Section 17B:27A-62 - Information to support, justify rate requests.

NJ Rev Stat § 17B:27A-62 (2019) (N/A)
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17B:27A-62 Information to support, justify rate requests.

2. a. An informational rate filing by a carrier for an individual or small employer health benefits plan offered in this State shall contain information to support and justify rate requests. A rate increase shall be subject to expanded review by the department pursuant to the provisions of this act if the informational rate filing requests a rate increase of 10 percent or more annually.

b. A rate increase meets or exceeds 10 percent annually if the average increase for all enrollees weighted by premium volume for any plan within the product meets or exceeds the 10 percent threshold.

c. With respect to small employer plans, rate increases submitted on a quarterly basis shall be considered both for each specific quarter and in combination with any previous quarterly rate increase or increases applicable to the same calendar year when determining whether the rate increase meets or exceeds the 10 percent threshold for expanded review.

d. For the purposes of this act, "informational filing" means a submission, by a carrier to the department, of rate-filings which specify the plans offered, premium rates, all factors to be used in the calculation of premium rates, and a detailed actuarial memorandum supporting the calculation of the rates including a certification by a qualified member of the American Academy of Actuaries, the Society of Actuaries, or the Casualty Actuarial Society, all supporting data for the premium rates and such other information as required by the department.

L.2019, c.355, s.2.