Rule 20:06:13:22.01 Filing of premium adjustments after Medicare benefit change.
20:06:13:22.01. Filing of premium adjustments after Medicare
benefit change. As soon as practicable, but prior to the effective date of
enhancements in Medicare benefits, each issuer of Medicare supplement policies
or certificates in this state shall file the following with the director, in
accordance with the applicable provisions of SDCL 58-17A-4, 58-17-4.1, 58-17-4.2, ARSD chapter 20:06:22, and this chapter:
(1) The premium adjustments
necessary to produce loss ratios as anticipated for the current premium for the
applicable policies or certificates. Supporting documents necessary to justify
the adjustment must accompany the filing.
An issuer shall make the premium
adjustments necessary to produce an expected loss ratio under the policy or
certificate that will conform with minimum loss ratio standards for Medicare
supplement policies in § 20:06:13:21 and which are expected to result in a
loss ratio at least as great as that originally anticipated in the rates used
to produce current premiums by the issuer for the Medicare supplement policies
or certificates. No premium adjustment which would modify the loss ratio
experience under the policy other than the adjustments described in this
section may be made to a policy at any time other than upon its renewal date or
If an issuer fails to make premium
adjustments acceptable to the director, the director may order premium
adjustments, refunds, or premium credits considered necessary to achieve the
loss ratio required by this section;
(2) Any riders,
endorsements, or policy forms needed to accomplish the Medicare supplement
policy or certificate modifications necessary to eliminate benefit duplications
with Medicare. The riders, endorsements, or policy forms must provide a clear
description of the Medicare supplement benefits provided by the policy or
15 SDR 143, effective March 29, 1989; 16 SDR 174, effective May 2, 1990; 18 SDR
225, effective July 17, 1992.
Authority: SDCL 58-4-1, 58-17A-2.
Implemented: SDCL 58-17A-2.
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