33-22-1314. Payment parameters. (1) The board shall design and adjust the payment parameters to ensure that the payment parameters will:
(a) stabilize or reduce premium rates in the individual market;
(b) increase or maintain participation in the individual market;
(c) mitigate the impact high-cost individuals have on premium rates in the individual market;
(d) consider any federal funding available for the plan; and
(e) consider the total amount available to fund the plan.
(2) The attachment point must be set by the board at $40,000 or more but may not exceed the reinsurance cap.
(3) The coinsurance rate must be set by the board between 50% and 80%.
(4) The reinsurance cap must be set by the board at $1 million or less.
(5) The board may adjust the payment parameters annually to the extent necessary to secure federal approval of the state innovation waiver.
History: En. Sec. 9, Ch. 210, L. 2019.