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Neb. Rev. Stat. § 44-5807

Insurer; third-party administrator; responsibilities

Laws 1992, LB 1006, § 82; Laws 2024, LB1073, § 23.

(1) If an insurer utilizes the services of a third-party administrator, the insurer shall be responsible for determining the benefits, premium rates, underwriting criteria, and claims-payment procedures and for securing reinsurance, if any. The rules pertaining to these matters shall be provided, in writing, by the insurer to the third-party administrator. The responsibilities of the third-party administrator as to any of these matters shall be set forth in the written agreement between the third-party administrator and the insurer. (2) It shall be the sole responsibility of the insurer to provide for competent administration of its programs. (3) In cases when a third-party administrator administers benefits for more than one hundred certificate holders or subscribers on behalf of an insurer, the insurer shall, at least semiannually, conduct a review of the operations of the third-party administrator. The director may require the insurer to conduct an onsite audit of the operations of the third-party administrator.

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