LD 1190
pg. 12
Page 11 of 18 An Act To Create the Comprehensive Health Insurance Risk Pool Association Page 13 of 18
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LR 436
Item 1

 
expenses incurred in the performance of its 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 bid specifications.

 
§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 must be due not less than 30 days after written
notice to the member insurers and must accrue interest at 12%
per annum on and after the due date.

 
2.__Maximum assessment.__Each insurer must be assessed an
amount not to exceed $2 per covered 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.

 
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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