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
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
27-8-15-3. "Actuarial Certification"
27-8-15-4. "Base Premium Rate"
27-8-15-5. "Benefit Design Characteristics"
27-8-15-6. "Case Characteristics"
27-8-15-8.5. "Eligible Employee"
27-8-15-9. "Health Insurance Plan"
27-8-15-12. "New Business Premium Rate"
27-8-15-15. "Small Employer Insurer"
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
27-8-15-26. 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
27-8-15-31.1. Continuing Coverage
27-8-15-34.1. All Products Required to Be Offered; All Employers Required to Be Accepted