This is the Final Public Hearing on the adoption of proposed amendments to Rule 69O-149.005, Florida Administrative Code, published on December 22, 2006 in Vol. 32, No. 51, of the Florida Administrative Weekly. A Notice of Change was published in ...

 

DEPARTMENT OF FINANCIAL SERVICES
OIR – Insurance Regulation

RULE NO: RULE TITLE
69O-149.005: Reasonableness of Benefits in Relation to Premiums

The Financial Services Commission announces a public hearing to which all persons are invited.

DATE AND TIME: April 17, 2007, 9:00 a.m., during a regular meeting of the Financial Services Commission

PLACE: Cabinet Meeting Room, Lower Level, The Capitol, Tallahassee, Florida

GENERAL SUBJECT MATTER TO BE CONSIDERED: This is the Final Public Hearing on the adoption of proposed amendments to Rule 69O-149.005, F.A.C., published on December 22, 2006 in Vol. 32, No. 51, of the F.A.W.  A Notice of Change was published in the F.A.W. on March 9, 2007.

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this program, please advise the contact person at least 5 calendar days before the program by contacting Tracie Lambright at e-mail [e-mail].  If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

THE FULL TEXT OF THE PROPOSED RULE IS:

69O-149.005 Reasonableness of Benefits in Relation to Premiums.

(1) through (13) No change.

(14) An insurer may issue multiple year rate guarantee or rating cap provisions subject to the following:

(a) The coverage is for annually rated group health insurance policies for which filing of rates is exempted by Section 627.410(6), F.S., and excluding disability income policies;

(b) The provision may not apply for greater than 24 months;

(c) The rate for the entire rating period reflects the increased risk of a rate guarantee with an increased premium or other consideration, is actuarially sound, includes claim costs projected at trend levels at least as high as those applicable to other groups with similar benefit structures in the rating area covered under the form(s) and is reasonably anticipated to meet the target loss ratio for the group;

(d) The provision is available to groups on a nondiscriminatory basis as determined by the insurer’s underwriting standards; and

(e) The insurer uses experience rating in determining the group’s rate consistently based on its rating and underwriting practices without regard to whether the rate is issued with or without a rate guarantee.

Specific Authority 624.308(1), 627.410(6)(b), (d), (e) FS. Law Implemented 626.9541(1), 627.410(6)(d), (e), 627.410(7), 627.411(1)(a), (e), 627.9175 FS. History–New 7-1-85, Formerly 4-58.05, 4-58.005, Amended 4-18-94, 11-20-02, Formerly 4-149.005, Amended 5-18-04, _________.

A copy of the agenda may be obtained by contacting the Governor and Cabinet Website at http://www.myflorida.com/myflorida/cabinet/mart.html. The agenda should be available approximately one week before the cabinet meeting.