44-32,149. Premium rates.
(1) No premium rate may be used until either a schedule of premium rates or methodology for determining premium rates has been filed with and approved by the director. A specific schedule of premium rates or a methodology for determining premium rates shall be established in accordance with actuarial principles for various categories of enrollees. The premium applicable to an enrollee shall not be individually determined based on the status of his or her health. The premium rates shall not be excessive, inadequate, or unfairly discriminatory. A certification by a qualified actuary or other qualified person acceptable to the director as to the appropriateness of the use of the methodology, based on reasonable assumptions, shall accompany the filing along with adequate supporting information.
(2) The director shall approve the schedule of premium rates or methodology for determining premium rates if the requirements of this section are met. If the director disapproves such filing, he or she shall notify the health maintenance organization. In the notice, the director shall specify the reasons for his or her disapproval. A hearing shall be conducted within thirty days after a request in writing by the person filing. If the director does not take action on such schedule or methodology within thirty days of the filing of such schedule or methodology, it shall be deemed approved.
Source
Copyright ©2024 LegalFix. All rights reserved. LegalFix is not a law firm, is not licensed to practice law, and does not provide legal advice, services, or representation. The information on this website is an overview of the legal insurance products you can purchase—or that may be provided by your employer as an employee benefit or by your credit union or other membership group as a membership benefit.
LegalFix provides its members with access to legal services through a network of provider law firms. LegalFix, its corporate entity, and its officers, directors, employees, agents, and contractors do not provide legal advice, services, or representation—directly or indirectly.
The articles and information on the site are not legal advice and should not be relied upon—they are for information purposes only. You should become a LegalFix member to get legal services from one of our provider law firms.
You should not disclose confidential or potentially incriminating information to LegalFix—you should only communicate such information to your provider law firm.
The benefits and legal services described in the LegalFix legal plans are not always available in all states or with all plans. See the legal plan Benefit Overview and the more comprehensive legal plan contract during checkout for coverage details in your state.
Use of this website, the purchase of legal insurance products, and access to the LegalFix network of provider law firms are subject to the LegalFix Terms of Service and Privacy Policy.
