Nebraska Statutes 44-7,119. Self-funded health benefit plan; not considered insurance; when; certification; required; reinsurance; authorized
(1) A health benefit plan is not insurance and except as provided in this section is not subject to any law regarding insurance if:
Terms Used In Nebraska Statutes 44-7,119
- Company: shall include any corporation, partnership, limited liability company, joint-stock company, joint venture, or association. See Nebraska Statutes 49-801
- Contract: A legal written agreement that becomes binding when signed.
- Department: shall mean the Department of Insurance. See Nebraska Statutes 44-103
- Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
- State: when applied to different states of the United States shall be construed to extend to and include the District of Columbia and the several territories organized by Congress. See Nebraska Statutes 49-801
(a) The health benefit plan provides health benefits under a self-funded arrangement administered by an entity licensed as a third-party administrator under the Third-Party Administrator Act; and
(b) The health benefit plan is sponsored by a nonprofit agricultural organization or an affiliate of a nonprofit agricultural organization that:
(i) Is domiciled in this state;
(ii) Was created primarily to promote programs for the development of rural communities and the economic stability and sustainability of farmers in this state pursuant to its articles of incorporation;
(iii) Provides membership opportunities for eligible persons in each county of this state;
(iv) Collects annual dues from its members;
(v) Holds regular meetings to further the purposes of its members;
(vi) Provides its members with representation on its governing board and any committees of such board; and
(vii) Contracts with the third-party administrator described in subdivision (a) of this subsection for administration of the health benefit plan.
(2) Before providing health benefits under a self-funded plan, an organization shall file a certification with the Department of Insurance verifying that the organization meets the requirements of this section. Such certification shall be filed at a time and in a manner prescribed by the Department of Insurance.
(3) The risk assumed by a health benefit plan under health care benefit coverage under this section may be reinsured by a company authorized to do business in this state.
(4) Any health benefit plan application for coverage and any contract provided to a member shall prominently state the following:
(a) The health benefit plan is not insurance;
(b) The health benefit plan is not provided by an insurance company;
(c) The health benefit plan is not subject to the laws and rules governing insurance; and
(d) The health benefit plan is not subject to the jurisdiction of the Department of Insurance.