Summary


Section 627.6675(3)(c), F.S., requires the Office to annually determine standard risk rates, using reasonable actuarial techniques and standards. According to the statute, the standard risk rates must be determined as follows: 1. Standard risk rates for individual coverage must be determined separately for indemnity policies, preferred provider/exclusive provider policies, and health maintenance organization contracts. 2. The office shall survey insurers and health maintenance organizations representing at least an 80 percent market share, based on premiums earned in the state for the most recent calendar year, for each of the categories specified in # 1. 3. Standard risk rate schedules must be determined, computed as the average rates charged by the carriers surveyed, giving appropriate weight to each carrier’s statewide market share of earned premiums. 4. The rate schedule shall be determined from analysis of the one county with the largest market share in the state of all such carriers. 5. The rate for other counties must be determined by using the weighted average of each carrier’s county factor relationship to the county determined in # 4. 6. The rate schedule must be determined for different age brackets and family size brackets. In compliance with this statutory mandate the Office conducted a survey, calculated the rate schedules, and by this rule amendment publishes the results. 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.