24-A §3905. Duties and powers of the association

Title 24-A: MAINE INSURANCE CODE

Chapter 54: MAINE INDIVIDUAL REINSURANCE ASSOCIATION

§3905. Duties and powers of the association

1. Duties. The association shall:

A. Establish administrative and accounting procedures for the operation of the association; [2007, c. 629, Pt. A, §8 (NEW).]

B. Establish procedures under which applicants and participants in the plan may have grievances reviewed by an impartial body and reported to the board; [2007, c. 629, Pt. A, §8 (NEW).]

C. Select a plan administrator in accordance with section 3906; [2007, c. 629, Pt. A, §8 (NEW).]

D. Establish procedures for the handling and accounting of association assets; and [2007, c. 629, Pt. A, §8 (NEW).]

E. Establish an amount to be retained in the Reinsurance Association Reserve in accordance with section 3907. [2007, c. 629, Pt. A, §8 (NEW).]

[ 2007, c. 629, Pt. A, §8 (NEW) .]

2. Powers. The association may:

A. Exercise powers granted to nonprofit corporations under the laws of this State; [2007, c. 629, Pt. A, §8 (NEW).]

B. Enter into contracts as necessary or proper to carry out the provisions and purposes of this chapter, including the authority, with the approval of the superintendent, to enter into contracts with similar organizations in other states for the joint performance of common administrative functions or with persons or other organizations for the performance of administrative functions; [2007, c. 629, Pt. A, §8 (NEW).]

C. Sue or be sued, including taking any legal actions necessary or proper to recover or collect obligations due the association; [2007, c. 629, Pt. A, §8 (NEW).]

D. Take any legal actions necessary to avoid the payment of improper claims against the association or the coverage provided by or through the association, to recover any amounts erroneously or improperly paid by the association, to recover any amounts paid by the association as a result of mistake of fact or law or to recover other amounts due the association; [2007, c. 629, Pt. A, §8 (NEW).]

E. Appoint appropriate legal, actuarial and other committees as necessary to provide technical assistance in the operation of the plan, policy or other contract design and any other function within the authority of the association; [2007, c. 629, Pt. A, §8 (NEW).]

F. Establish procedures for reinsuring risks of insurers in the association in accordance with section 3908; [2007, c. 629, Pt. A, §8 (NEW).]

G. Provide for reinsurance of risks incurred by the association. The provision of reinsurance may not subject the association to any of the capital or surplus requirements, if any, otherwise applicable to reinsurers; and [2007, c. 629, Pt. A, §8 (NEW).]

H. Apply for funds or grants from public or private sources, including federal grants provided to qualified high-risk reinsurance associations. [2007, c. 629, Pt. A, §8 (NEW).]

[ 2007, c. 629, Pt. A, §8 (NEW) .]

3. Additional duties and powers. The superintendent may, by rule, establish additional powers and duties of the association and may adopt such rules as are necessary and proper to implement this chapter. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.

[ 2007, c. 629, Pt. A, §8 (NEW) .]

4. Review for solvency. The superintendent shall review the operations of the association at least every 3 years to determine its solvency. If the superintendent determines that the funds of the association are insufficient to support the need for reinsurance, the superintendent may order the association to adjust the initial level of claims and the reserve amount to be retained by the association.

[ 2007, c. 629, Pt. A, §8 (NEW) .]

5. Annual report. The association shall report annually to the joint standing committee of the Legislature having jurisdiction over health insurance matters by March 15th. The report must include information on the financial solvency of the association and the administrative expenses of the association.

[ 2007, c. 629, Pt. A, §8 (NEW) .]

6. Audit. The association must be audited at least every year by an independent auditor. A copy of the audit must be provided to the superintendent and to the joint standing committee of the Legislature having jurisdiction over health insurance matters.

[ 2007, c. 629, Pt. A, §8 (NEW) .]

SECTION HISTORY

2007, c. 629, Pt. A, §8 (NEW).