42 CFR 403.254 - Calculation of premiums.

§ 403.254 Calculation of premiums.

(a)General provisions. To calculate the amount of “premiums”, calculate the present value on the initial calculation date of expected earned premiums for the loss ratio calculation period.

(b)Specific provisions.

(1)Earned premium for a given period means -

(i) Written premiums for the period; plus -

(ii) The total premium reserve at the beginning of the period; less -

(iii) The total premium reserve at the end of the period.

(2)Written premiums in a period means -

(i) Premiums collected in that period; plus -

(ii) Premiums due and uncollected at the end of that period; less -

(iii) Premiums due and uncollected at the beginning of that period.

(3)Total premium reserve means the sum of -

(i) The unearned premium reserve;

(ii) The advance premium reserve; and

(iii) The reserve for rate credits.

(4)Unearned premium reserve means the portion of gross premiums due that provide for days of insurance coverage after the valuation date.

(5)Advance premium reserve means premiums received by the insuring organization that are due after the valuation date.

(6)Reserve for rate credits means rate credits on a group policy that -

(i) Accrue by the valuation date of the policy; and

(ii) Are paid or credited after the valuation date.

This is a list of United States Code sections, Statutes at Large, Public Laws, and Presidential Documents, which provide rulemaking authority for this CFR Part.

This list is taken from the Parallel Table of Authorities and Rules provided by GPO [Government Printing Office].

It is not guaranteed to be accurate or up-to-date, though we do refresh the database weekly. More limitations on accuracy are described at the GPO site.


United States Code
Public Laws

Title 42 published on 2015-11-28

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 42 CFR Part 403 after this date.

  • 2016-09-16; vol. 81 # 180 - Friday, September 16, 2016
    1. 81 FR 63860 - Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Final rule.
      Effective date: These regulations are effective on November 15, 2016. Incorporation by reference: The incorporation by reference of certain publications listed in the rule is approved by the Director of the Federal Register November 15, 2016. Implementation date: These regulations must be implemented by November 15, 2017.
      42 CFR Parts 403, 416, 418, 441, 460, 482, 483, 484, 485, 486, 491, and 494
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