304.17B-013 Premium rates for health benefit plans under Kentucky Access. (1) The schedule of rates, premium rates charged to enrollees, deductible amounts, copayment amounts, coinsurance amounts, and other cost-sharing amounts shall be established by the Office of Health Data and Analytics. Premium rates charged to enrollees are not intended to fully cover the cost of providing health care coverage to Kentucky Access enrollees, and any claims in excess of premium rates shall be covered by the Kentucky Access fund. (2) Premium rates for health benefit plans provided under Kentucky Access shall bear a reasonable relationship to each other. Premium rates shall be varied based on age and gender. The initial premium rates for plan coverage shall not exceed one hundred fifty percent (150%) of the applicable individual standard risk rates, as established by the department. In no event shall premium rates exceed one hundred seventy-five percent (175%) of the rates applicable to individual standard risks. (3) Premium rates for coverage issued by Kentucky Access shall be established annually by the office, using reasonable actuarial principles, and shall reflect anticipated experience and expenses for risks under Kentucky Access. Effective: June 27, 2019 History: Amended 2019 Ky. Acts ch. 90, sec. 17, effective June 27, 2019. -- Amended 2010 Ky. Acts ch. 24, sec. 1279, effective July 15, 2010. -- Created 2000 Ky. Acts ch. 476, sec. 7, effective July 14, 2000.
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