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insurance carriers.__Except for the carriers and 3rd-party | | administrators that are specifically excluded in subsection 2, each | | health insurance carrier, 3rd-party administrator and employee | | benefit excess insurance carrier shall pay a savings offset | | payment. The following provisions govern savings offset payments. |
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| | | A. The board shall calculate savings offset payments as a | | percentage of paid claims, as defined by the board pursuant | | to subsection 10. The board shall make reasonable efforts to | | ensure that paid claims are counted only once with respect | | to any savings offset payment. The board may verify each | | health insurance carrier's, 3rd-party administrator's and | | employee benefit excess insurance carrier's savings offset | | payment based on annual statements and other reports the | | board determines to be necessary. |
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| | | B. Maximum savings offset payments are as follows: |
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| | | (1) For health insurance carriers, the savings offset | | payment may not exceed 4.0% of annual paid claims for | | health care on policies issued pursuant to the laws of | | this State that insure residents of this State; |
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| | | (2) For 3rd-party administrators, the savings offset | | payment may not exceed 4.0% of annual paid claims for | | health care for residents of this State; and |
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| | | (3) For employee benefit excess insurance carriers, the | | savings offset payment may not exceed 4.0% of annual | | paid claims on employee benefit excess insurance | | policies, as defined in section 707, subsection 1, | | paragraph C-1, issued pursuant to the laws of this | | State that insure residents of this State. |
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| | | C.__A health insurance and employee benefit excess insurance | | carrier may not be required to pay a savings offset payment | | on policies or contracts insuring federal employees. |
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| | | D. Savings offset payments apply to claims paid for plan | | years beginning on or after January 1, 2006. |
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| | | E. Savings offset payments may not begin until 12 months | | after Dirigo Health begins providing health insurance | | coverage; |
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| | | F. Savings offset payments must be made quarterly and are | | due not less than 60 days after the close of the quarter and |
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| | | with a minimum of 30 days' written notice by Dirigo Health to | | health insurance carriers, employee benefit excess |
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