PARRIS N. GLENDENING, Governor

Ch. 35

use of the defined term. A reinsuring carrier is one "that participates in the
Pool".

Defined terms: "Board" § 15-1201
"Commissioner" § 1-101
"Health benefit plan" § 15-1201
"Insurer" § 1-101
"Person" § 1-101
"Pool" § 15-1201
"Reinsurance" § 1-101
"Reinsuring carrier" § 15-1201
"State" § 1-101

15-1218. REINSURANCE.

(A) IN GENERAL.

A REINSURING CARRIER MAY REINSURE WITH THE POOL AS PROVIDED IN
THIS SECTION.

(B) MINIMUM LEVEL OF REINSURANCE.

AT A MINIMUM, THE POOL SHALL REINSURE UP TO THE LEVEL OF COVERAGE
SPECIFIED UNDER THE STANDARD PLAN.

(C) TIMING OF REINSURANCE OF GROUPS.

A REINSURING CARRIER MAY REINSURE AN ENTIRE EMPLOYER GROUP
WITHIN 60 DAYS AFTER COMMENCEMENT OF THE GROUP'S COVERAGE UNDER A
HEALTH BENEFIT PLAN.

(D) TIMING OF REINSURANCE OF INDIVIDUALS.

(1) A REINSURING CARRIER MAY REINSURE AN ELIGIBLE EMPLOYEE
OR DEPENDENT WITHIN 60 DAYS AFTER COMMENCEMENT OF COVERAGE WITH THE
SMALL EMPLOYER.

(2) A REINSURING CARRIER MAY REINSURE A NEWLY ELIGIBLE
EMPLOYEE OR DEPENDENT WITHIN 60 DAYS AFTER COMMENCEMENT OF
COVERAGE OF THE ELIGIBLE EMPLOYEE OR DEPENDENT.

(E) REIMBURSEMENT OF CLAIMS.

(1) THE POOL MAY NOT REIMBURSE A REINSURING CARRIER WITH
RESPECT TO THE CLAIMS OF AN INDIVIDUAL UNTIL THE REINSURING CARRIER HAS
INCURRED CLAIMS FOR THE INDIVIDUAL OF $5,000 IN A CALENDAR YEAR FOR
BENEFITS COVERED BY THE POOL.

(2) AFTER THE INITIAL $5,000 OF INCURRED CLAIMS, THE REINSURING
CARRIER IS RESPONSIBLE FOR 10% OF THE NEXT $50,000 OF INCURRED CLAIMS
DURING THE CALENDAR YEAR, AND THE POOL SHALL REINSURE THE REMAINDER.

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