---
kind: "range"
citation: "45 C.F.R. §§ 158.321–158.323"
title: "45"
from: "158.321"
to: "158.323"
count: 3
url: "https://uscodex.org/cfr/45/158.321..158.323"
---

# §158.321. Information regarding the State's individual health insurance market.

- (a) Subject to [§ 158.320](/cfr/45/158.320.md), the State must provide, for each issuer who actively offers coverage in the individual market in the State, the following information, in accordance with [paragraph (b)](#b) of this section, for the preceding calendar year and, at the State's option, for the current year:
  - (1) Total earned premium and incurred claims;
  - (2) Total number of enrollees (life-years and covered lives);
  - (3) Total agents' and brokers' commission expenses;
  - (4) Net underwriting gain;
  - (5) Risk-based capital level; and
  - (6) Whether the issuer has provided notice to the State's insurance commissioner, superintendent, or comparable State authority that the issuer will cease or begin offering individual market coverage on the Exchange, certain geographic areas, or the entire individual market in the State.
- (b) The information required in paragraphs [(a)(1) through (4)](#a-1..a-4) and [(6)](#a-6) of this section must be provided separately for the issuer's individual market plans grouped by the following categories, as applicable: On-Exchange, off-Exchange, grandfathered health plans as defined in [§ 147.140](/cfr/45/147.140.md) of this subchapter, coverage that meets the criteria for transitional policies outlined in applicable guidance, and non-grandfathered single risk pool coverage. The information required in [paragraph (a)(5)](#a-5) of this section must be provided at the issuer level.
- (c) The State must also provide information regarding whether any issuer other than those described in [paragraph (a)](#a) of this section has provided notice to the State's insurance commissioner, superintendent, or comparable State authority that the issuer will cease or begin offering individual market coverage on the Exchange, certain geographic areas, or the entire individual market in the State.

# §158.322. Proposal for adjusted medical loss ratio.


A State must provide its own proposal as to the adjustment it seeks to the MLR standard. This proposal must include an explanation of how an adjustment to the MLR standard for the State's individual market will help stabilize the State's individual market.


# §158.323. State contact information.


A State must provide the name, telephone number, e-mail address, and mailing address of the person the Secretary may contact regarding the request for an adjustment to the MLR standard.