any enrollee.
(2) Annual limits on the dollar value of benefits for
any participant or beneficiary.
§ 9605. Dependent coverage.
An insurer that offers a health insurance policy through the
exchange that provides dependent coverage of children shall
continue to make the coverage available for an adult child until
the child turns 26 years of age. Nothing in this section shall
require an insurer to make coverage available for a child of a
child receiving dependent coverage.
§ 9606. Premiums.
(a) Premium revenue.--The ratio of the amount of premium
revenue expended by the insurer on reimbursement for clinical
services provided to enrollees under a health care plan and for
activities that improve health care quality to the total amount
of premium revenue for the plan year may not be less than 80%.
(b) Duties of department.--The department shall:
(1) Establish a process for the annual review of
unreasonable increases in premiums for health insurance
coverage. The process shall require an insurer to submit to
the department a justification for an unreasonable premium
increase prior to the implementation of the increase. The
insurer shall prominently post the premium increase
information on the insurer's publicly accessible Internet
website.
(2) Ensure the public disclosure of information on
premium increases and justifications for all insurers.
(3) Consider whether particular insurers should be
excluded from participation in the exchange based on a
pattern or practice of excessive or unjustified premium
20200HB2434PN3648 - 3 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30