33-22-1313. Association member assessments. (1) (a) (i) For 2020 and each year thereafter, the commissioner shall assess each member insurer 1.2% of its total premium volume covering Montana residents, from the prior calendar year, regardless of type of license.
(ii) For purposes of subsection (1)(a)(i), total premium volume may not include premiums that member insurers collect on any coverage issued for excepted benefits as defined in 33-22-140.
(b) The board shall determine the timing of the assessment.
(c) The commissioner shall consider the board's recommendation when determining the assessment amounts.
(d) The commissioner shall verify the amount of each insurer's assessment based on annual financial statements and other reports determined to be necessary.
(2) The association shall determine and report to the commissioner the association's reinsurance payments and other expenses for the previous calendar year, including administrative expenses and any incurred but not reported claims for the previous calendar year.
(a) The report must consider investment income and other appropriate gains.
(b) The report must include an estimate of the assessments needed to cover the expected reinsurance claims for the following calendar year.
(3) If assessments and other funds collected by the association exceed the actual losses and administrative expenses of the association, the board shall use the excess funds to offset future claims or to reduce future assessments.
(4) The commissioner may, after notice and hearing:
(a) suspend or revoke the certificate of authority to transact insurance in this state of any member insurer that fails to pay an assessment;
(b) impose a penalty on any insurer that fails to pay an assessment when due; or
(c) use any power granted to the commissioner to collect any unpaid assessment.
(5) An eligible health insurer may not submit claims for reinsurance payments unless the insurer has a medical loss ratio of 80% or greater, as defined in 45 CFR 158.232(f).
History: En. Sec. 8, Ch. 210, L. 2019; amd. Sec. 6, Ch. 471, L. 2021.