Section 3 AAC 31.510 - Association duties(a) The association shall establish a plan of operation for the administration and operation of the Alaska Reinsurance Program under which a health care insurer shall cede the risk of a high risk resident to the program. The plan of operation must include (1) a description of the data a health care insurer submitting a reinsurance payment request must provide to the association for the association to implement and administer the reinsurance program, including data necessary far the association to determine a health care insurer's eligibility for reinsurance payments;(2) guidance to insurers relating to diagnosis codes for identifying residents with covered conditions under the program;(3) the manner and time period in which a health care insurer must (A) provide the data described under (1) of this subsection;(B) pay the quarterly(i) premium amounts required to be paid under 3 AAC 31.515(b); and(ii) pharmacy rebates required to be paid under 3 AAC 31.515(c): and(C) cede risk under this section;(4) requirements for reporting and processing reports submitted by health care insurers as required by the association;(5) requirements for conducting audits under 3 AAC 31.530; and(6) details of an annual actuariaI study of this state's individual market that(A) measures the impact of the program;(B) recommends funding levels; and(C) reveals emerging conditions within the market.(b) The association shall accept a risk ceded to it with respect to a high risk resident in compliance with 3 AAC 31.500 - 3 AAC 31.549 effective on the date coverage becomes effective with the health care insurer and shall continue to accept a risk ceded to it until March 31 of the year following the calendar year in which the high risk resident's coverage becomes effective with the health care Insurer or, if earlier, the date on which the coverage terminates or the reinsurance program ceases active operation.(c) The association shall establish a process to reimburse, on a quarterly basis, participating health insurers for claims paid with respect to risk ceded to the program.(d) The association shall ensure, in accordance with applicable provisions of generally accepted accounting requirements, circulars on funds management of the United States Office of Management and Budget, and guidance on accounting of the United States Government Accountability Office, that the Alaska Reinsurance Program uses no federal funds for coverage of abortion services described under 42 U.S.C. 18023(b)(l)(B)(i).Eff. 2/2/2013, Register 205; am 12/22/2016, Register 220, January 2017; am 11/1/2018,Register 228, January 2019Authority:AS 21.06.090
AS 21.55.040
AS 21.55.220
AS 21.55.400
AS 21.55.430