Form 440-4872 - Standards For Filing Individual And Small Group Health Benefit Plan Rates - Oregon Department Of Consumer And Business Service Page 13
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14GENERAL REQUIREMENTS FOR ALL SMALL GROUP AND INDIVIDUAL HBP RATE FILINGS
Category
Reference
Description of review standards requirements
Answers
Page #
This exhibit should be identical between the plan filing and the rate
filing.
The plan name,
issuer plan identification number,
metal level or catastrophic plan,
List of Geographic areas that plan will be offered (1-7)
whether the plan will be sold:
o inside the Exchange only, (in)
o outside the Exchange only. (out)
o both inside and outside the Exchange, or (both)
Whether or not pediatric dental is embedded (yes/no)
INSURER’S
A document labeled INSURER’S FINANCIAL POSITION that includes:
OAR 836-053-
Yes
N/A
Information about the company’s financial position including but not
FINANCIAL
0473 (2)(j)
POSITION
limited to profitability, surplus, reserves, and investment earnings
Discussion of whether the proposed change in the premium rate is
(Appendix I)
necessary to maintain the company’s solvency or to maintain rate
stability and prevent excessive rate increases for the line of business
in the future
Although public documents filed with the department as part of the
annual statement or other requisite filings may be referenced in this
item, information about the company’s profitability, surplus, reserves,
and investment earnings must still be included in the Insurer’s
Financial Position document; if such references are made, include
copies of the supporting documents with this filing
The last 5 years of RBC and a statement regarding the need for
surplus
COST
OAR 836-053-
A document labeled COST CONTAINMENT AND QUALITY IMPROVEMENT
Yes
N/A
CONTAINMENT
EFFORTS that:
0473 (2)(k)
AND QUALITY
Identifies new health care cost containment efforts and quality
IMPROVEMENT
improvement efforts since the last rate filing for the same category of
EFFORTS
health benefit plan, with estimated savings for the projection period
Describes significant changes to existing health care cost containment
(Appendix II)
initiatives and quality improvement efforts, with estimated savings for
the projection period, savings realized over the prior experience
period, and a description of how the company is measuring the impact
of its initiatives
440-4872 (4/4/13 INS)
13
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