CHAPTER 420-O SELF-FUNDED STUDENT HEALTH BENEFIT PLANS
Section 420-O:4
420-O:4 Minimum Loss Ratio; Reporting. –
I. A plan under this chapter shall have an expected loss ratio of not less than 85 percent. In reviewing a rate filing or application by a plan, the commissioner may modify the expected minimum loss ratio requirement if the commissioner determines the modification to be in the interests of the people of this state or if the commissioner determines that a modification is necessary to maintain plan solvency.
II. No later than 120 days after the close of a plan's fiscal year, a plan shall annually report the actual loss ratio for the previous plan fiscal year in a format acceptable to the commissioner. If the expected loss ratio is not met, the commissioner may direct the plan to take corrective action. Mandatory uniform student administrative health fees paid by the students irrespective of whether the student is a plan member to an institution shall not be deemed to be included in the premiums paid by students for health benefit coverage under a plan.