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62E.091 APPROVAL OF STATE PLAN PREMIUMS.
The association shall submit to the commissioner any premiums it proposes to become
effective for coverage under the comprehensive health insurance plan, pursuant to section 62E.08,
subdivision 3
. No later than 45 days before the effective date for premiums specified in section
62E.08, subdivision 3, the commissioner shall approve, modify, or reject the proposed premiums
on the basis of the following criteria:
(a) whether the association has complied with the provisions of section 62E.11, subdivision
11
;
(b) whether the association has submitted the proposed premiums in a manner which
provides sufficient time for individuals covered under the comprehensive insurance plan to receive
notice of any premium increase no less than 30 days prior to the effective date of the increase;
(c) the degree to which the association's computations and conclusions are consistent with
section 62E.08;
(d) the degree to which any sample used to compute a weighted average by the association
pursuant to section 62E.08 reasonably reflects circumstances existing in the private marketplace
for individual coverage;
(e) the degree to which a weighted average computed pursuant to section 62E.08 that uses
information pertaining to individual coverage available only on a renewal basis reflects the
circumstances existing in the private marketplace for individual coverage;
(f) a comparison of the proposed increases with increases in the cost of medical care and
increases experienced in the private marketplace for individual coverage;
(g) the financial consequences to enrollees of the proposed increase;
(h) the actuarially projected effect of the proposed increase upon both total enrollment in,
and the nature of the risks assumed by, the comprehensive health insurance plan;
(i) the relative solvency of the contributing members; and
(j) other factors deemed relevant by the commissioner.
In no case, however, may the commissioner approve premiums for those plans of coverage
described in section 62E.08, subdivision 1, paragraphs (a) to (d), that are lower than 101 percent
or greater than 125 percent of the weighted averages computed by the association pursuant to
section 62E.08. The commissioner shall support a decision to approve, modify, or reject any
premium proposed by the association with written findings and conclusions addressing each
criterion specified in this section. If the commissioner does not approve, modify, or reject the
premiums proposed by the association sooner than 45 days before the effective date for premiums
specified in section 62E.08, subdivision 3, the premiums proposed by the association under this
section become effective.
History: 1993 c 324 s 3; 2003 c 109 s 3