[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR403.215]



[Page 38-39]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 403_SPECIAL PROGRAMS AND PROJECTS--Table of Contents

 

                Subpart B_Medicare Supplemental Policies

 

Sec. 403.215  Loss ratio standards.



    (a) The policy must be expected to return to the policyholders, in 

the form of aggregate benefits provided under the policy--

    (1) At least 75 percent of the aggregate amount of premiums in the 

case of group policies; and

    (2) At least 60 percent of the aggregate amount of premiums in the 

case of individual policies.

    (b) For purposes of loss ratio requirements, policies issued as a 

result of solicitation of individuals through the mail or by mass media 

advertising are considered individual policies.



[[Page 39]]



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