TITLE 41

INSURANCE

CHAPTER 41

JOINT PUBLIC AGENCY SELF-FUNDED HEALTH CARE PLANS

41-4110.  Reserves. (1) A joint public agency self-funded plan shall establish and maintain in its trust fund the following reserves:

(a)  A reserve in an amount as certified by a member of the American academy of actuaries as being necessary for payment of claims against the trust fund for benefits, including both claims reported and not yet paid and claims incurred but not yet reported. Any joint public agency self-funded plan in existence as of July 1, 2006, shall also have three (3) years from the effective date of this act to fund the applicable reserves.

(b)  If under the plan periodic contributions of either the employer or employees to the trust fund are payable less frequently than monthly, there shall be a reserve for unearned contributions as computed pro rata on the basis of the unexpired portion of the period for which the contribution has been paid.

(2)  In any determination of the financial condition of the trust fund, the claims reserve and reserve for unearned contributions shall constitute liabilities.

(3)  Upon request of a plan, the director shall have the authority to annually waive the requirement that the plan maintain aggregate stop-loss coverage if:

(a)  The joint public agency self-funded plan established by a joint powers agreement is governed by a board of trustees and is operating as a public agency;

(b)  Enrollment under the plan averages a minimum of one thousand (1,000) covered persons in each of the preceding twelve (12) months;

(c)  The plan establishes and maintains, in its trust fund, reserves as set forth in subsection (1)(a) of this section; and

(d)  The plan establishes and maintains, in its trust fund, surplus of at least the amount certified annually by a member of the American academy of actuaries as sufficient without aggregate stop-loss coverage, but no less than three (3) months of contributions.

History:

[41-4110, added 2006, ch. 415, sec. 1, p. 1276; am. 2018, ch. 61, sec. 3, p. 152.]