Sec. 21.85.500. Definitions.

323 words·~1 min read·/ak/title-21/chapter-85/21-85-500

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

In this chapter,

(1)“allowable benefit” means a benefit for medical care;

(2)“bona fide association” has the meaning given in AS 21.54.500 ;

(3)“claims liability” means the total of all incurred and unpaid claims for allowable benefits under a self-funded multiple employer welfare arrangement that are not reimbursed or reimbursable by stop-loss insurance, subrogation, or other sources;

(4)“health benefit plan” has the meaning given in AS 21.54.500 ;

(5)“multiple employer welfare arrangement” has the meaning given in 29 U.S.C. 1002;

(6)“qualified actuary” means an individual who

(A)is a member in good standing of the American Academy of Actuaries;

(B)meets the qualification standards of the American Academy of Actuaries to sign statements of actuarial opinion;

(C)is familiar with the valuation requirements under AS 21.18 ; and

(D)has not been disqualified by the director, after notice and hearing under AS 21.06.180 , for

(i)a violation of this title or other law pertinent to the duties or responsibilities of a qualified actuary;

(ii)conviction of a fraudulent act;

(iii)conduct considered by the director to reflect incompetence or untrustworthiness;

(iv)resignation or removal as an actuary with a company or a consulting firm within the past five years due to acts or omissions indicated in a report of examination or due to failure to adhere to generally accepted actuarial standards; or

(v)failure to notify the director of an action taken against the actuary by an insurance regulator of another state for grounds that are substantially the same as a provision under this paragraph;

(7)“reserves” means the excess of assets of a self-funded multiple employer welfare arrangement minus the liabilities of the arrangement;

(8)“self-funded multiple employer welfare arrangement” or “arrangement” means a multiple employer welfare arrangement that does not provide for payment of benefits under the arrangement solely through a policy of insurance issued by one or more authorized insurance companies.