LD 1168
pg. 12
Page 11 of 20 An Act To Reduce Individual Health Insurance Premiums Page 13 of 20
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LR 790
Item 1

 
4.__Review for solvency.__The superintendent shall review the
association at least every 3 years to determine its solvency.__If
the superintendent determines that the funds of the association are
insufficient to support enrollment of additional persons, the
superintendent may order the association to increase its
assessments or increase its premium rates.__If the superintendent
determines that the funds of the association are insufficient to
support the enrollment of additional persons and that the
assessments required pursuant to section 3907 are too low to
support the enrollment of additional persons, the superintendent
may order the association to charge special assessments for a
period not to exceed 12 months.

 
5.__Annual report.__The association shall report annually to
the joint standing committee of the Legislature having
jurisdiction over health insurance matters by March 15th.__The
report must include information on the benefits and rate
structure of coverage offered by the association, the financial
solvency of the association and the administrative expenses of
the plan.

 
6.__Audit.__The association must be audited at least every 3
years. A copy of the audit must be provided to the superintendent
and to the joint standing committee of the Legislature having
jurisdiction over health insurance matters.

 
§3906.__Selection of plan administrator

 
1.__Selection of plan administrator.__The board shall select
an insurer or 3rd-party administrator, through a competitive
bidding process, to administer the plan.__The board shall
evaluate bids submitted under this subsection based on criteria
established by the board, including:

 
A.__The insurer's proven ability to handle large group
accident and health insurance;

 
B.__The efficiency and timeliness of the insurer's claims-
payment procedures;

 
C.__An estimate of total charges for administering the plan;

 
D.__The ability of the insurer to apply effective cost
containment programs and procedures to administer the plan
in a cost-efficient manner; and

 
E.__The financial condition and stability of the insurer.


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