Terms Used In Louisiana Revised Statutes 22:1646

  • Insurer: means any person undertaking to provide life or health and accident insurance coverage or workers' compensation insurance in this state. See Louisiana Revised Statutes 22:1641
  • underwriting: means but is not limited to the acceptance of employer or individual applications for coverage of individuals in accordance with the written rules of the insurer, the overall planning and coordinating of an insurance program, and the ability to procure bonds and excess insurance. See Louisiana Revised Statutes 22:1641

A.  If an insurer utilizes the services of an administrator, the insurer shall be responsible for determining the benefits, premium rates, underwriting criteria, and claims payment procedures applicable to such coverage and for securing reinsurance, if any.  The rules pertaining to these matters must be provided, in writing, by the insurer to the administrator.  The responsibilities of the administrator as to any of these matters shall be set forth in the written agreement between the administrator and the insurer.

B.  It shall be the sole responsibility of the insurer to provide for competent administration of its programs.

C.  In cases where an administrator administers benefits for more than one hundred certificate holders on behalf of an insurer, the insurer may, at least semiannually, conduct a review of the operations of the administrator.  At least one such review may be an on-site audit of the operations of the administrator.

Acts 1993, No. 144, §1; Redesignated from La. Rev. Stat. 22:3036 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.