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KRS 304.17A-760

Duties and powers of insurance purchasing outlet

Effective: July 15, 2010 History: Amended 2010 Ky

(1) An insurance purchasing outlet shall:

(a) Set and collect fees to finance necessary costs incurred in marketing, selling, servicing, and administering its services;

(b) Offer health benefit plans to eligible persons;

(c) Provide premium and voucher collection services for participating insurers;

(d) Establish and adhere to appropriate administrative and accounting procedures for operating the health purchasing outlet;

(e) Establish and adhere to rules, conditions, and procedures for insurance purchasing outlet members and participating insurers;

(f) Establish and adhere to enrollment and participation requirements for insurance purchasing outlet members;

(g) Receive, review, and conduct appeals for persons who have been denied enrollment to an insurance purchasing outlet;

(h) Demonstrate and maintain at all times proof of financial responsibility and solvency;

(i) Prepare an annual report on the operations of the insurance purchasing outlet in accordance with administrative regulations promulgated by the commissioner;

(j) Establish procedures for billing and collection of premiums from insurance purchasing outlet members;

(k) Establish procedures for collecting and redeeming vouchers; and (l) Maintain an administrator license in accordance with Subtitle 9 of Chapter 304.

(2) An insurance purchasing outlet may:

(a) Contract with qualified third parties for any services necessary to carry out the powers and duties authorized or required by this chapter;

(b) Employ necessary staff;

(c) Sue or be sued;

(d) Contract with independent licensed administrators to adjust or settle claims, since the insurance purchasing outlet is prohibited from these activities in accordance with KRS 304.17A-758; and (e) Employ, contract, or otherwise use licensed insurance agents to market and service coverage.

Official source: Kentucky General Assembly. Reproduced from public-domain Kentucky statutes; confirm against the official source for the current text. Not legal advice.