3901-3-13 Health insurance reserves.

 

 

 

Rule Summary and Fiscal Analysis (Part A)

 

Department Of Insurance

Agency Name

 

Katherine Melton

Division                                                                  Contact

 

2100 Stella Court Columbus OH 43215 - 1067             [phone]     (614)

644-3742

Agency Mailing Address (Plus Zip)                                       Phone                     Fax

 

 

 

3901-3-13

Rule Number

AMENDMENT

TYPE of rule filing

Rule Title/Tag Line              Minimum reserve standards for individual and group health

insurance contracts.

RULE SUMMARY

1.  Is the rule being filed consistent with the requirements of the RC 119.032 review? No

2.  Are you proposing this rule as a result of recent legislation? No

3.  Statute prescribing the procedure in accordance with the agency is required to adopt the rule: 119.03

4.  Statute(s) authorizing agency to adopt the rule: 3901.041, 3903.72(M), 3901.04

5.  Statute(s) the rule, as filed, amplifies or implements: 3903.72(M)

6.  State the reason(s) for proposing (i.e., why are you filing,) this rule:

To conform rule more closely to the National Association of Insurance Commissioners Model regulation on health insurance reserves.

7.  If the rule is an AMENDMENT, then summarize the changes and the content of the proposed rule; If the rule type is RESCISSION, NEW or NO CHANGE, then summarize the content of the rule:

Rule establishes minimum reserve standards for all individual and group health insurance coverages, including single premium credit disability insurance. The changes require use of updated reserve/claim factors that will produce larger, more conservative reserves.

8.  If the rule incorporates a text or other material by reference and the agency claims the incorporation by reference is exempt from compliance with sections

121.71 to 121.74 of the Revised Code because the text or other material is generally available to persons who reasonably can be expected to be affected by the rule, provide an explanation of how the text or other material is generally available to those persons:

The rule references the following tables that are generally available to those affected by the rule. These are found in public and university libraries in the publications, Transactions of the Society of Actuaries ("TSA") and in NAIC Proceedings (National Association of Insurance Commissioners). These documents can also be found either on the internet websites for these organizations, LEXIS or by contacting the librarian or publications office for each organization. 64CDT (1964 Commissioners Disability Table); 85CIDA (1985 Commissioners Individual Disability Tables A); 85CIDB (1985 Commissioners Individual Disability Tables B); DTS valuation table (Exhibits 3c and 4, Transactions of the Society of Actuaries XXXVII, pages 462-463; 85CIDC (1985 Commissioners Individual Disability Tables C - this table is to be computed using factors in DTS valuation table above to make adjustments to 85CIDA); 1956 inter-company hospital-surgical tables; 1974 medical expense tables, Table A, Transactions of the Society of Actuaries Volume XXX, page 63; Paper to which previous is appended: "Development of the 1974 Medical Expense Benefits", Houghton and Wolf in Transactions of the Society of Actuaries XXX, page 9; 1985 NAIC cancer claim cost tables; 1959 accidental death benefits table; 87CGDT (1987 Commissioners Group Disability Income Table); 1983 Group Annuity Mortality Table - this table is also found in Ohio Administrative Code Rule 3901-3-17, Appendix B.

9.  If the rule incorporates a text or other material by reference, and it was infeasible for the agency to file the text or other material electronically, provide an explanation of why filing the text or other material electronically was infeasible:

N/A

10.  If the rule is being rescinded and incorporates a text or other material by reference, and it was infeasible for the agency to file the text or other material, provide an explanation of why filing the text or other material was infeasible:

Not Applicable.

11.  If revising or refiling this rule, identify changes made from the previously filed version of this rule; if none, please state so:

Changed single premium credit disability to exclude it from unearned premium requirement; changed definitions as to when insurers can use their own experience; changed from public hearing to a filing for claim reserves methods.

12. 119.032 Rule Review Date: 12/29/2005

(If you answered NO to question No. 1, provide the scheduled review date. If you answered YES to No. 1, the review date for this rule is the filing date.)

NOTE: At time of final filing, two dates are required: the current review date plus a date not to exceed 5 years from the effective date for Amended rules or a date not to exceed 5 years from the review date for No Change rules.

FISCAL ANALYSIS

13.  Estimate the total amount by which this proposed rule would increase / decrease either revenues / expenditures for the agency during the current biennium (in dollars): Explain the net impact of the proposed changes to the budget of your agency/department.

This will have no impact on revenues or expenditures. 0

N/A

14.  Identify the appropriation (by line item etc.) that authorizes each expenditure necessitated by the proposed rule:

N/A

15.  Provide a summary of the estimated cost of compliance with the rule to all directly affected persons. When appropriate, please include the source for your information/estimated costs, e.g. industry, CFR, internal/agency:

N/A

16.  Does this rule have a fiscal effect on school districts, counties, townships, or

municipal corporations? No

17.  Does this rule deal with environmental protection or contain a component dealing with environmental protection as defined in R. C. 121.39? No