Summary


The Office is required by Section 627.6675(3)(c), F.S., to conduct an annual survey of the individual market (as contrasted with the group market) and determine “standard risk rates”. These standard risk rates are the average rates charged in the individual market for health insurance. The standard risk rates are used by the health insurers in setting their conversion rates, because pursuant to Section 627.6675(3)(a), F.S., the maximum a health insurer can charge for a conversion policy is 200% of the standard risk rate. The annual survey is conducted for PPO/EPO, Indemnity and HMO separately. The rates for indemnity benefit plans set out in the existing rule have been determined by the Office to be unreasonably high, due to the inclusion in the survey of an out of state company that is no longer writing insurance in this state. The Office does not regulate the rates of out of state companies. Because inclusion of this company’s rates have skewed the results of the survey, the rates in this rule amendment have been recalculated without this company’s rates. The standard risk rates for indemnity plans in this amended rule are more reasonable.