(1) An insurance purchasing outlet shall:
(a) Set and collect fees to finance necessary costs incurred in marketing, selling, servicing, and administering its services;
(b) Offer health benefit plans to eligible persons;
(c) Provide premium and voucher collection services for participating insurers;
(d) Establish and adhere to appropriate administrative and accounting procedures for operating the health purchasing outlet;
(e) Establish and adhere to rules, conditions, and procedures for insurance purchasing outlet members and participating insurers;
(f) Establish and adhere to enrollment and participation requirements for insurance purchasing outlet members;
(g) Receive, review, and conduct appeals for persons who have been denied enrollment to an insurance purchasing outlet;
(h) Demonstrate and maintain at all times proof of financial responsibility and solvency;
(i) Prepare an annual report on the operations of the insurance purchasing outlet in accordance with administrative regulations promulgated by the commissioner;
(j) Establish procedures for billing and collection of premiums from insurance purchasing outlet members;
(k) Establish procedures for collecting and redeeming vouchers; and
(l) Maintain an administrator license in accordance with Subtitle 9 of Chapter
304.
(2) An insurance purchasing outlet may:
(a) Contract with qualified third parties for any services necessary to carry out the powers and duties authorized or required by this chapter;
(b) Employ necessary staff; (c) Sue or be sued;
(d) Contract with independent licensed administrators to adjust or settle claims, since the insurance purchasing outlet is prohibited from these activities in accordance with KRS § 304.17A-758; and
(e) Employ, contract, or otherwise use licensed insurance agents to market and service coverage.
Effective: July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1254, effective July 15, 2010. — Created
2002 Ky. Acts ch. 207, sec. 6, effective July 15, 2002.