§3912.__Actions against association or members based upon joint

or collective actions

Participation in the association, the establishment of rates, forms or procedures or any other joint or collective action required by this chapter may not be the basis of any legal action or criminal or civil liability or penalty against the association or any member insurer.

§3913.__Reimbursement of carriers

1.__Reimbursement. A carrier may seek reimbursement from the association and the association shall reimburse the carrier to the extent claims made by a member after January 1, 2008 exceed premiums paid on a calendar year basis by the member to the carrier for a member who meets the following criteria:

A.__The carrier sold an individual health plan to the member between December 1, 1993 and January 1, 2008, and the policy that was sold has been continuously renewed by the member;

B.__The carrier is able to determine through the use of individual health statements, claims history or any reasonable means that at any time while the policy was in effect, the member was diagnosed with one of the following medical conditions: acquired immune deficiency syndrome, angina pectoris, ascites, chemical dependency cirrhosis of the liver, coronary occlusion, cystic fibrosis, Friedreich's ataxia, hemophilia, Hodgkin's disease, Huntington's chorea, juvenile diabetes, leukemia, metastatic cancer, motor or sensory aphasia, multiple sclerosis, muscular dystrophy, myasthenia gravis, myotonia, heart disease requiring open- heart surgery, Parkinson's disease, polycystic kidney disease, psychotic disorders, quadriplegia, stroke, syringomyelia or Wilson's disease; and

C.__The carrier has closed its book of business for individual health plans sold prior to January 1, 2008.

2.__Rules.__The superintendent may adopt rules to facilitate payment to a carrier pursuant to this section. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.