Conn. Agencies Regs. § 38a-495a-11 - Filing and approval of policies and certificates and premium rates
(a) An issuer shall not deliver or issue for
delivery a policy or certificate to a resident of this state unless the policy
form or certificate form has been filed with and approved by the commissioner
in accordance with filing requirements and procedures prescribed by the
commissioner.
(b) An issuer shall
file any riders or amendments to policy or certificate forms to delete
outpatient prescription drugs as revised by the Medicare Prescription Drug,
Improvement and Modernization Act of 2003 only with the commissioner in the
state in which the policy or certificate was issued.
(c) An issuer shall not use or change premium
rates for a Medicare supplement policy or certificate unless the rates, rating
schedule and supporting documentation have been filed with and approved by the
commissioner in accordance with the filing requirements and procedures
prescribed by the commissioner.
(d)
(1) Except as provided in subdivision (2) of
this subsection, an issuer shall not file for approval more than one form of a
policy or certificate of each type for each standard Medicare supplement
benefit plan.
(2) An issuer may
offer, with the approval of the commissioner, up to four (4) additional policy
forms or certificate forms of the same type for the same standard Medicare
supplement benefit plan, one for each of the following cases:
(A) The inclusion of new or innovative
benefits;
(B) The addition of
either direct response or agent marketing methods;
(C) The addition of either guaranteed issue
or underwritten coverage;
(D) The
offering of coverage to individuals eligible for Medicare by reason of
disability.
(3) For the
purposes of this section, a "type" means an individual policy, a group policy,
an individual Medicare Select policy, or a group Medicare Select
policy.
(e)
(1) Except as provided in subparagraph (A) of
this subdivision, an issuer shall continue to make available for purchase any
policy form or certificate form issued after the effective date of this
regulation that has been approved by the commissioner. A policy form or
certificate form shall not be considered to be available for purchase unless
the issuer has actively offered it for sale in the previous twelve (12) months.
(A) An issuer may discontinue the
availability of a policy form or certificate form if the issuer provides to the
commissioner in writing its decision at least thirty (30) days prior to
discontinuing the availability of the form of the policy or certificate. After
receipt of the notice by the commissioner, the issuer shall no longer offer for
sale the policy form or certificate form in this state.
(B) An issuer that discontinues the
availability of a policy form or certificate form pursuant to Subparagraph (A)
of this subdivision shall not file for approval a new policy form or
certificate form of the same type for the same standard Medicare supplement
benefit plan as the discontinued form for a period of five (5) years after the
issuer provides notice to the commissioner of the discontinuance. The period of
discontinuance may be reduced if the commissioner determines that a shorter
period is appropriate.
(2) The sale or other transfer of Medicare
supplement business to another issuer shall be considered a discontinuance for
the purposes of this subsection.
(3) A change in the rating structure or
methodology shall be considered a discontinuance under subdivision (1) of this
subsection unless the issuer complies with the following requirements:
(A) The issuer provides an actuarial
memorandum, in a form and manner prescribed by the commissioner, describing the
manner in which the revised rating methodology and resultant rates differ from
the existing rating methodology and resultant rates.
(B) The issuer does not subsequently put into
effect a change of rates or rating factors that would cause the percentage
differential between the discontinued and subsequent rates as described in the
actuarial memorandum to change. The commissioner may approve a change to the
differential which is in the public interest.
(f)
(1)
Except as provided in subdivision (2) of this subsection, the experience of all
policy forms or certificate forms of the same type in a standard Medicare
supplement benefit plan shall be combined for purposes of the refund or credit
calculation prescribed in section
38a-495a-10
of the Regulations of Connecticut State Agencies.
(2) Forms assumed under an assumption
reinsurance agreement shall not be combined with the experience of other forms
for purposes of the refund or credit calculation.
Notes
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