CFR /  Title 45  /  Part 158: Issuer Use Of Premium Revenue: Reporting And Rebate Requirements

Section No.	Description
Section 158.101	Applicability
Section 158.102	Definitions
Section 158.103	Reporting requirements related to premiums and expenditures
Section 158.110	Aggregate reporting
Section 158.120	Newer experience
Section 158.121	Premium revenue
Section 158.130	Reimbursement for clinical services provided to enrollees
Section 158.140	Activities that improve health care quality
Section 158.150	Expenditures related to Health Information Technology and meaningful use requirements
Section 158.151	Other non-claims costs
Section 158.160	Reporting of Federal and State licensing and regulatory fees
Section 158.161	Reporting of Federal and State taxes
Section 158.162	Reporting of Federal and State taxes
Section 158.162	Allocation of expenses
Section 158.170	Minimum medical loss ratio
Section 158.210	Requirement in States with a higher medical loss ratio
Section 158.211	Aggregation of data in calculating an issuer's medical loss ratio
Section 158.220	Formula for calculating an issuer's medical loss ratio
Section 158.221	Credibility adjustment
Section 158.230	Life-years used to determine credible experience
Section 158.231	Calculating the credibility adjustment
Section 158.232	Rebating premium if the applicable medical loss ratio standard is not met
Section 158.240	Form of rebate
Section 158.241	Recipients of rebates
Section 158.242	De minimis rebates
Section 158.243	Unclaimed rebates
Section 158.244	Notice of rebates
Section 158.250	Notice of MLR information
Section 158.251	Reporting of rebates
Section 158.260	Effect of rebate payments on solvency
Section 158.270	Standard for adjustment to the medical loss ratio
Section 158.301	Who may request adjustment to the medical loss ratio
Section 158.310	Duration of adjustment to the medical loss ratio
Section 158.311	Information supporting a request for adjustment to the medical loss ratio
Section 158.320	Information regarding the State's individual health insurance market
Section 158.321	Proposal for adjusted medical loss ratio
Section 158.322	State contact information
Section 158.323	Criteria for assessing request for adjustment to the medical loss ratio
Section 158.330	Process for submitting request for adjustment to the medical loss ratio
Section 158.340	Treatment as a public document
Section 158.341	Invitation for public comments
Section 158.342	Optional State hearing
Section 158.343	Secretary's discretion to hold a hearing
Section 158.344	Determination on a State's request for adjustment to the medical loss ratio
Section 158.345	Request for reconsideration
Section 158.346	Subsequent requests for adjustment to the medical loss ratio
Section 158.350	HHS enforcement
Section 158.401	Audits
Section 158.402	Circumstances in which a State is conducting audits of issuers
Section 158.403	Access to facilities and records
Section 158.501	Maintenance of records
Section 158.502	General rule regarding the imposition of civil penalties
Section 158.601	Basis for imposing civil penalties
Section 158.602	Notice to responsible entities
Section 158.603	Request for extension
Section 158.604	Responses to allegations of noncompliance
Section 158.605	Amount of penalty--general
Section 158.606	Factors HHS uses to determine the amount of penalty
Section 158.607	Determining the amount of the penalty--mitigating circumstances
Section 158.608	Determining the amount of penalty--aggravating circumstances
Section 158.609	Determining the amount of penalty--other matters as justice may require
Section 158.610	Settlement authority
Section 158.611	Limitations on penalties
Section 158.612	Notice of proposed penalty
Section 158.613	Appeal of proposed penalty
Section 158.614	Failure to request a hearing
Section 158.615	Basis and scope