D.C. Mun. Regs. tit. 26, r. 26-A2213

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 26-A2213 - REFUND OR CREDIT OF PREMIUM

2213.1

An issuer shall collect and file with the Commissioner by May 31 of each year the data contained in the reporting form contained in Appendix A for each type in a Standard Medicare Supplement Benefit Plan, described in section 2208.

2213.2

If on the basis of the experience as reported the benchmark loss ratio since inception (ratio 1) exceeds the adjusted experience loss ratio since inception (ratio 3), then a refund or credit calculation is required.

(a) The refund calculation shall be done on a District-wide basis for each type in a standard Medicare supplement benefit plan.

(b) For purposes of the refund or credit calculation, experience on policies issued within the reporting year shall be excluded.

(c) For purposes of this section, with regard to policies or certificates issued prior to July 22, 1992 the issuer shall make the refund or credit calculation separately for all individual policies (including all group policies subject to an individual loss ratio standard when issued) combined, and all group policies combined for experience after May 1, 1999. The first such report shall be due by May 31, 2001.

2213.4

A refund or credit shall be made only when:

(a) The benchmark loss ratio exceeds the adjusted experience loss ratio; and

(b) The amount to be refunded or credited exceeds a de minimis level.

2213.5

The refund or credit described in subsection 2213.4 shall include interest from the end of the calendar year to the date of the refund or credit at a rate specified by the Secretary, but in no event shall it be less than the average rate of interest of thirteen (13) week Treasury notes.

2213.6

A refund or credit against premiums due shall be made by September 30 following the experience year upon which the refund or credit is based.

D.C. Mun. Regs. tit. 26, r. 26-A2213

Final Rulemaking published at 46 DCR 10175 (December 17, 1999); as amended by Final Rulemaking published at 50 DCR 4166 (May 30, 2003); as amended by Final Rulemaking published at 50 DCR 5882 (July 25, 2003); as amended by Final Rulemaking published at 53 DCR 2955(April 14, 2006)