Current through December 21, 2024
Section 3 AAC 31.520 - Health care insurer duties and rules(a) A health care insurer shall comply with the requirements established by the association in order to cede a risk to the association.(b) A health care insurer shall continue to administer and manage the policy for risk ceded to the association in accordance with the terms of the insurance policy and with the insurance law of this state. (c) A health care insurer shall offer individuals that may be ceded to the association the same plans offered to other individuals.(d) A health care insurer may not vary premium rates based on whether a risk is ceded to the association. (e) A health care insurer shall cede a risk to the association with respect to a high risk resident during the period beginning on the date the high risk resident's coverage becomes effective with the health care insurer and ending on March 31 of the year following the calendar year in which the high risk resident's coverage becomes effective with the health care insurer. A health care insurer required to cede risk with respect to a high risk resident to the association in a subsequent calendar year shall re-cede that risk for that calendar year. A health care insurer shall use the dates set by the association and specified in the association's plan of operation when ceding a risk required to be ceded to the association under this subsection.(f) A health care insurer shall submit to the program claims incurred during a calendar year for a ceded risk not later than April 30 after that calendar year for the claim to be eligible for reimbursement from the program.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 21.55.220
AS 21.55.400