Rule 120-2-79-.09. Premium Collection

1. (1) All insurance charges, fees, or premiums collected by a health plan purchasing cooperative on behalf of or for a participating carrier, and return premiums received from such carrier, shall be held by the health plan purchasing cooperative in a fiduciary capacity. Such funds shall be immediately remitted to the person or persons entitled thereto, or shall be deposited promptly in a fiduciary bank account established and maintained by the health plan purchasing cooperative. If charges or premiums so deposited have been collected on behalf of or for more than one carrier, the health plan purchasing cooperative shall cause the bank in which such fiduciary account is maintained to keep records clearly recording the deposits in and withdrawals from such account on behalf of or for each carrier. The health plan purchasing cooperative shall promptly obtain and keep copies of all such records and, upon request of a participating carrier, shall furnish such carrier with copies of such records pertaining to deposits and withdrawals on behalf of or for such carrier. Withdrawals from such account shall be made, as provided in the written agreement or contract between the health plan purchasing cooperative and a participating carrier, for:

   1. (1) remittance to a carrier, entitled thereto;
   2. (2) deposit in an account maintained in the name of such carrier;
   3. (3) payment to a policyholder for remittance to the carrier entitled thereto; or
   4. (4) remittance of return premiums to the person or persons entitled thereto.
2. (2) In collecting premiums, a health plan purchasing cooperative must bill separately and explicitly to distinguish premium charges from administrative fees collected for the operation of the health plan purchasing cooperative. Any funds collected as premiums shall be held separately and accounted for or reported separately from funds collected from membership or administrative fees charged to members by the health plan purchasing cooperative.

Authority: O.C.G.A. Secs. 33-2-9, 33-30A-5, 33-30A-9.

History. Original Rule entitled "Premium Collection" adopted. F. Feb. 23, 2000; eff. Mar. 14, 2000.