(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.
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