Indiana Code
Chapter 15. Small Employer Group Health Insurance
27-8-15-16. Premium Rates

Sec. 16. Premium rates for a health insurance plan are subject to the following:
(1) For all small employer business, the premium rates charged during a rating period to small employers with similar case characteristics for the same or similar benefit design characteristics, or the rates that could be charged to small employers under the rating system may not vary from the midpoint rate by more than thirty-five percent (35%) above or below the midpoint rate.
(2) The percentage increase in the premium rate charged to a small employer for a new rating period may not exceed the sum of the following:
(A) The percentage change in the new business premium rate for a plan with the same or similar benefit design characteristics measured from the first day of the prior rating period to the first day of the new rating period. For a plan for which the small employer insurer is not issuing new policies, the insurer shall use the percentage change in the base premium rate.
(B) An adjustment, not to exceed fifteen percent (15%) annually and adjusted pro rata for rating periods of less than one (1) year, due to the claim experience, health status, or duration of coverage of the employees or dependents of the small employer.
(C) Any adjustment due to change in benefit design characteristics or change in the case characteristics of the small employer.
(3) For health insurance plans issued before July 1, 1992, a premium rate for a rating period may exceed the ranges described in subdivisions (1) and (2) for five (5) years following July 1, 1992. The percentage increase in the premium rate charged to a small employer in such a class of business for a new rating period may not exceed the sum of the following:
(A) The percentage change in the new business premium rate measured from the first day of the prior rating period to the first day of the new rating period. For a plan for which the small employer insurer is not issuing new policies, the insurer shall use the percentage change in the base premium rate.
(B) Any adjustment due to change in benefit design characteristics or change in the case characteristics of the small employer.
As added by P.L.127-1992, SEC.1.

Structure Indiana Code

Indiana Code

Title 27. Insurance

Article 8. Life, Accident, and Health

Chapter 15. Small Employer Group Health Insurance

27-8-15-0.1. Application of Certain Amendments to Chapter

27-8-15-1. Application of Chapter

27-8-15-2. Repealed

27-8-15-3. "Actuarial Certification"

27-8-15-4. "Base Premium Rate"

27-8-15-5. "Benefit Design Characteristics"

27-8-15-6. "Case Characteristics"

27-8-15-7. "Commissioner"

27-8-15-8. "Department"

27-8-15-8.5. "Eligible Employee"

27-8-15-9. "Health Insurance Plan"

27-8-15-10. "Insurer"

27-8-15-10.5. "Late Enrollee"

27-8-15-11. "Midpoint Rate"

27-8-15-12. "New Business Premium Rate"

27-8-15-13. "Rating Period"

27-8-15-14. "Small Employer"

27-8-15-15. "Small Employer Insurer"

27-8-15-16. Premium Rates

27-8-15-17. Rating Factors

27-8-15-18. Offer to Transfer

27-8-15-19. Cancellation or Refusal of Renewal of Plans

27-8-15-20. Renewal Cessation; Notice

27-8-15-21. Renewal Cessation; Prohibitions

27-8-15-22. Disclosure of Premium Rate Changes

27-8-15-23. Maintenance of Rating and Renewal Practice Information and Documentation

27-8-15-24. Maintenance of Actuarial Certification; Submission to Department

27-8-15-25. Availability of Information and Documentation to Commissioner; Disclosure by Commissioner

27-8-15-26. Suspension of Premium Rate Provisions

27-8-15-27. Application in Conformity With Act; Compliance

27-8-15-28. Waiver of Exclusion and Limitation Period

27-8-15-29. Application in Conformity With Act; Exclusion of Coverage

27-8-15-30. Plan Modifications Prohibited

27-8-15-31. Conversion Policy

27-8-15-31.1. Continuing Coverage

27-8-15-32. Employees Becoming Eligible After Employer's Commencement of Health Insurance Plan Entitled to Coverage

27-8-15-33. Mandatory Coverage by Employer Insurer to All Employer's Eligible Employees and Employees' Dependents; Employees Declining Coverage; Minimum Participation and Contribution Requirements

27-8-15-34. Repealed

27-8-15-34.1. All Products Required to Be Offered; All Employers Required to Be Accepted