689C.210 - Procedure for increasing premium rates.
689C.210 Procedure for increasing premium rates.
1. Except as otherwise provided in subsection 3, a carrier shall not increase the premium rate charged to a small employer for a new rating period by a percentage greater than the sum of:
(a) The percentage of change in the premium rate for new business for the policy under which the small employer is covered, measured from the first day of the previous rating period to the first day of the new rating period;
(b) An adjustment, not to exceed 15 percent annually, adjusted pro rata for rating periods of less than 1 year, on account of the claim experience, health status, or duration of coverage of the employees or dependents of the small employer as determined from the carrier’s rate manual for the class of business; and
(c) Any adjustment on account of change in coverage or change in the characteristics of the small employer as determined from the carrier’s rate manual for the class of business.
2. If the carrier no longer issues new policies for that class of business, the carrier shall use the percentage of change in the premium rate for new business for the class of business which is most similar to the closed class of business and for which the carrier is issuing new policies.
3. In the case of health benefit plans delivered or issued for delivery before January 1, 1996, for groups with not fewer than 2 employees and not more than 25 employees, or before July 1, 1997, for groups with not fewer than 26 employees and not more than 50 employees, a premium rate for a rating period may exceed the ranges set forth in NRS 689C.230 for a period of 3 years following that date. In that case, the percentage of increase in the premium rate charged to a small employer for a new rating period may not exceed the sum of:
(a) The percentage of change in the premium rate for new business measured from the first day of the previous rating period to the first day of the new rating period. In the case of a health benefit plan into which the carrier is no longer enrolling new small employers, the carrier shall use the percentage of change in the base premium rate if that change does not exceed, on a percentage basis, the change in the premium rate for new business for the most similar health benefit plan into which the carrier is actively enrolling new small employers.
(b) Any adjustment on account of change in coverage or change in the characteristics of the small employer as determined from the carrier’s rate manual for the class of business.
(Added to NRS by 1995, 983; A 1997, 2946; 1999, 2813)