40-2120. Same; plan administering carrier, selection, functions.
40-2120
40-2120. Same; plan administering carrier,selection, functions.(a) The board shall select an insurer or third-partyadministrator to administer the plan. The board shall evaluate bids submittedby interested parties based on criteria established by the board which shallinclude:
(1) The bidder's proven ability to handle individual accident and healthinsurance;
(2) the efficiency of the bidder's claim paying procedure;
(3) an estimate of total charges for administering the plan; and
(4) the bidder's ability to administer the plan in a cost efficient manner.
(b) The administering carrier so selected shall serve for a period of threeyears subject to removal for cause. At least one year prior to the expirationof each three-year period of service, the board shall invite all interestedparties, including the current administering carrier, to submit bids to serveas the administering carrier for the succeeding three-year period. Selectionof the administering carrier for the succeeding period shall be made at leastsix months prior to the end of the current three-year period. Theadministering carrier shall be paid as provided in the plan of operation.
(c) The administering carrier shall perform all administrative, eligibilityand administrative claims payment functions relating to the plan, including:
(1) Establishing a billing procedure for collection of premiums from insuredpersons. Billings shall be made on a periodic basis as determined by theboard, which shall not be more frequent than a monthly billing;
(2) performing all necessary functions to assure timely payment of benefitsto covered persons under the plan including making available informationrelating to the proper manner of submitting a claim for benefits to the plan,distributing forms upon which submission shall be made and evaluating theeligibility of each claim for payment under the plan;
(3) accepting payments of premiums from insured persons andremittingsuch payments to the state treasurer in accordance with theprovisions of K.S.A. 75-4215, and amendments thereto. Upon receipt of eachsuch remittance, the state treasurer shall deposit the entire amount in thestate treasury to the credit of the uninsurable healthinsurance plan fund established in K.S.A. 40-2126, and amendmentsthereto;
(4) submitting regular reports to the board regarding the operation of theplan. The frequency, content and form of the reports shall be as determined bythe board;
(5) determining net written and earned premiums, the expense ofadministration, and the paid and incurred losses for each year and reportingsuch information to the board and the commissioner in a form and mannerprescribed by the commissioner.
History: L. 1992, ch. 209, § 4;L. 2001, ch. 5, § 116; July 1.