§ 36-6536. Mandatory powers and duties of Board.  


Latest version.
  • The Board of Directors of the Health Insurance High Risk Pool shall:

    1.  Establish administrative and accounting procedures for the operation of the Pool;

    2.  Establish procedures under which applicants and participants in the plans adopted by the Board may have grievances reviewed by an impartial body and reported to the Board;

    3.  Select an administering insurer in accordance with Section 6538 of this title;

    4.  Levy and collect assessments from all insurers and reinsurers to provide for claims paid under the plans adopted by the Board and for administrative expenses incurred or estimated to be incurred during the period for which assessment is made.  The level of assessments shall be established by the Board in accordance with Section 6539 of this title.  Assessment of the insurers shall occur at the end of each calendar year and shall be due and payable within thirty (30) days of receipt of the assessment notice by the insurer to the Insurance Commissioner;

    5.  In addition to assessments required pursuant to paragraph 4 of this subsection, collect an organizational assessment or assessments from all insurers and reinsurers as necessary to provide for expenses which have been incurred or are estimated to be incurred prior to the receipt of the first calendar year assessments.  Organizational assessments shall be equal for all insurers and reinsurers, but shall not exceed One Hundred Dollars ($100.00) per insurer for all such assessments.  Such assessments are due and payable within thirty (30) days of receipt of the assessment notice by the insurer;

    6.  Require that all policy forms issued by the Board conform to standard forms as approved by the Insurance Commissioner;

    7.  Develop a program to publicize the existence of the plans adopted by the Board, the eligibility requirements of the plans, and the procedures for enrollment in the plans, and to maintain public awareness of the plan;

    8.  Implement disease management programs, at the Board’s discretion, to improve health status for congestive heart failure, diabetes, asthma, coronary artery disease, chronic renal failure, and other diseases as appropriate;

    9.  Implement a multi-tier pharmacy benefit design; and

    10.  Prior to February 1 of each year, report to the President Pro Tempore of the Senate, Speaker of the House of Representatives, and Governor concerning the status of the Health Insurance High Risk Pool and the effect of cost-containment measures implemented.  Further, in such report, the Board shall make recommendations to the Legislature concerning any other cost-containment measures that would be beneficial to the Pool.

Added by Laws 1995, c. 250, § 6, eff. July 1, 1995.  Amended by Laws 1996, c. 249, § 4, emerg. eff. May 28, 1996; Laws 2002, c. 439, § 4, eff. July 1, 2002.

Note

NOTE:  Laws 1996, c. 246, § 21 repealed by Laws 1996, c. 249, § 9, emerg. eff. May 28, 1996.