33-22-1314. Payment parameters. (1) The board shall design and adjust the payment parameters to ensure that the payment parameters will:
(a) stabilize or reduce premium rates in the individual market;
(b) increase or maintain participation in the individual market;
(c) mitigate the impact high-cost individuals have on premium rates in the individual market;
(d) consider any federal funding available for the plan; and
(e) consider the total amount available to fund the plan.
(2) The attachment point must be set by the board at $40,000 or more but may not exceed the reinsurance cap.
(3) The coinsurance rate must be set by the board between 50% and 80%.
(4) The reinsurance cap must be set by the board at $1 million or less.
(5) The board may adjust the payment parameters annually to the extent necessary to secure federal approval of the state innovation waiver.
History: En. Sec. 9, Ch. 210, L. 2019.
Structure Montana Code Annotated
Title 33. Insurance and Insurance Companies
Chapter 22. Disability Insurance
Part 13. Montana Reinsurance Association Act
33-22-1301. Short title -- purpose
33-22-1302. Reinsurance association -- mandatory membership -- exceptions
33-22-1304. and 33-22-1305 reserved
33-22-1306. Association board of directors
33-22-1307. Duties of commissioner -- rulemaking
33-22-1308. Board duties -- powers
33-22-1309. Association administrator
33-22-1310. through 33-22-1312 reserved
33-22-1313. Association member assessments
33-22-1314. Payment parameters
33-22-1315. Calculation of reinsurance payments
33-22-1316. Administration of reinsurance payments
33-22-1317. Eligible health insurer requests for reinsurance payments
33-22-1318. and 33-22-1319 reserved
33-22-1320. Liability of association members
33-22-1321. State and federal special revenue accounts -- reinsurance program