# KY Insurance Advisory Opinion 1999-05: Group Claim Experience

> Kentucky · Agency guidance · In force

URL: https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-05

## Section

- **Citation:** KY Insurance Advisory Opinion 1999-05
- **Heading:** Group Claim Experience
- **Jurisdiction:** Kentucky
- **Kind:** Agency guidance
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Kentucky Department of Insurance Bulletins and Advisory Opinions / Group Claim Experience

## Text

The following Advisory Opinion is to advise the reader of the current position of the Kentucky
Department of Insurance ("the Department") on the specified issue. The Advisory Opinion is not legally
binding on either the Department or the reader.
Kentucky Department of Insurance
Advisory Opinion 99-05
In re: Group Claim Experience
RELEVANT FACTS AND STATUTES: A recent question has arisen concerning health carriers denying
requests to provide the claims experience to small employer groups. The relevant statute is KRS 304.18-
055. KRS 304.18-055 states, " [p]ooling of claims for groups with fewer than fifty (50) insureds shall be
required."
DEPARTMENT’S POSITION: An insurer should explain to the purchaser how a rate is calculated,
including loss ratios for the block of business. While pooling for small groups is required by statute, the
insurer should explain the loss ratio for the pool and the economic reasons for pooling claims for small
employers. The insurer should also give an explanation of all the factors that are utilized in determining
a rate.
Any questions may be directed to Shaun T. Orme, Counsel for the Department.
_____________________
George Nichols III
Commissioner

## Nearby sections

- [KY Insurance Advisory Opinion 1998-01 The Issuance And Renewal Of Health Benefit Plans Under 98 RS HB 315/En](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1998-01.md)
- [KY Insurance Advisory Opinion 1998-02 Hospice Care Coverage Under Health Benefit Plans](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1998-02.md)
- [KY Insurance Advisory Opinion 1998-03 Health Care Discount Programs](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1998-03.md)
- [KY Insurance Advisory Opinion 1998-04 Participation Requirements For Groups](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1998-04.md)
- [KY Insurance Advisory Opinion 1998-05 Damages For Motor Vehicle Loss Of Use And Settlement Of Claims For Motor Vehicles](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1998-05.md)
- [KY Insurance Advisory Opinion 1999-01 Conversion Plans As Health Benefits Plans](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-01.md)
- [KY Insurance Advisory Opinion 1999-02 Use Of Fee Schedules For Payment Of Medical Expenses In Basic And Added Reparation Benefits Coverage](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-02.md)
- [KY Insurance Advisory Opinion 1999-03 Experience-Information Reports Of Insurers](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-03.md)
- [KY Insurance Advisory Opinion 1999-05 Group Claim Experience](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-05.md)
- [KY Insurance Advisory Opinion 1999-06 Claims Practice](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-06.md)
- [KY Insurance Advisory Opinion 1999-07 Dual Rates For Medicare Supplement Policies](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-07.md)
- [KY Insurance Advisory Opinion 1999-08 Any Willing Provider Law](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-08.md)
- [KY Insurance Advisory Opinion 1999-12 Bulletin 98-2 Personal Lines Property Insurance For Earthquake Damages](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-12.md)
- [KY Insurance Advisory Opinion 1999-13 Waiver Of Our Right To Recover From Others Endorsements (Ncci Form Wc 00 01 13)](https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-13.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/KY_INS_AO_1999-05. Check the current official text before relying on it. Not legal advice.