(a) The Commissioner may, at any time, require any insurer subject to this chapter to demonstrate that its rates and method for setting rates are in compliance with this chapter, notwithstanding that the filings then in effect had previously been approved. Any rates previously approved by the Commissioner, but subsequently disapproved under this chapter, shall be considered disapproved on a prospective basis only from the date of the notice of disapproval, unless the insurer made a material misrepresentation in its contract form or rate filings, in which case the rates shall be deemed disapproved on a retroactive basis.
(b) If, at any time subsequent to the approval of rates, the Commissioner finds that a filing does not meet the requirements of this chapter, the Commissioner shall issue an order to the insurer specifying why the filing fails to meet the requirements of this chapter, and, stating when, within a reasonable period thereafter, the filing shall be no longer effective. The order shall not affect any subscriber contract, group certificate, or other contract made or issued prior to the expiration of the period set forth in the order. The Commissioner may, prior to issuing the order and if requested by the insurer, hold a hearing upon not less than 10 business days’ written notice to the insurer specifying the matters to be considered at the hearing.
(c) For violations of this chapter, the Commissioner may order any relief which is appropriate, including disapproving a rate and awarding interest.
(Apr. 8, 2011, D.C. Law 18-360, § 106, 58 DCR 896; Sept. 26, 2012, D.C. Law 19-171, § 85(b), 59 DCR 6190.)
The 2012 amendment by D.C. Law 19-171 substituted “this title” for “this act” [translated as “this chapter”] in (b).
This act, referred to in subsec. (b), is D.C. Law 18-360, the Reasonable Health Insurance Ratemaking and Health Care Reform Act of 2010.
Structure District of Columbia Code
Title 31 - Insurance and Securities
Chapter 33A - Health Insurance Ratemaking
§ 31–3311.01. Ratemaking principles and standards
§ 31–3311.02. Aggregate medical loss ratios; dividend; and rating bands
§ 31–3311.03. Loss ratio disclosure
§ 31–3311.03a. Essential health benefits
§ 31–3311.03b. Underwriting ratemaking criteria
§ 31–3311.04. Annual rate filing requirement
§ 31–3311.05. Commissioner’s authority to rescind approved rates