Texas Statutes
Subchapter E. Underwriting and Rating of Small Employer Health Benefit Plans
Section 1501.206. Premium Rates: Adjustments

Sec. 1501.206. PREMIUM RATES: ADJUSTMENTS. (a) The percentage increase in the premium rate charged to a small employer for a new rating period may not exceed the sum of:
(1) the percentage change in the new business premium rate, measured from the first day of the preceding rating period to the first day of the new rating period;
(2) any adjustment, not to exceed 15 percent annually and adjusted pro rata for a rating period of less than one year, due to the claims experience, health status, or duration of coverage of the employees or dependents of employees of the small employer, as determined under the small employer health benefit plan issuer's rate manual for the class of business; and
(3) any adjustment due to change in coverage or change in the case characteristics of the small employer, as determined under the issuer's rate manual for the class of business.
(b) An adjustment in the premium rate for claims experience, health status, or duration of coverage:
(1) may not be charged to individual employees or dependents; and
(2) must be applied uniformly to the rates charged for all employees and dependents of employees of the small employer.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

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