Section 376.962

Title XXIV BUSINESS AND FINANCIAL INSTITUTIONS

Chapter 376

Effective - 28 Aug 2013   

  376.962.  Plan of operation to be submitted by board — effective when — failure to submit, director's duty to develop rules — plan content — amendments, procedure. — 1.  The board of directors on behalf of the pool shall submit to the director a plan of operation for the pool and any amendments thereto necessary or suitable to assure the fair, reasonable and equitable administration of the pool.  After notice and hearing, the director shall approve the plan of operation, provided it is determined to be suitable to assure the fair, reasonable and equitable administration of the pool, and it provides for the sharing of pool gains or losses on an equitable proportionate basis.  The plan of operation shall become effective upon approval in writing by the director consistent with the date on which the coverage under sections 376.960 to 376.989 becomes available.  If the pool fails to submit a suitable plan of operation within one hundred eighty days after the appointment of the board of directors, or at any time thereafter fails to submit suitable amendments to the plan, the director shall, after notice and hearing, adopt and promulgate such reasonable rules as are necessary or advisable to effectuate the provisions of this section.  Such rules shall continue in force until modified by the director or superseded by a plan submitted by the pool and approved by the director.

  2.  In its plan, the board of directors of the pool shall:

  (1)  Establish procedures for the handling and accounting of assets and moneys of the pool;

  (2)  Select an administering insurer or third-party administrator in accordance with section 376.968;

  (3)  Establish procedures for filling vacancies on the board of directors; and

  (4)  Establish procedures for the collection of assessments from all members to provide for claims paid under the plan and for administrative expenses incurred or estimated to be incurred during the period for which the assessment is made.  The level of payments shall be established by the board pursuant to the provisions of section 376.973.  Assessment shall occur at the end of each calendar year and shall be due and payable within thirty days of receipt of the assessment notice.

  3.  On or before September 1, 2013, the board shall submit the amendments to the plan of operation as are necessary or suitable to ensure a reasonable transition period to allow for the termination of issuance of policies by the pool.

  4.  The amendments to the plan of operation submitted by the board shall include all of the requirements outlined in subsection 2 of this section and shall address the transition of individuals covered under the pool to alternative health insurance coverage as it is available after January 1, 2014.  The plan of operation shall also address procedures for finalizing the financial matters of the pool, including assessments, claims expenses, and other matters identified in subsection 2 of this section.

  5.  The director shall review the plan of operation submitted under subsection 3 of this section and shall promulgate rules to effectuate the transitional plan of operation.  Such rules shall be effective no later than October 1, 2013.  Any rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.  This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2013, shall be invalid and void.

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(L. 1990 H.B. 998 § 2 subsecs. 4, 5, A.L. 2013 S.B. 262)