Sec. 38a-218. (Formerly Sec. 33-172). Approval of rates to be paid by subscribers and contracts.

(a) No such medical service corporation shall enter into any contract with subscribers unless and until it has filed with the Insurance Commissioner a full schedule of the rates to be paid by the subscriber and has obtained said commissioner's approval thereof. Such filing shall include an actuarial memorandum that includes, but is not limited to, pricing assumptions and claims experience, and premium rates and loss ratios from the inception of the contract. The commissioner may refuse such approval if the commissioner finds such rates are excessive, inadequate or discriminatory. As used in this subsection, “loss ratio” means the ratio of incurred claims to earned premiums by the number of years of policy duration for all combined durations.

(b) Premium rates and special enrollment periods offered to individuals shall be consistent with the requirements set forth in section 38a-481.

(c) Premium rates offered to small employers, as defined in section 38a-564, shall be consistent with the requirements set forth in section 38a-567.

(d) No such medical service corporation shall enter into any contract with subscribers unless and until it has filed with the Insurance Commissioner a copy of such contract, including all riders and endorsements thereof, and until said commissioner's approval thereof has been obtained. The Insurance Commissioner shall, within a reasonable time after the filing of any such form, notify such corporation of the commissioner's approval or disapproval thereof.

(1949 Rev., S. 5285; P.A. 77-614, S. 163, 610; P.A. 80-482, S. 222, 348; P.A. 15-247, S. 5; P.A. 18-43, S. 5.)

History: P.A. 77-614 made insurance department a division within the department of business regulation with commissioner as its head, effective January 1, 1979; P.A. 80-482 restored insurance division as independent department with commissioner as its head and abolished department of business regulation; Sec. 33-172 transferred to Sec. 38a-218 in 1991; P.A. 15-247 designated existing provisions re filing and approval of rates to be paid by subscribers as Subsec. (a) and amended same by adding provision re information to be included with such filing and definition of “loss ratio”, added Subsecs. (b) and (c) re rates offered to individuals and small employers, respectively, designated existing provisions re filing and approval of contract with subscribers as Subsec. (d), and made technical changes, effective July 10, 2015; P.A. 18-43 added “and special enrollment periods” in Subsec. (b), effective January 1, 2019.

Notation

Annotation to former section 33-172:

Cited. 29 CS 474.