LD 1168
pg. 14
Page 13 of 20 An Act To Reduce Individual Health Insurance Premiums Page 15 of 20
Download Bill Text
LR 790
Item 1

 
E.__Submit regular reports to the board regarding the
operation of the plan.__The frequency, content and form of
the reports must be as determined by the board;

 
F.__Following the close of each calendar year, determine net
premiums, reinsurance premiums less an administrative
expense allowance, the expense of administration pertaining
to the reinsurance operations of the association and the
incurred losses of the year and report this information to
the superintendent; and

 
G.__Pay claims expenses from the premium payments received
from or on behalf of covered persons under the plan.__If the
payments by the plan administrator for claims expenses
exceed the portion of premiums allocated by the board for
payment of claims expenses, the board shall provide the plan
administrator with additional funds for payment of claims
expenses.

 
4.__Payment to plan administrator.__A plan administrator
selected pursuant to subsection 1 must be paid, as provided in
the contract of the association, for its direct and indirect
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.

 
§3907.__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 on a calendar-year basis
and establish the assessment no later than November 1st in the
year preceding the calendar year for which the insurer's
experience will be used to calculate the assessment.__The
assessment must be anticipated to be sufficient to meet the
funding needs of the association.

 
2.__Regular assessment; initial assessment.__The association
must establish a regular assessment based on the number of
covered persons times a specified assessment rate.__The board
shall submit the regular assessment rate to the superintendent
for approval and specify the basis for the rate.__The
superintendent shall approve the rate if the superintendent finds
that the amount is required to fulfill the purposes of the


Page 13 of 20 Top of Page Page 15 of 20