69O-149.205: Indemnity Standard Risk Rate
PURPOSE AND EFFECT: To comply with the statutory mandates of Section 627.6675(3), F.S., relating to the creation of standard risk rates.
SUMMARY: The Office is required by Section 627.6675(3)(c), F.S., to conduct an annual survey of the individual market (as contrasted with the group market) and determine “standard risk rates”. These standard risk rates are the average rates charged in the individual market for health insurance. The standard risk rates are used by the health insurers in setting their conversion rates, because pursuant to Section 627.6675(3)(a), F.S., the maximum a health insurer can charge for a conversion policy is 200% of the standard risk rate. The annual survey is conducted for PPO/EPO, Indemnity and HMO separately.
The rates for indemnity benefit plans set out in the existing rule have been determined by the Office to be unreasonably high, due to the inclusion in the survey of an out of state company that is no longer writing insurance in this state. The Office does not regulate the rates of out of state companies. Because inclusion of this company’s rates have skewed the results of the survey, the rates in this rule amendment have been recalculated without this company’s rates. The standard risk rates for indemnity plans in this amended rule are more reasonable.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 624.308, 627.6675(3)(c) FS.
LAW IMPLEMENTED: 624.307(1), 627.6498(4), 627.6675(3), 641.3922(3) FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE,TIME AND PLACE SHOWN BELOW(IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):
DATE AND TIME: May 13, 2009, 9:30 a.m.
PLACE: 143 Larson Building, 200 East Gaines Street, Tallahassee, Florida
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 5 days before the workshop/meeting by contacting: Dan Keating, Office of Insurance Regulation; E-mail: Dan.Keating@floir.com. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Dan Keating, Office of Insurance Regulation, E-mail: Dan.Keating@floir.com
THE FULL TEXT OF THE PROPOSED RULE IS:
69O-149.205 Indemnity Standard Risk Rate.
(1) through (3) No change.
|
STANDARD HEALTH BENEFIT PLAN | |||||
|
Age |
Male |
Female |
|
County |
Area Factor |
|
0-17 |
$1,407.85 |
$1,407.85 |
|
Alachua |
0.70 |
|
18 |
$1,796.44 |
$2,599.81 |
|
Baker |
0.78 |
|
19 |
$1,796.44 |
$2,599.81 |
|
Bay |
0.80 |
|
20 |
$1,796.44 |
$2,599.81 |
|
Bradford |
0.82 |
|
21 |
$1,796.44 |
$2,599.81 |
|
Brevard |
0.93 |
|
22 |
$1,796.44 |
$2,599.81 |
|
Broward |
1.41 |
|
23 |
$1,796.44 |
$2,599.81 |
|
Calhoun |
0.75 |
|
24 |
$1,796.44 |
$2,599.81 |
|
Charlotte |
0.95 |
|
25 |
$1,796.44 |
$2,599.81 |
|
Citrus |
0.72 |
|
26 |
$1,965.21 |
$2,760.44 |
|
Clay |
0.80 |
|
27 |
$2,105.71 |
$2,915.99 |
|
Collier |
0.93 |
|
28 |
$2,219.57 |
$3,067.27 |
|
Columbia |
0.80 |
|
29 |
$2,311.89 |
$3,214.48 |
|
Dade |
1.30 |
|
30 |
$2,385.29 |
$3,358.84 |
|
De Soto |
0.74 |
|
31 |
$2,443.44 |
$3,499.75 |
|
Dixie |
0.69 |
|
32 |
$2,490.21 |
$3,639.65 |
|
