211 CMR 41.12 - Hearing Request for Disapproved Closed Guaranteed Issue Health Plan Rate Filing

Current through Register 1466, April 1, 2022

(1) A Carrier whose proposed rate for a Closed Guaranteed Issue Health Plan has been disapproved by the Commissioner pursuant to 211 CMR 41.11(6) may, within 21 days of the Commissioner's decision, submit a Hearing Request to the Division.

(2) Contents. The Hearing Request constitutes the Carrier's direct case in the Proceeding. The Hearing Request must consist of sequentially numbered pages, must use any format previously prescribed by the Presiding Officer or the Commissioner and must contain:

(a) A title stating the nature of the Proceeding, and the complete name and address of the Party submitting the request;

(b) The name and address of counsel or other authorized representative as prescribed in 211 CMR 41.14(7);

(c) An executive summary describing, in narrative form, the reasons for the Hearing Request, including a description of errors the Carrier believes may have been made by the Commissioner in the review process, a description of the grounds in support of the rate requested, and the specific relief sought;

(d) A copy of the Rate Filing;

(e) A copy of all materials submitted as part of the further review;

(f) A copy of all written communications between the Carrier and the Division as part of the review process;

(g) Identification of each witness on whose testimony the Carrier intends to rely in support of its request for relief, and identification of the subject matter of the witness' testimony, with sufficient clarity to enable the Presiding Officer to determine his or her qualifications to testify on that subject matter;

(h) The sworn written direct testimony of each witness in narrative form, including all information and commentary submitted in support of each issue the Carrier intends to raise in the Proceeding;

(i) All additional information, including data, statistics, schedules and exhibits which the Carrier intends to present for consideration in the Proceeding and upon which its recommendations are based; and

(j) Other information as prescribed from time to time by the Commissioner or the Presiding Officer by order, decision or bulletin.

(3) Failure to Submit Complete Hearing Request. If within 21 days after the Commissioner's decision, a Carrier submits an incomplete Hearing Request, the Presiding Officer may, upon determining that the Carrier has attempted in good faith to comply with the requirements of 211 CMR 41.12(2), order the Carrier to supplement the Hearing Request in accordance with 211 CMR 41.12(4) and delay the effective date of filing of the Hearing Request for purposes of determining the date of the commencement of the Proceeding.

(4) Amendments to Hearing Request. No additions, amendments, or corrections may be allowed after the submission described in 211 CMR 41.12, except as permitted or ordered by the Presiding Officer.

(5) Supporting Information. The Presiding Officer may require a Carrier to furnish any data or information which he or she determines necessary or appropriate in connection with the submission of a Hearing Request.

(6) Rejection of Hearing Request. The Presiding Officer may, before issuance of a hearing notice, reject a Hearing Request if he or she determines that it does not comply with M.G.L. c. 176M or 211 CMR 41.00. A Carrier whose Hearing Request has been rejected may resubmit a Hearing Request with appropriate modifications within the time period determined by the Presiding Officer.

Notes

211 CMR 41.12