§ 31A-29-117. Premium rates.

(1)

(a) Premium charges for coverage under the pool may not be unreasonable in relation to:

(i) the benefits provided;

(ii) the risk experience; and

(iii) the reasonable expenses provided in the coverage.

(b) Separate schedules of premium rates based on age and other appropriate demographic characteristics may apply for individual risks.

(2) Small employer carriers, as defined in Section 31A-30-103, shall annually inform the commissioner by February 1 of the carrier's:

(a) small employer index premium rates as of January 1 of the current and preceding year; and

(b) average percentage change in the index premium rate as of January 1, of the current and preceding year.

(3)

(a) Premium rates may be adjusted by the board on a biannual basis, for an effective date of January 1 and July 1.

(b) In adjusting premium rates, the board shall:

(i) consider the average increase in small employer index rates for the five largest small employer carriers submitted under Subsection (2); and

(ii) be subject to Subsection (1).

(4) The board may establish a premium scale based on income. The highest rate may not exceed the expected claims and expenses for the individual.

(5) If an individual is HIPAA eligible, the maximum premium rate for that individual may not exceed the amount permitted under HIPAA.

(6) All rates and rate schedules shall be submitted by the board to the commissioner for approval.

Amended by Chapter 40, 2007 General Session