Colorado Code § 10-4-403

Standards for rates - competition - procedure - requirement for independent actuarial opinions regarding 1991 legislation
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(1) Rates shall not be excessive,
inadequate, or unfairly discriminatory. The following rate standards shall apply:
(a) Rates are excessive if they are likely to produce a long run profit that is unreasonably
high for the insurance provided or if expenses are unreasonably high in relation to services
rendered.
(b) Concerning inadequacy, rates are not inadequate unless clearly insufficient to sustain
projected losses and expenses, or the use of such rates, if continued, will tend to create a
monopoly in the market.
(c) Concerning unfair discrimination, 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 solely if different premiums result for
policyholders with like loss exposures but different expenses, or like expenses but different loss
exposures, so long as the rate reflects the differences with reasonable accuracy. Additionally, the
provisions of section 10-3-1104 (1)(f) shall apply.
(2) (a) In determining whether rates comply with the excessiveness standard, the
inadequacy standard, and the unfair discrimination standard, the following criteria shall apply:
(I) Concerning basic factors in rates, due consideration shall be given to past and
prospective loss and expense experience, to catastrophe hazards and contingencies, to events or
trends, to loadings for leveling premium rates over time or for dividends or savings to be allowed
or returned by insurers to their policyholders, members, or subscribers, and to all other relevant
factors, including judgment;
(II) Concerning expenses, the expense provisions included in the rates to be used by an
insurer shall reflect the operating methods of the insurer and, so far as it is credible, its own
actual and anticipated expenses experience;
(III) Concerning profits, the rate shall contain provisions for contingencies and an
allowance permitting a reasonable profit. In determining the reasonableness of profit,
consideration should be given to all investment income attributable to premiums and the reserves
associated with those premiums.
(b) In setting rates, insurers shall consider past and prospective loss experience and
catastrophic hazards, if any, solely within the state of Colorado. However, if there is insufficient
experience within Colorado upon which a rate can be based, the insurer may consider
experiences within any other state or states which have a similar cost of claim and frequency of
claim experience as the state of Colorado; and, if insufficient experience is available, the insurer
may use a countrywide experience. The insurer, in its rate filing or in its records, shall expressly
state and describe what rate experience it is using, and for Colorado business other than workers'
compensation insurance, the insurer shall specify the state or states from which experiences were
drawn and the considerations used in setting the rates. In considering experience outside the state
of Colorado, as much weight as possible shall be given to the Colorado experience. The rates
shall allow a reasonable margin for profit, as allowed in subparagraph (III) of paragraph (a) of
this subsection (2), and contingencies.
(2.1) (a) In setting rates for medical malpractice insurance, rates shall not be excessive or
inadequate, as defined in this section, nor shall they be unfairly discriminatory. No rate shall be
held to be excessive unless such rate is unreasonably high for the insurance provided and a
reasonable degree of competition does not exist in the area with respect to the classification to
which such rate is applicable. No rate shall be held to be inadequate unless such rate is
unreasonably low for the insurance provided and the continued use of such rate endangers the
solvency of the insurer using the same, or unless such rate is unreasonably low for the insurance
provided and the use of rate by the insurer using the same has, or if continued will have, the
effect of destroying competition or creating a monopoly.
(b) In setting rates, medical malpractice insurers shall consider past and prospective loss
experience and catastrophic hazards, if any, solely within the state of Colorado. However, if
there is insufficient experience within Colorado upon which a rate can be based, the insurer may
consider experiences within any other state or states which have a similar cost of claim and
frequency of claim experience as the state of Colorado; and, if insufficient experience is
available, the insurer may use a nationwide experience. The insurer, in its rate filing or in its
records, shall expressly state and describe what rate experience it is using, specifying the state or
states from which experiences were drawn and the considerations used in setting the rates. In
considering experience outside the state of Colorado, as much weight as possible shall be given
to the Colorado experience. The rates shall allow a reasonable margin for profit and
contingencies, including dividends, savings, or unearned premium deposits allowed or returned
by insurers to their policyholders, members, or subscribers. In determining profits, the insurer
shall consider investment income from unearned premium reserves and reserves for incurred
losses and incurred but not reported losses.
(c) Medical malpractice insurers shall specify in their rate filings and shall consider and
support the evaluation with an analysis and opinion of a qualified property and casualty actuary,
and the commissioner as a result of such filing or upon his own motion may also consider, the
impact of the following on medical malpractice rates:
(I) Tort reform legislation;
(II) Risk management activities;
(III) Underwriting standards and practices;
(IV) Any other activity designed to reduce rates or rate increases or the cost of
administration and determination of claims.
(d) and (e) Repealed.
(2.5) Notwithstanding any provision of law to the contrary, any insurer licensed to sell
motor vehicle insurance within the state of Colorado may offer a reduction in premiums if the
claims experience subsequent to the enactment of section 42-4-237, C.R.S., so warrants.
(3) The systems of expense provisions included in the rates for use by any insurer or
group of insurers may differ from those of other insurers or groups of insurers to reflect the
requirements of the operating methods of any such insurer or group with respect to any
subdivision or combination thereof for which subdivision or combination separate expense
provisions are applicable.
(4) Risks may be grouped by classifications for the establishment of rates and minimum
premiums. Classification rates may be modified to produce rates for individual risks in
accordance with rating plans which establish standards for measuring variations in hazards or
expense provisions or both. Such standards may measure any difference among risks that can be
demonstrated to have a probable effect upon losses or expenses.
(4.6) Repealed.
(5) Under the commissioner's power to review rates of all companies, if he determines,
after a hearing and on the basis of findings of fact and conclusions, that, with respect to any
territory or to any kind, subdivision, or class of insurance, competition is either insufficient to
assure that rates will not be excessive, or so conducted as to be destructive of competition or
detrimental to the solvency of insurers, he shall order that the rates for such insurance or territory
shall be regulated as type I kinds of insurance as defined in section 10-4-401 (3)(a). Such order
shall have a specified duration of not more than one year but may be renewed by the
commissioner upon appropriate findings of fact, conclusions, and order.
(6) The commissioner shall require an independent actuarial opinion that the best
estimate of the impact of the reforms to the workers' compensation system enacted in Senate Bill
91-218 during the first regular session of the fifty-eighth general assembly have been
incorporated in any workers' compensation rate change filed with the commissioner until July 1,
1994.
(7) This section shall not apply to insurers providing coverage to exempt commercial
policyholders, as defined pursuant to section 10-4-1402 and rules adopted by the commissioner
pursuant to that section.

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