HOUSE AMENDMENT
Bill No. HB 1439 Barcode 895715
Amendment No. 3 (for drafter's use only)
CHAMBER ACTION
Senate House
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5 ORIGINAL STAMP BELOW
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11 The Committee on Health Promotion offered the following:
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13 Amendment
14 On page 5, line 28, through page 7, line 28,
15 remove: all of said lines
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17 and insert in lieu thereof:
18 4. Results in actuarially justified rate increases on
19 an annual basis:
20 a. Attributed to the insurer reducing the portion of
21 the premium used to pay claims from the loss ratio standard
22 certified in the last actuarial certification filed by the
23 insurer, in excess of the greater of 50 percent of annual
24 medical trend or 5 percent. At its option, the insurer may
25 file for approval of an actuarially justified new business
26 rate schedule for new insureds and a rate increase for
27 existing insureds that is equal to the rate increase which
28 equals the greater of 150 percent of annual medical trend or
29 10 percent. Future annual rate increases for existing insureds
30 shall be limited to the greater of 150 percent of the rate
31 increase approved for new insureds or 10 percent until the two
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File original & 9 copies 03/29/01
hci0001 04:59 pm 01439-hp -895715
HOUSE AMENDMENT
Bill No. HB 1439 Barcode 895715
Amendment No. 3 (for drafter's use only)
1 rate schedules converge;
2 b. In excess of the greater of 150 percent of annual
3 medical trend or 10 percent and the company did not comply
4 with the annual filing requirements of s. 627.410(7) or
5 department rule for health maintenance organizations pursuant
6 to s. 641.31. At its option the insurer may file for approval
7 of an actuarially justified new business rate schedule for new
8 insureds and a rate increase for existing insureds that is
9 equal to the rate increase allowed by the preceding sentence.
10 Future annual rate increases for existing insureds shall be
11 limited to the greater of 150 percent of the rate increase
12 approved for new insureds or 10 percent until the two rate
13 schedules converge; or
14 c. In excess of the greater of 150 percent of annual
15 medical trend or 10 percent on a form or block of pooled forms
16 in which no form is currently available for sale.
17 (f) Excludes coverage for human immunodeficiency virus
18 infection or acquired immune deficiency syndrome or contains
19 limitations in the benefits payable, or in the terms or
20 conditions of such contract, for human immunodeficiency virus
21 infection or acquired immune deficiency syndrome which are
22 different than those which apply to any other sickness or
23 medical condition.
24 (2) In determining whether the benefits are reasonable
25 in relation to the premium charged, the department, in
26 accordance with reasonable actuarial techniques, shall
27 consider:
28 (a) Past loss experience and prospective loss
29 experience within and without this state.
30 (b) Allocation of expenses.
31 (c) Risk and contingency margins, along with
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File original & 9 copies 03/29/01
hci0001 04:59 pm 01439-hp -895715
HOUSE AMENDMENT
Bill No. HB 1439 Barcode 895715
Amendment No. 3 (for drafter's use only)
1 justification of such margins.
2 (d) Acquisition costs.
3 (3) If a health insurance rate filing changes the
4 established rate relationships between insureds, the aggregate
5 effect of such change shall be revenue neutral. The change to
6 the new relationship shall be phased in over a period not to
7 exceed 3 years as approved by the department. The rate filing
8 may also include increases based on overall experience or
9 annual medical trend, or both, which portions shall not be
10 phased in over any period.
11 (4) In determining medical trend for application of
12 subparagraph (1)(e)4., the department shall
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File original & 9 copies 03/29/01
hci0001 04:59 pm 01439-hp -895715