§ 27-20-6 - Rates charged subscribers – Reserves – Hearing by director.
SECTION 27-20-6
§ 27-20-6 Rates charged subscribers –Reserves – Hearing by director. – (a) Public hearings: The rates proposed to be charged or a ratingformula proposed to be used by any corporation organized under this chapter toits subscribers, employers, the state or any political subdivision of thestate, or individuals, shall be filed by the corporation at the office of thehealth insurance commissioner. Within sixty (60) days after receipt of theapplication, the commissioner, or his or her designee, shall hold a hearing onall rates proposed for health insurance coverage offered in the individualmarket as defined in § 27-18.5-2 upon not less than ten (10) days writtennotice prior to the hearing. With regard to any other rates or rating formulasubject to the commissioner's jurisdiction the commissioner, or his or herdesignee, may hold a hearing upon not less than ten (10) days written noticeprior to the hearing. The notice shall be published by the commissioner in anewspaper or newspapers having aggregate general circulation throughout thestate at least ten (10) days prior to the hearing. The notice shall contain adescription of the rates proposed to be charged and a copy of the notice shallbe sent to the applicant and to the department of the attorney general. Inaddition, the applicant shall provide by mail, at least ten (10) days prior tothe hearing, notice of the proposed rate increase for health insurance coverageoffered in the individual market as defined in § 27-18.5-2 to allsubscribers subject to the proposed rate increase.
(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 or for a Medicare supplement policy as defined in § 27-18.2-1 tothe Insurance Advocacy Unit of the Attorney General's Office simultaneouslywith the filing at the office of the health insurance commissioner.
(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 proposed to be used are consistent with theproper conduct of its business and with the interest of the public.
Rates proposed to be charged by any corporation organizedunder this chapter shall maintain total reserves in a dollar amount sufficientto pay claims and operating expenses for not less than one month. Thosereserves shall be computed as of each December 31st, and a report setting forththe computation shall be submitted to the commissioner together with thecorporation's Rhode Island annual statement to the insurance commissioner ofthe state of Rhode Island. Any documents presented in support of a filing ofproposed rates under this section shall be made available for inspection by anyparty entitled to participate in a hearing or admitted as an intervenor in ahearing on such conditions as the commissioner may prescribe provided pursuantto this section at a time and at a place as the commissioner may deemreasonable. The commissioner, or his or her designee, upon the hearing, mayadminister oaths, examine and cross examine witnesses, receive oral anddocumentary evidence, and shall have the power to subpoena witnesses, compeltheir attendance, and require the production of books, papers, records,correspondence, or other documents which the director deems relevant. Thecommissioner shall issue a decision as soon as is reasonably possible followingcompletion of the hearing. The decision may approve, disapprove, or modify therates proposed to be charged by the applicant. Applicants requesting changes inrates shall underwrite the reasonable expenses of the commissioner inconnection with the hearing, including any costs related to advertisements,stenographic reporting, and expert 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.