Actuarial Soundness. Insurer shall provide an actuarial memorandum supporting the premium rate adjustment request. The actuarial memorandum shall include the information and level of detail required by FHKC. The proposed premium rates shall: a. Be consistent with actuarially sound principles as required by 42 CFR 457.1203; b. Not be excessive nor inadequate in accordance with the applicable requirements of Chapter 409, Florida Statutes; and c. Be designed to reasonably achieve a medical loss ratio (MLR) standard for the Contract year that is at least equal to the greater of eighty-five percent (85%) or the target MLR implicit in Insurer’s best and final offer in response to the ITN and provide for reasonable administrative costs in accordance with 42 CFR 457.1203, Section 624.91, Florida Statutes, and section 9-5 of this Contract.
Appears in 2 contracts
Sources: Medical Services Agreement, Medical Services Agreement