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Indiana Code Title 27. Insurance § 27-16-8-4

Current as of January 02, 2024 | Updated by Findlaw Staff

Sec. 4. If a PEO offers to the PEO's covered employees a health benefit plan that is not fully insured by an insurer authorized under this title to conduct the business of insurance in Indiana, the health benefit plan must:

(1) be administered by an administrator licensed under IC 27-1-25;

(2) hold all plan assets, including participant contributions, in a trust account;

(3) provide sound reserves for the health benefit plan as determined using generally accepted actuarial standards as set forth in an actuarial opinion filed with the commissioner and prepared and signed by a qualified actuary who:

(A) is a member in good standing of the American Academy of Actuaries;  and

(B) meets the requirements established by the commissioner in rules adopted under IC 4-22-2;

(4) annually submit current audited financial statements to the commissioner;

(5) at the discretion of the commissioner, possess a written commitment, binder, or policy for stop-loss insurance:

(A) issued by an insurer authorized to conduct the business of insurance in Indiana;  and

(B) that meets any specific and total coverage requirements established by the commissioner in rules adopted under IC 4-22-2;

(6) be subject to audit for compliance with the requirements of this section by the department on a random basis or upon a finding of reasonable need;  and

(7) provide written notice to each covered employee participating in the health benefit plan that the health benefit plan is:

(A) self-insured or not fully insured;  and

(B) subject to the federal Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 et seq.).

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Cite this article: FindLaw.com - Indiana Code Title 27. Insurance § 27-16-8-4 - last updated January 02, 2024 | https://codes.findlaw.com/in/title-27-insurance/in-code-sect-27-16-8-4/

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