LD 1945
pg. 10
Page 9 of 18 An Act To Establish a High-risk Health Insurance Pool Page 11 of 18
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LR 2814
Item 1

 
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.

 
§3907.__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 or the 3rd-party administrator's proven
ability to handle large group accident and health insurance;

 
B.__The efficiency of the insurer's or the 3rd-party
administrator's claims-payment procedures; and

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

 
2.__Contract with plan administrator.__The plan administrator
selected pursuant to subsection 1 is contracted for a period of 3
years.__At least one year prior to the expiration of each 3-year
period of service by a plan administrator, the board shall invite
all insurers, including the current plan administrator, to submit
bids to serve as the plan administrator for the succeeding 3-year
period.__The selection of the plan administrator for the
succeeding period must be made at least 6 months prior to the
expiration of the 3-year period.

 
3.__Duties of plan administrator.__The plan administrator
selected pursuant to subsection 1 shall:

 
A.__Perform all eligibility and administrative claims-
payment functions relating to the plan;

 
B.__Pay a producer's referral fee as established by the board to
each producer who refers an applicant to the plan, if the
applicant's application is accepted.__The selling or marketing of
the plan is not limited to the plan


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