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.]
Structure Idaho Code
Chapter 41 - JOINT PUBLIC AGENCY SELF-FUNDED HEALTH CARE PLANS
Section 41-4101 - DECLARATION OF PURPOSE.
Section 41-4102 - DEFINITIONS.
Section 41-4103 - REGISTRATION REQUIRED — EXEMPTIONS — NOT SUBJECT TO INSURANCE CODE.
Section 41-4104 - QUALIFICATIONS FOR REGISTRATION.
Section 41-4105 - APPLICATION FOR REGISTRATION.
Section 41-4106 - GRANT OR DENIAL OF APPLICATION.
Section 41-4107 - TRUST FUND — POWERS.
Section 41-4108 - TRUST FUND LIABILITY.
Section 41-4109 - INVESTMENT OF TRUST FUND.
Section 41-4110 - RESERVES.
Section 41-4111 - RECORDS AND ACCOUNTS — ANNUAL STATEMENT.
Section 41-4112 - TAXES — EXEMPTION.
Section 41-4113 - EXAMINATION OF BOOKS, RECORDS AND ACCOUNTS.
Section 41-4114 - BOARD OF TRUSTEES — ADMINISTRATORS.
Section 41-4115 - PROHIBITED PECUNIARY INTERESTS IN PLAN MANAGEMENT.
Section 41-4116 - POLITICAL CONTRIBUTIONS PROHIBITED.
Section 41-4117 - RECOVERY OF DEPLETED FUNDS.
Section 41-4118 - TERMINATION OF REGISTRATION.
Section 41-4119 - LIQUIDATION OF TRUST FUND.
Section 41-4121 - OTHER PROVISIONS APPLICABLE.
Section 41-4123 - COVERAGE FROM MOMENT OF BIRTH — COMPLICATIONS OF PREGNANCY.
Section 41-4124 - SERVICES PROVIDED BY GOVERNMENTAL ENTITIES.