Section 3.31.530. Accounting and reporting.

	(a)  A health care insurer that cedes a risk to the association shall submit information required by the association, including  
		(1) demographic information;  
		(2) reported claims;  
		(3) paid claims; and  
		(4) paid premiums.  
	(b)  A health care insurer shall forward all premiums to the association for each risk ceded to the association and may not retain any portion of the premium.  
	(c)  A health care insurer must submit to the association claims incurred during an active period of coverage for a ceded risk not later than 12 months after the date of service in order to be eligible for reimbursement from the association.  
	(d)  The premium for an individual ceded to the association covered as a dependent under a family policy in which the family policy does not have separately identifiable premiums for each dependent is the total premium for all dependents under 19 years of age divided by the number of dependents under 19 years of age.  
	(e)  Payments collected by a health care insurer for third party liabilities, payments recovered for overpayments, and payments for commercial reinsurance recoveries must be reported to the association and processed according to requirements established by the association.  
	(f)  A health care insurer may retain pharmacy rebates.  
	(g)  The association shall retain all premiums it receives in excess of claims it pays for ceded risks and apply the excess premiums toward payment of future claims incurred by ceded risks.  

Authorities

21.06.090;21.55.220;21.55.400

Notes

Authority

AS 21.06.090 AS 21.55.220 AS 21.55.400

History

Eff. 2/2/2013, Register 205