LD 1945
pg. 9
Page 8 of 18 An Act To Establish a High-risk Health Insurance Pool Page 10 of 18
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LR 2814
Item 1

 
J.__Prepare and distribute application forms and enrollment
instruction forms to producers and to the general public;

 
K.__Provide for reinsurance of risks incurred by the
association. The provision of reinsurance may not subject
the association to any of the capital or surplus
requirements, if any, otherwise applicable to reinsurers;

 
L.__Issue additional types of health insurance policies to
provide optional coverage, including Medicare supplement
health insurance;

 
M.__Provide for and employ cost-containment measures and
requirements, including, but not limited to, preadmission
screening, 2nd surgical opinions, concurrent utilization
review and individual case management for the purpose of
making the plan more cost-effective;

 
N.__Design, utilize, contract or otherwise arrange for the
delivery of cost-effective health care services, including
establishing or contracting with preferred provider
organizations, health maintenance organizations and other
limited network provider arrangements; and

 
O.__Apply for funds or grants from public or private
sources, including federal grants provided to qualified
high-risk pools.

 
3.__Additional duties and powers.__The superintendent may, by
rule, establish additional powers and duties of the board and may
adopt such rules as are necessary and proper to implement this
chapter.__Rules adopted pursuant to this subsection are routine
technical rules as defined in Title 5, chapter 375, subchapter 2-
A.

 
4.__Review for solvency.__The superintendent shall review the
operations of 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 cap of assessments in section 3908 is too low to
support the enrollment of additional persons, the superintendent
may order the association to charge an assessment in excess of
the cap for a period not to exceed 12 months.


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