred to premiums earned on policies that are issued, delivered, or renewed in the State.
Aggregate benefits reasonable in relation to premium charged
(b) Medicare supplement policies shall return aggregate benefits that are reasonable in relation to the premium charged.
Regulations to establish minimum standards for loss ratios
(c)(1) For purposes of administering this subtitle and §§ 12-203 through 12-205 of this article, the Commissioner shall adopt reasonable regulations to establish minimum standards for loss ratios of Medicare supplement policies.
(2) The minimum standards for loss ratios shall be based on incurred claims experience and earned premiums in accordance with accepted actuarial principles and practices and the principles and standards of the National Association of Insurance Commissioners.
Medicare supplement policies subject to minimum acceptable loss ratios
(d) The minimum acceptable loss ratios for Medicare supplement policies are:
(1) for group Medicare supplement policies, at least 75% of the aggregate amount of premiums earned; and
(2) for individual Medicare supplement policies or subscriber contracts that are issued or renewed on a policy anniversary after July 1, 1991, at least 65% of the aggregate amount of premiums earned.
Rates, rating schedule, and supporting documentation filed with Commissioner
(e)(1) To demonstrate compliance with the applicable minimum loss ratio standards established in the State for Medicare supplement policies, each carrier that provides Medicare supplement policies or certificates in the State shall file annually with the Commissioner the carrier's rates, rating schedule, and supporting documentation.
(2) Each filing of rates and rating schedules shall demonstrate that the actual and expected losses in relation to premiums comply with the requirements of this subtitle.
Adjustment of rates, credits or refunds to policyholders
(f) The Commissioner may require a carrier to adjust rates or give credits or refunds to policyholders of Medicare supplement policies that in practice do not meet the minimum loss ratio standards required under this section.

Credits

Added by Acts 1997, c. 35, § 2, eff. Oct. 1, 1997.
Formerly Art. 48A, § 648D.
MD Code, Insurance, § 15-911, MD INSURANCE § 15-911
Current through legislation effective through May 9, 2024, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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