Duval |
0.94 |
|
33 |
$2,528.84 |
$3,777.51 |
|
Escambia |
0.77 |
|
34 |
$2,562.39 |
$3,914.75 |
|
Flagler |
0.86 |
|
35 |
$2,581.30 |
$4,072.95 |
|
Franklin |
0.75 |
|
36 |
$2,600.42 |
$4,173.39 |
|
Gadsden |
0.75 |
|
37 |
$2,619.33 |
$4,291.12 |
|
Gilchrist |
0.75 |
|
38 |
$2,637.02 |
$4,423.90 |
|
Glades |
0.98 |
|
39 |
$2,707.98 |
$4,571.31 |
|
Gulf |
0.76 |
|
40 |
$2,809.03 |
$4,759.80 |
|
Hamilton |
0.77 |
|
41 |
$2,940.59 |
$4,927.55 |
|
Hardee |
0.80 |
|
42 |
$3,101.43 |
$5,100.79 |
|
Hendry |
0.97 |
|
43 |
$3,297.44 |
$5,260.81 |
|
Hernando |
0.85 |
|
44 |
$3,516.83 |
$5,434.66 |
|
Highlands |
0.71 |
|
45 |
$3,749.65 |
$5,605.46 |
|
Hillsborough |
0.82 |
|
46 |
$3,985.51 |
$5,774.43 |
|
Holmes |
0.75 |
|
47 |
$4,217.72 |
$5,925.51 |
|
Indian River |
0.92 |
|
48 |
$4,327.72 |
$5,976.75 |
|
Jackson |
0.77 |
|
49 |
$4,484.69 |
$6,040.80 |
|
Jefferson |
0.75 |
|
50 |
$4,687.01 |
$6,149.58 |
|
Lafayette |
0.78 |
|
51 |
$4,933.86 |
$6,225.42 |
|
Lake |
0.90 |
|
52 |
$5,219.74 |
$6,299.43 |
|
Lee |
0.97 |
|
53 |
$5,426.53 |
$6,311.43 |
|
Leon |
0.79 |
|
54 |
$5,720.55 |
$6,336.64 |
|
Levy |
0.80 |
|
55 |
$6,090.61 |
$6,370.19 |
|
Liberty |
0.75 |
|
56 |
$6,517.61 |
$6,440.55 |
|
Madison |
0.79 |
|
57 |
$6,973.07 |
$6,541.60 |
|
Manatee |
0.91 |
|
58 |
$7,420.81 |
$6,678.85 |
|
Marion |
0.77 |
|
59 |
$7,820.77 |
$6,853.51 |
|
Martin |
0.94 |
|
60 |
$8,133.69 |
$7,038.14 |
|
Monroe |
1.30 |
|
61 |
$8,327.27 |
$7,276.65 |
|
Nassau |
0.85 |
|
62 |
$8,372.81 |
$7,528.98 |
|
Okaloosa |
0.76 |
|
63 |
$8,372.81 |
$7,769.53 |
|
Okeechobee |
0.97 |
|
64 |
$8,372.81 |
$7,960.46 |
|
Orange |
0.90 |
|
65 |
$8,372.81 |
$7,960.46 |
|
Osceola |
0.91 |
|
66 |
$8,372.81 |
$7,960.46 |
|
Palm Beach |
1.00 |
|
67 |
$8,372.81 |
$7,960.46 |
|
Pasco |
0.90 |
|
68 |
$8,372.81 |
$7,960.46 |
|
Pinellas |
0.87 |
|
69 |
$8,372.81 |
$7,960.46 |
|
Polk |
0.84 |
|
70 |
$8,372.81 |
$7,960.46 |
|
Putnam |
0.81 |
|
71 |
$8,372.81 |
$7,960.46 |
|
St. Johns |
0.77 |
|
72 |
$8,372.81 |
$7,960.46 |
|
St. Lucie |
0.99 |
|
73 |
$8,372.81 |
$7,960.46 |
|
Santa Rosa |
0.77 |
|
74 |
$8,372.81 |
$7,960.46 |
|
Sarasota |
0.76 |
|
75 |
$8,372.81 |
$7,960.46 |
|
Seminole |
0.92 |
|
76 |
$8,372.81 |
$7,960.46 |
|
Sumter |
0.81 |
|
77 |
$8,372.81 |
$7,960.46 |
|
Suwannee |
0.82 |
|
78 |
$8,372.81 |
$7,960.46 |
|
Taylor |
0.79 |
|
79 |
$8,372.81 |
$7,960.46 |
|
Union |
0.79 |
|
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Volusia |
0.92 |
|
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Wakulla |
0.75 |
|
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|
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Walton |
0.76 |
|
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Washington |
0.76 |
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Rulemaking Specific Authority 624.308, 627.6675(3)(c) FS. Law Implemented 624.307(1), 627.6498(4), 627.6675(3), 641.3922(3) FS. History–New 3-2-00, Amended 4-2-01, 4-17-02, 1-20-03, Formerly 4-149.205, Amended 5-18-04, 5-22-05, 6-1-06, 8-23-07, 10-29-08,________.