In this chapter,
(1) "allowable benefit" means a benefit for medical care;
(2) "bona fide association" has the meaning given in AS 21.54.500 ;
(3) "claims liability" means the total of all incurred and unpaid claims for allowable benefits under a self-funded multiple employer welfare arrangement that are not reimbursed or reimbursable by stop-loss insurance, subrogation, or other sources;
(4) "health benefit plan" has the meaning given in AS 21.54.500 ;
(5) "multiple employer welfare arrangement" has the meaning given in 29 U.S.C. 1002; "multiple employer welfare arrangement" does not include a group that the director designates under AS 21.54.060 (5) as subject to issuance of a group health insurance policy;
(6) "qualified actuary" means an individual who
(A) is a member in good standing of the American Academy of Actuaries;
(B) meets the qualification standards of the American Academy of Actuaries to sign statements of actuarial opinion;
(C) is familiar with the valuation requirements under AS 21.18; and
(D) has not been disqualified by the director, after notice and hearing under AS 21.06.180 , for
(i) a violation of this title or other law pertinent to the duties or responsibilities of a qualified actuary;
(ii) conviction of a fraudulent act;
(iii) conduct considered by the director to reflect incompetence or untrustworthiness;
(iv) resignation or removal as an actuary with a company or a consulting firm within the past five years due to acts or omissions indicated in a report of examination or due to failure to adhere to generally accepted actuarial standards; or
(v) failure to notify the director of an action taken against the actuary by an insurance regulator of another state for grounds that are substantially the same as a provision under this paragraph;
(7) "reserves" means the excess of assets of a self-funded multiple employer welfare arrangement minus the liabilities of the arrangement;
(8) "self-funded multiple employer welfare arrangement" or "arrangement" means a multiple employer welfare arrangement that does not provide for payment of benefits under the arrangement solely through a policy of insurance issued by one or more authorized insurance companies.
Section: Previous 21.85.010 21.85.020 21.85.030 21.85.040 21.85.050 21.85.060 21.85.070 21.85.080 21.85.090 21.85.100 21.85.500Last modified: November 15, 2016