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administrator or its producers.__The plan administrator shall | | pay the referral fees from funds received as premiums for the | | plan; |
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| | | C.__Establish a premium billing procedure for collection of | | premiums from insured persons.__Billings must be made | | periodically as determined by the board; |
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| | | D.__Perform all necessary functions to ensure timely payment | | of benefits to covered persons under the plan, including: |
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| | | (1)__Making available information relating to the | | proper manner of submitting a claim for benefits under | | the plan and distributing forms upon which submissions | | must be made; |
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| | | (2)__Evaluating the eligibility of each claim for | | payment under the plan; and |
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| | | (3)__Notifying each claimant within 45 days after | | receiving a properly completed and executed proof of | | loss of whether the claim is accepted, rejected or | | compromised. The board shall establish reasonable | | reimbursement amounts for any services covered under | | the benefit plans; |
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| | | 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; |
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| | | F.__Following the close of each calendar year, determine net | | premiums, reinsurance premiums less administrative expense | | allowance, the expenses 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 |
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| | | 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. |
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| | | 4.__Payment to plan administrator.__The plan administrator | | selected pursuant to subsection 1 must be paid, as provided in | | the contract of the association under subsection 2, for the plan | | administrator's direct and indirect expenses incurred in the |
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