LD 1945
pg. 12
Page 11 of 18 An Act To Establish a High-risk Health Insurance Pool Page 13 of 18
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LR 2814
Item 1

 
performance of plan administrator's services. As used in this
subsection, "direct and indirect expenses" includes that portion of
the audited administrative costs, printing expenses, claims
administration expenses, management expenses, building overhead
expenses and other actual operating and administrative expenses of
the plan administrator that are approved by the board as allocable
to the administration of the plan and included in the
specifications of a bid under subsection 2.

 
§3908.__Assessments against insurers

 
1.__Assessments.__For the purpose of providing the funds
necessary to carry out the powers and duties of the association,
the board shall assess member insurers at such a time and for
such amounts as the board finds necessary. Assessments are due
not less than 30 days after receipt of written notice by member
insurers and accrue interest at 12% per annum on and after the
due date.

 
2.__Maximum assessment.__The board shall assess each insurer
an amount not to exceed $3 per person insured or reinsured by
each insurer per month for medical insurance.__A member insurer
may not be assessed on policies or contracts insuring federal or
state employees.__This assessment begins January 1, 2007.

 
3.__Determination of assessment.__The board shall make
reasonable efforts to ensure that each covered person is counted
only once with respect to any assessment.__For that purpose, the
board shall require each insurer that obtains excess or stop loss
insurance to include in its count of covered persons all
individuals whose coverage is insured, in whole or in part,
through excess or stop loss coverage.__The board shall allow a
reinsurer to exclude from its number of covered persons those who
have been counted by the primary insurer or by the primary
reinsurer or primary excess or stop loss insurer for the purpose
of determining its assessment under this subsection. The board
may verify each insurer's assessment based on annual statements
and other reports determined to be necessary by the board.__The
board may use any reasonable method of estimating the number of
covered persons of an insurer if the specific number is unknown.

 
4.__Excess funds.__If assessments and other receipts by the
association, board or plan administrator exceed the actual losses
and administrative expenses of the plan, the board shall hold the
excess as interest and may use those excess funds to offset
future losses or to reduce plan premiums. As used in this
subsection, "future losses" includes reserves for claims incurred
but not reported.


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