Montana Code 33-16-1021. Ratemaking standards — review by commissioner
33-16-1021. Ratemaking standards — review by commissioner. (1) Rates may not be excessive, inadequate, or unfairly discriminatory.
Terms Used In Montana Code 33-16-1021
- Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
- Contingencies: means provisions in rates to recognize the uncertainty of the estimates of losses, loss adjustment expenses, other operating expenses, and investment income and profit that comprise those rates. See Montana Code 33-16-1008
- Developed losses: means adjusted losses, including loss adjustment expenses, using accepted actuarial standards to eliminate the effect of differences between current payment or reserve estimates and those needed to provide actual ultimate loss payments, including loss adjustment expense payments. See Montana Code 33-16-1008
- Expenses: means the portion of a rate that is attributable to acquisition, filed supervision and collection expenses, general expenses and taxes, licenses, or fees. See Montana Code 33-16-1008
- Insurer: means a person licensed to write workers' compensation insurance as a plan No. See Montana Code 33-16-1008
- Market: means the interaction in this state between buyers and plan No. See Montana Code 33-16-1008
- Prospective loss costs: means historical aggregate losses and loss adjustment expenses, including all assessments that are loss-based and excluding any separately stated policyholder surcharges, projected through development to their ultimate value and through trending to a future point in time and ascertained by accepted actuarial standards. See Montana Code 33-16-1008
- rates: means rate of premium, policy and membership fee, or any other charge made by an insurer for or in connection with a contract or policy of workers' compensation and employer's liability insurance, prior to application of individual risk variations based on loss or expense considerations. See Montana Code 33-16-1008
- State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See Montana Code 1-1-201
(2)(a) Except as provided in subsection (2)(b), rates in a competitive market are not excessive. Rates in a noncompetitive market are excessive if they are likely to produce a long-run profit that is unreasonably high in relation to services rendered.
(b)Rates for the state fund may not be determined to be excessive unless the rate clearly is likely to produce an excess of assets over what is reasonably necessary to pay developed losses, contingencies, expenses, and a reasonable level of surplus.
(3)A rate may not be determined to be inadequate unless:
(a)the rate is clearly insufficient to sustain projected losses and expenses;
(b)the rate is unreasonably low and the use of the rate by the insurer has had or, if continued, will tend to create a monopoly in the market; or
(c)funds equal to the full, ultimate cost of anticipated losses and loss adjustment expenses are not produced when prospective loss costs are applied to anticipated payrolls.
(4)Unfair discrimination exists if, after allowing for practical limitations, price differentials fail to reflect equitably the differences in expected losses and expenses. A rate is not unfairly discriminatory because different premiums result for policyholders with different loss exposures or expense levels.
(5)In determining whether rates comply with standards under subsection (1), consideration must be given to:
(a)past and prospective loss experience within and outside Montana, in accordance with accepted actuarial principles;
(b)catastrophe hazards and contingencies;
(c)past and prospective expenses within and outside Montana;
(d)loadings for leveling premium rates over time for dividends, savings, or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members, or subscribers;
(e)a reasonable margin for underwriting profit; and
(f)all other relevant factors within and outside Montana.
(6)The systems of expense provisions included in the rates for use by an insurer or group of insurers may differ from those of any other insurer or group of insurers to reflect the requirements of the operating methods of the insurer or group of insurers.
(7)The rate may contain provisions of contingencies and an allowance permitting a reasonable profit. In determining the reasonableness of a profit, consideration must be given to all investment income attributable to premiums and the reserves associated with those premiums.
(8)The commissioner may investigate and determine whether rates in Montana are excessive, inadequate, or unfairly discriminatory. In any investigation and determination, the commissioner shall also consider the factors specified in 33-16-1020.