Michigan Laws 500.3851 – Aggregate benefits; rates, rating schedules, and rate revisions
Current as of: 2023 | Check for updates
|
Other versions
(1) A medicare supplement policy form or certificate form shall not be delivered or issued for delivery unless the policy form or certificate form can be expected, as estimated for the entire period for which rates are computed to provide coverage, to return to policyholders and certificate holders in the form of aggregate benefits, not including anticipated refunds or credits, the following:
(a) For group policies at least 75% of the aggregate amount of premiums earned calculated on the basis of incurred claims experience and earned premiums for the entire period for which rates are computed and in accordance with accepted actuarial principles and practices.
Terms Used In Michigan Laws 500.3851
- Certificate: means any certificate delivered or issued for delivery in this state under a group Medicare supplement policy. See Michigan Laws 500.3801
- Certificate form: means the form on which a certificate is delivered or issued for delivery by an insurer. See Michigan Laws 500.3801
- Medicare: means subchapter XVIII of the social security act, 42 USC 1395 to 1395lll. See Michigan Laws 500.3801
- Policy form: means the form on which the policy or certificate is delivered or issued for delivery by the insurer. See Michigan Laws 500.3801
- Rate: means the cost of insurance per payroll before adjustment for an individual insured's size, exposure, or loss experience. See Michigan Laws 500.2402
(b) For individual policies at least 65% of the aggregate amount of premium earned calculated on the basis of incurred claims experience and earned premiums for the entire period for which rates are computed and in accordance with accepted actuarial principles and practices.
(2) All filings of rates and rating schedules shall demonstrate that expected claims in relation to premiums comply with the requirements of this section when combined with actual experience to date. Filings of rate revisions shall also demonstrate that the anticipated loss ratio over the entire future period for which the revised rates are computed to provide coverage can be expected to meet the appropriate loss ratio standards.