CHAPTER 20. FILING REQUIREMENTS
IC 27-13-20
Chapter 20. Filing Requirements
IC 27-13-20-1
Rates; approval
Sec. 1. The rates to be used by a health maintenance organization,
including the actuarial assumptions underlying those rates, must be
filed with the commissioner for approval and:
(1) must be established in accordance with actuarial principles
for various categories of enrollees and, in the case of a group
contract, shall not be individually determined based on the
status of an enrollee's health;
(2) must be developed by an actuary or other qualified person
acceptable to the commissioner; and
(3) may not be excessive, inadequate, or unfairly
discriminatory.
As added by P.L.26-1994, SEC.25.
IC 27-13-20-2
Approval of documents by commissioner
Sec. 2. (a) Except as provided in subsection (b), a document
submitted to the commissioner under this chapter is deemed
approved when one (1) of the following conditions is met:
(1) The health maintenance organization receives a written
communication of approval from the commissioner.
(2) Thirty (30) days pass after the commissioner receives the
document.
(b) A document is not deemed approved under subsection (a)(2)
if, within thirty (30) days after the commissioner receives the
document, or within any period of extension granted by the
commissioner, the commissioner deposits in the United States mail
addressed to the health maintenance organization a written
communication to the contrary. Not more than thirty (30) days after
receiving the written communication from the commissioner, the
health maintenance organization may request a hearing. If, not more
than thirty (30) days after receiving the communication from the
commissioner, the health maintenance organization requests a
hearing, the commissioner shall hold a hearing upon not less than ten
(10) days notice to the health maintenance organization.
As added by P.L.26-1994, SEC.25.