§ 27-19-6 - Rates charged subscribers – Reserves.
SECTION 27-19-6
§ 27-19-6 Rates charged subscribers –Reserves. – (a) Public hearings: The rates proposed to be charged or a ratingformula proposed to be used by any corporation organized under this chapter toemployers, the state or any political subdivision of the state, or individuals,shall be filed by the corporation at the office of the health insurancecommissioner. Within sixty (60) days after receipt of the application, thecommissioner, or his or her designee shall hold a hearing on all rates proposedfor health insurance coverage offered in the individual market as defined in§ 27-18.5-2 upon not less than ten (10) days written notice prior to thehearing. With regard to any other rates subject to the commissioner'sjurisdiction the commissioner, or his or her designee, may hold a hearing uponnot less than ten (10) days written notice prior to the hearing. The noticeshall be published by the commissioner in a newspaper or newspapers havingaggregate general circulation throughout the state at least ten (10) days priorto the hearing. The notice shall contain a description of the rates proposed tobe charged and a copy of the notice shall be sent to the applicant and to thedepartment of the attorney general. In addition, the applicant shall provide bymail, at least ten (10) days prior to the hearing, notice of the proposed rateincrease for health insurance coverage offered in the individual market asdefined in § 27-18.5-2 to all subscribers subject to the proposed rateincrease.
(b) Filings with the Attorney General's Office: Theapplicant shall provide a copy of the filing on all rates proposed for healthinsurance coverage offered in the individual market as defined in §27-18.5-2 to the Insurance Advocacy Unit of the Attorney General's Officesimultaneously with the filing at the office of the health insurancecommissioner.
(c) Procedures: At any hearing held under thissection, the applicant shall be required to establish that the rates proposedto be charged or the rating formula to be used are consistent with the properconduct of its business and with the interest of the public.
Rates proposed to be charged by any corporation organizedunder this chapter shall be sufficient to maintain total reserves in a dollaramount sufficient to pay claims and operating expenses for not less than onemonth. Those reserves shall be computed as of each December 31st, and a reportsetting forth the computation shall be submitted to the commissioner togetherwith the corporation's Rhode Island annual statement to the commissioner. Anydocuments presented in support of a filing of proposed rates under this sectionshall be made available for inspection by any party entitled to participate ina hearing or admitted as an intervenor in a hearing or such conditions as thecommissioner may prescribe provided under this section at a time and at a placeas the commissioner may deem reasonable. The commissioner, or his or herdesignee, upon the hearing, may administer oaths, examine and cross-examinewitnesses, receive oral and documentary evidence, and shall have the power tosubpoena witnesses, compel their attendance, and require the production ofbooks, papers, records, correspondence, or other documents which he or shedeems relevant. The commissioner shall issue a decision as soon as isreasonably possible following the completion of the hearing. The decision mayapprove, disapprove, or modify the rates proposed to be charged by theapplicant. Applicants requesting changes in rates shall underwrite thereasonable expenses of the commissioner in connection with the hearing,including any costs related to advertisements, stenographic reporting, andexpert witnesses fees.
(d) The term "designee" as used in this section shall mean aperson who is impartial, a member in good standing of the Rhode Island bar anda person who is sufficiently acquainted with the rules of evidence as used inthe superior court of the state so as to enable that person to conduct ahearing as designee of the commissioner. The reasonable per diem cost of thedesignee as appointed by the commissioner shall be paid by the applicantrequesting changes in the rates.