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Idaho Code § 41-5210

Application to become a risk-assuming carrier

Known as the Individual Health Insurance Availability Act

The act spans §§ 41–41 (14 sections).

I.C., § 41-5210, as added by 1994, ch. 427, § 1, p. 1337.

(1) An individual carrier may apply to become a risk-assuming carrier by filing an application with the director in a form and manner prescribed by the director.

(2) The director shall consider the following factors in evaluating an application filed under the provisions of subsection (1) of this section: The carrier’s financial condition;

(3) The carrier’s history of rating and underwriting individuals;

(4) The carrier’s commitment to market fairly to all individuals in the state or its established geographic service area, as applicable;

(5) The carrier’s experience with managing the risk of individuals; and

(6) The extent to which a carrier has and will be able to maintain reinsurance pursuant to the provisions of subsection (3) of section 41-5204, Idaho Code.

(7) The director shall provide public notice of an application by an individual carrier to be a risk-assuming carrier and shall provide at least a sixty (60) day period for public comment prior to making a decision on the application. If the application is not acted upon within ninety (90) days of the receipt of the application by the director, the carrier may request a hearing.

(8) The director may rescind the approval granted to a risk-assuming carrier under the provisions of this section if the director finds that: The carrier’s financial condition will no longer support the assumption of risk from issuing coverage to individuals in compliance with the provisions of section 41-5208, Idaho Code, without the protection afforded by the program;

(9) The carrier has failed to market fairly to all individuals in the state or its established geographic service area, as applicable; or

(10) The carrier has failed to provide coverage to eligible individuals as required in section 41-5208, Idaho Code.

(11) An individual carrier electing to be a risk-assuming carrier shall not be subject to the provisions of section 41-4711, Idaho Code, except to the extent such individual carrier is subject to assessment for additional funding pursuant to the provisions of subsection (12)(c) of section 41-4711, Idaho Code.

Current official text: Idaho Statutes (Idaho Legislature). Digitized from the UniCourt Code Improvement Commission public-domain capture. Reproduced from public-domain Idaho statutes; confirm against the official source for the current text. Not legal advice.