Section 230-RICR-20-30-15.7 - Commissioner's Review and Decision - Rates, Rating Formulas, and Rate ManualsA. The provisions of § 15.7 of this Part apply to rates, rating formulas, and rate manuals filed under §§ 15.5 and 15.6 of this Part.B. The Commissioner shall review the rate, rating formula, or rate manual filing and approve the filing, propose to the health insurance issuer how the filing can amended and approved, notice an administrative hearing, or take such other actions separately or in combination as the Commissioner deems appropriate and as authorized by law. 1. If the Commissioner proposes amendments to the filing, the health insurance issuer shall be provided with an opportunity to amend its filing in conformity with the proposed amendments. If the health insurance issuer amends its filing in conformity with the proposed amendments, the Commissioner shall approve the filing.2. If the health insurance issuer does not amend its filing within the time period prescribed by the Commissioner, the Commissioner shall notice an administrative hearing on the filing.3. Notwithstanding the foregoing, after the Commissioner has determined a filing to be complete in connection with an individual health insurance plan rate, rating formula, or rate manual filing of a hospital or medical services corporation, including a rate, rating formula, or rate manual of a hospital or medical services corporation filed in connection with a qualified health plan, the Commissioner shall conduct an administrative hearing.C. Administrative hearings shall be conducted in accordance with R.I. Gen. Laws Chapter 42-35, R.I. Gen. Laws §§ 27-19-6, 27-20-6, 42-62-13, and any orders as to the conduct of the hearing issued by the Commissioner, or the Commissioner's designee.D. The Commissioner may approve, disapprove, or modify the rates, rating formula, or rating manual filed by the Issuer. A health insurance rate, rating formula, or rate manual shall not be approved unless the Commissioner determines that the health insurance issuer has demonstrated to the satisfaction of the Commissioner that it is consistent with the proper conduct of the business of the issuer, and consistent with the interests of the public. A health insurance rate, rating formula, or rate manual shall not be considered consistent with the proper conduct of the business of the issuer, and consistent with the interests of the public unless it is also consistent with the legislative purposes of the Office of the Health Insurance Commissioner under R.I. Gen. Laws § 42-14.5-2, and any regulations adopted by the Commissioner to carry out such legislative purposes. A rate, rating formula, or rate manual also shall not be considered to be consistent with the public interest if it fails to comply with the Commissioner's filing instructions.E. In connection with the Commissioner's approval of a health insurance plan rate, rating formula or rate manual, the Commissioner may attach to the decision such conditions as the Commissioner determines are necessary for the rate, rating formula, or rate manual to be consistent with the proper conduct of the issuer's business, consistent with the public interest, and consistent with the requirements of the laws and regulations applicable to health insurance rates, rating formulas, and rate manuals. Such conditions may include issues obligations relating to: 1. Affordability standards adopted by the Commissioner, including hospital contracting conditions adopted by the Commissioner;2. Issuer participation in a risk adjustment program or a reinsurance program administered by the Office in connection with health insurance plans;3. In connection with qualified health plans, compliance with the federal requirement concerning non-variability of premiums by geographic area; and4. Any other necessary and proper condition.F. A health insurance issuer may appeal the final decision of the Commissioner in accordance with R.I. Gen. Laws § 42-35-15.230 R.I. Code R. 230-RICR-20-30-15.7