Indiana § 27-8-10-0.5 - Dissolution of the association

§ 27-8-10-0.5. Dissolution of the association

Sec. 0.5. (a) Except as provided in this section, the insurance operations of the association cease on the later of:

(1) the date on which a health benefit exchange (as defined in IC 27-19-2-8) begins operating in Indiana; or

(2) December 31, 2013.

(b) A claim for payment under an association policy must be made to the association not later than the later of:

(1) sixty (60) days after the date on which the insurance operations cease under subsection (a); or

(2) March 1, 2014.

(c) An appeal or grievance under this chapter must be resolved not later than ninety (90) days after the date on which the insurance operations cease under subsection (a).

(d) Balance billing under this chapter by a health care provider that is not a member of a health care provider network arrangement used by the association is prohibited after the later of:

(1) ninety (90) days after the date on which the insurance operations cease under subsection (a); or

(2) March 30, 2014.

(e) The association shall, not later than June 30, 2013, submit to the commissioner a plan of dissolution for the association. The following apply to a plan of dissolution submitted under this subsection:

(1) The plan of dissolution must provide for the following:

(A) Continuity of care for an individual who is covered under an association policy and is an inpatient on the date on which the insurance operations cease under subsection (a).

(B) A final accounting described in section 2.1(g) of this chapter of the:

(i) assessments; and

(ii) cessation of the liability;

of members of the association.

(C) Resolution of any net asset deficiency.

(D) Cessation of all liability of the association.

(E) Final dissolution of the association.

(2) The plan of dissolution may provide that, with the approval of the board and the commissioner, a power or duty of the association may be delegated to a person that is to perform functions similar to the functions of the association.

(f) The commissioner shall, after notice and hearing, approve a plan of dissolution submitted under subsection (e) if the commissioner determines that the plan:

(1) is suitable to ensure the fair, reasonable, and equitable dissolution of the association; and

(2) complies with subsection (e).

(g) A plan of dissolution submitted under subsection (e) is effective upon the written approval of the commissioner.

(h) An action by or against the association must be filed not more than one (1) year after the date on which the insurance operations cease under subsection (a).

(i) This chapter expires on the date on which final dissolution of the association occurs under the plan of dissolution approved by the commissioner under subsection (f).

(j) Funds remaining in the association on the date on which final dissolution of the association occurs must be transferred into the state general fund.

(k) The association, or the person to which the association delegates powers or duties under subsection (e), may implement this section in accordance with the plan of dissolution approved by the commissioner under subsection (f).

As added by P.L.278-2013, SEC.26.