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Revised Statues - Chapter 44 Insurance


44-4225: Member's assessment; annual determination; abate or defer; when; failure to pay; director; powers.

(1) Following the close of each calendar year, the board shall determine the paid and incurred losses for the year, taking into account investment income and other appropriate gains and losses.

(2) Each member's proportion of participation in the pool shall be determined annually by the board on the basis of annual statements and other reports deemed necessary by the board and filed with the department or with the board by the member.

(3) Each member's assessment shall be determined by multiplying the total net loss from operation of the pool by a fraction. The numerator shall equal that member's premium and subscriber contract charges for health insurance written and renewed in the state during the preceding calendar year. The denominator shall equal the total of all premiums and subscriber contract charges of insurers for health insurance written or renewed in the state during the preceding calendar year. Health insurance premiums and subscriber contract charges producing assessments less than the amount determined by the board to justify the cost of collection shall not be considered for the purpose of determining assessments.

(4) Any deficit incurred by the pool shall be recouped by assessments apportioned among the members in the manner specified in subsection

(3) of this section by the board.

(5) If assessments exceed the net loss of the pool, the excess shall be held at interest and used by the board to offset future losses or to reduce pool premiums.

(6) The board may abate or defer, in whole or in part, the assessment of a member if, in the opinion of the board, payment of the assessment would endanger the ability of the member to fulfill its contractual obligations. In the event an assessment against a member is abated or deferred, in whole or in part, the amount by which such assessment is abated or deferred may be assessed against the other members in a manner consistent with the basis for assessments specified in subsection

(3) of this section. The member receiving such abatement or deferment shall remain liable to the pool for the deficiency for four years. In the event an assessment which was previously abated or deferred is later recovered by the pool, the board shall credit such recovery against future assessments made against the other members who paid the assessment as a result of such abatement or deferral.

(7) If any member fails to pay an assessment when due as required by subdivision (5) of section 44-4220, the director may, after notice and hearing, take either or both of the following actions unless such payment is deferred by the board as provided for in subsection

(6) of this section: (a) Suspend or revoke the member's certificate of authority to transact insurance business in this state; or (b) impose a monetary penalty of one hundred dollars per day, not to exceed an aggregate of ten thousand dollars, accruing from the date the assessment is due.



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