Rating Requirements

01. Enhanced Short-term Plans. In addition to the requirements applicable to individual health benefit plans, the following rating requirements apply: (3-31-22) a. Premium rates do not vary by gender. (3-31-22) b. Geographic rating areas are identical to those used for Exchange-offered QHPs. (3-31-22) c. Medical underwriting criteria may be used to ascertain the risk characteristics of an applicant, if the criteria are limited to those in the Universal Health Statement Addendum and available claims data. (3-31-22) d. The rating period is on a calendar year basis, whereby the rates filed apply to all enrollees uniformly during a given calendar year and premium rate changes occur at the start of a new calendar year. (3-31-22) 02. Nonrenewable Short-term Coverage. The following rating requirements apply: (3-31-22) a. The rates cannot utilize case characteristics other than age, individual tobacco use, and geography but may vary by the duration of coverage requested. (3-31-22) b. Case characteristics are applied uniformly, without regard to the risk characteristics of an eligible individual. (3-31-22) c. The premium rate is not affected by an applicant’s risk characteristics or health status. (3-31-22) d. The premium rate remains the same for the duration of the policy. (3-31-22) 023. -- 029. (RESERVED)