Medicare Supplement Insurance Policies and Premium Rates
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Governs filing requirements for Medicare Supplement insurance policy forms and annual premium rate submissions to the Hawaii Insurance Division; affects issuers of Medicare Supplement policies and certificates in Hawaii.
No material clinical or coverage changes in this revision.
Filing and Loss Ratio Requirements
Filing and loss ratio criteria
Filing and benefit-return requirements for Medicare Supplement policy forms and annual premium rate submissions:
ALL of the following
ALL of the following
- The issuer must file Medicare Supplement insurance forms with the Insurance Division accompanied by a certification that the forms meet the Division's Medicare Supplement Insurance Minimum Standards Rules and all applicable Hawaii laws (including, but not limited to, Sections 431:10A-101 to 431:10A-131 and 431:10A-301 to 431:10A-312, HRS).
ALL of the following
- Issuers must file premium rates, rating schedules, and supporting documentation on an annual basis.
- All annual filings must include a certification by a qualified actuary demonstrating conformity with the loss ratio standards established by Section 16-12-7 of the Rules.
ALL of the following
- ONE of: Group policies expected to return at least 75% of aggregate premiums as aggregate benefits (not including anticipated refunds or credits).
- ONE of: Individual policies expected to return at least 65% of aggregate premiums as aggregate benefits (not including anticipated refunds or credits).
ALL of the following
- Group policies issued as a result of solicitations of individuals through the mails or by mass media advertising (including both print and broadcast) shall, for purposes of applying the loss ratio provisions, be deemed to be group policies.
Loss Ratio Minimums
Filing and Certification Obligations for Issuers
Filing and certification requirements
Issuers must submit any Medicare Supplement insurance forms filed with the Insurance Division accompanied by a certification that the forms meet the Division’s Medicare Supplement Insurance Minimum Standards Rules and all applicable Hawaii laws; premium rates, rating schedules, and supporting documentation must be filed annually and must include a certification by a qualified actuary demonstrating compliance with the loss ratio standards in Section 16-12-7 of the Rules.
- Certification must state forms meet Medicare Supplement Minimum Standards Rules and applicable Hawaii statutes (including sections cited in source).
- Premium rates, rating schedules, and supporting documentation must be filed annually.
- All filings must include a qualified actuary certification per the loss ratio standards in Section 16-12-7.
Loss Ratio and Actuary Certification Definitions
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