LD 394
pg. 8
Page 7 of 21 An Act To Create a High-risk Pool in the Health Insurance Market Page 9 of 21
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LR 516
Item 1

 
12.__Reinsurer.__"Reinsurer" means an insurer from whom a
person providing health insurance for a resident procures
insurance for itself with the insurer with respect to all or part
of the medical insurance risk of the person.__"Reinsurer"
includes an insurer that provides employee benefits excess
insurance.

 
13.__Third-party administrator.__"Third-party administrator"
means any entity that is paying or processing medical insurance
claims for any resident.

 
§3904.__Comprehensive Health Insurance Risk Pool Association

 
1.__Risk pool established.__The Comprehensive Health Insurance
Risk Pool Association is established as a nonprofit legal entity.__
As a condition of doing business, an insurer that has sold
medical insurance within the previous 12 months or is actively
marketing a medical insurance policy in this State must
participate in the association.

 
2.__Board of directors.__The association is governed by a
board of directors in accordance with the following.

 
A.__The board consists of 9 members appointed as follows:

 
(1)__Six members appointed by the superintendent:__2
members chosen from the general public and who are not
associated with the medical profession, a hospital or
an insurer; 2 members who represent medical providers;
one member who represents a statewide organization that
represents small businesses and that receives a
majority of its funding from small businesses located
in this State; and one member who represents producers.__
A board member appointed by the superintendent may be
removed at any time without cause; and

 
(2)__Three members appointed by the member insurers, at
least 2 of whom are domestic insurers.

 
B.__Members of the board serve for 3-year terms, except that
of those members initially appointed by the superintendent,
one member serves for a term of one year, 2 members for a
term of 2 years and one member for a term of 3 years and of
those members initially appointed by the member insurers,
one member serves for a term of one year, one member serves
for a term of 2 years and one member serves for a term of 3
years.__The appointing authority shall designate the period
of service of each initial appointee at the time of
appointment.


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