§ 23-95-105 - Plan for coverage -- Contents.
23-95-105. Plan for coverage -- Contents.
(a) Each plan promulgated or prepared pursuant to 23-95-104 shall:
(1) Give consideration to:
(A) The need for adequate and readily accessible coverage;
(B) Optional methods of improving the market affected;
(C) The inherent limitations of the insurance mechanism;
(D) The need for reasonable underwriting standards; and
(E) The requirement of reasonable loss prevention measures;
(2) Establish procedures that will create minimum interference with the voluntary market;
(3) Distribute the obligations imposed by the plan and any profits or losses experienced by the plan equitably and efficiently among the participating insurers;
(4) Establish procedures for applicants and participants to have their grievances reviewed by an impartial body. The filing and processing of a complaint or grievance pursuant to this section does not waive or stay the requirement for participation in the plan; and
(5) Establish a rating plan which shall be actuarially sound.
(b) Each plan may, on behalf of its participants:
(1) Issue policies of insurance to eligible applicants;
(2) Underwrite, adjust, and pay losses on insurance issued by the plan;
(3) Appoint a service company or companies to perform the functions enumerated in this subsection; and
(4) Obtain reinsurance for any part or all of its risks.
(c) Participation by the insurer in the losses and expenses of the plan shall be in the proportion that the direct written premiums of the insurer written in this state bears to the total aggregate written premium written in this state. Premiums which serve as the basis for participation in other risk-sharing plans established under prior law shall be excluded both from the insurer's direct written premium and the total aggregate direct written premium in determining participation in the losses and expenses of the plan.
(d) Each plan shall provide for:
(1) The method of classifying risks;
(2) The making and filing of rates which are not excessive, inadequate, or unfairly discriminatory and policy forms applicable to the various risks insured by the plan;
(3) The adjusting and processing of claims;
(4) The commission rates to be paid to agents or brokers for coverages written by the plan; and
(5) Any other insurance of investment functions that are necessary for the purpose of providing adequate and readily accessible coverage.