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Pennsylvania Statutes Title 40 P.S. Insurance § 981-7. Excessive loss provision

Current as of January 01, 2022 | Updated by FindLaw Staff

(a) At any time, the designated insurer may file for a rate adjustment for products offered under section 1005-A with the commissioner in accordance with the act of December 18, 1996 (P.L. 1066, No. 159),  1 known as the “Accident and Health Filing Reform Act.”

(b) The designated insurer may request that the commissioner conduct a hearing if:

(1) the losses experienced by the designated insurer on products offered under section 1005-A(a)(1)  2 or by eligible individuals under section 1005-A(a)(2) require a rate increase of greater than twenty per centum (20%) and the losses are in excess of a one hundred ten per centum (110%) medical loss ratio for any calendar year; or

(2) the designated insurer requested a rate increase for products under section 1005-A(a) and has reason to believe that continuation as a designated insurer will have a detrimental impact on its financial condition or solvency.

(c) Upon the request of a designated insurer under subsection (b), the commissioner shall conduct a public hearing regarding the rate filing, medical loss ratio or the impact that being a designated insurer is having on the designated insurer's solvency. The hearing shall be held as provided for in 2 Pa.C.S. Ch. 5 Subch. A (relating to practice and procedure of Commonwealth agencies). Following the hearing, the commissioner shall determine the extent of the impact, if any, of being a designated insurer under this article on the designated insurer's rate filing, medical loss ratio, overall operations and solvency, and shall do one or more of the following:

(1) grant, modify or deny the requested rate filing; or

(2) request to withdraw from the approved alternative mechanism and to authorize implementation of the Federal default standards set forth in section 2741 of the Federal act.

1 40 P.S. § 3801.101 et seq.
2 40 P.S. § 981-5(a)(1).
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Cite this article: FindLaw.com - Pennsylvania Statutes Title 40 P.S. Insurance § 981-7. Excessive loss provision - last updated January 01, 2022 | https://codes.findlaw.com/pa/title-40-ps-insurance/pa-st-sect-40-981-7/

Read this complete Pennsylvania Statutes Title 40 P.S. Insurance § 981-7. Excessive loss provision on Westlaw

FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.

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