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 plan 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 plan 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;
- 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 plan, the eligibility requirements of the plan, and the procedures for enrollment in the plan, and to maintain public awareness of the plan; and
- 8. Design and employ cost-containment measures and requirements which may include preadmission certification, home health care, hospice care, negotiated purchase of medical and pharmaceutical supplies and individual case management. The Board may employ a plan case manager or managers to supervise and manage the medical care or coordinate the supervision and management of the medical care with the administering insurer. The Board may employ other persons if the positions have been outlined in the Board's plan and approved by the Insurance Commissioner and are necessary to fulfill the duties and responsibilities of the Board.
Laws 1995, c. 250, § 6, eff. July 1, 1995; Amended by Laws 1996, c. 249, § 4, emerg. eff. May 28, 1996.