Louisiana Revised Statutes 22:1098 – Frequency of rate increases; limitations
Terms Used In Louisiana Revised Statutes 22:1098
- health insurance coverage: means services consisting of medical care, provided directly, through insurance or reimbursement, or otherwise, and including items and services paid for as medical care under any hospital or medical service policy or certificate, hospital or medical service plan contract, preferred provider organization, or health maintenance organization contract offered by a health insurance issuer. See Louisiana Revised Statutes 22:1091
- Health insurance issuer: means any entity that offers health insurance coverage through a policy, certificate of insurance, or subscriber agreement subject to state law that regulates the business of insurance. See Louisiana Revised Statutes 22:1091
- Individual market: means the market for health insurance coverage offered to individuals other than in connection with a group health plan. See Louisiana Revised Statutes 22:1091
- person: includes a body of persons, whether incorporated or not. See Louisiana Revised Statutes 1:10
- rate increase: includes a premium volume-weighted average increase for all insureds for the aggregate rate changes during the twelve-month period preceding the proposed rate increase effective date. See Louisiana Revised Statutes 22:1091
A. The following rate increase limitations shall apply to all health benefit plans, limited benefits, and excepted benefits:
(1) Health insurance issuers of limited benefits and excepted benefits policies shall not increase rates during the initial twelve months of coverage, and may not do so more than once in any six-month period following the initial twelve-month period.
(2) Health insurance issuers shall not increase rates for policies or plans in the individual market during the plan year. Rate increases for policies or plans in the individual market may occur only upon renewal or upon commencement of the policy or plan year.
(3) Rates for policies or plans in the small group market shall not increase during the initial twelve months of coverage.
B. No health insurance issuer issuing policies or subscriber agreements shall increase its rates or reduce the covered benefits under the policy or subscriber agreement after the commencement of the minimum one-hundred-eighty-day period following the notice of the discontinuation of offering all health insurance coverage as described in La. Rev. Stat. 22:1068(C)(2)(a)(i) or 1074(C)(2)(a)(i).
C. This Section shall not affect increases in the premium amount due to any change required for compliance with the addition of a newly covered person or policy benefit level, or such changes necessary to comply with La. Rev. Stat. 22:1095 or other state or federal law, regulation, or rule.
Acts 2014, No. 718, §1, eff. June 18, 2014.