TITLE 41

INSURANCE

CHAPTER 34

HOSPITAL AND PROFESSIONAL SERVICE CORPORATIONS

41-3421.  Reserves. (1) In addition to the surplus fund provided for in section 41-3422, every service corporation shall establish and maintain unimpaired reserves as follows:

(a)  Due obligations. A reserve in an amount not less than all legal obligations of the corporation, other than claims originating under subscriber’s contracts, due but unpaid;

(b)  Incurred losses. A reserve equal to not less than the amount necessary by reasonable estimate to pay all claims incurred under subscriber’s contracts but currently unpaid, and including a reasonable additional amount to cover claims incurred but not reported to the corporation at the time of determination of the corporation’s financial condition; but subject, as to amounts payable to participant physicians, participant hospitals, or participant pharmacists, to the right of the service corporation to prorate such amounts in accordance with the provisions of the service agreement;

(c)  Unearned indemnity charges. A reserve equal to fifty percent of all sums charged and received by the corporation during the calendar period covered by the financial statement, on account of indemnity benefits provided in subscriber’s contracts for terms for which premium was last paid and unexpired at the date of the financial statement; and

(d)  Deferred service benefits. A reserve in an amount reasonably adequate to offset the additional cost thereafter to be incurred on account of deferred maternity benefits and similar deferred service benefits, such reserve to be set aside out of charges currently received on account of subscriber’s contracts providing for such deferred benefits.

(2)  The reserves required under subsection (1) above, shall constitute a liability of the corporation in any determination of its financial condition.

History:

[41-3421, added 1961, ch. 330, sec. 779, p. 645; am. 1967, ch. 399, sec. 12, p. 1194.]