§ 9506. Payment of coverage and administrative costs.
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§ 9506. Payment of coverage and administrative costs.
(a)General rule.-- Consistent with Federal requirements, the department shall pay the following from the Reinsurance Fund:
(1)Administrative expenses of the reinsurance program, including the annual audit required under section 9508 (relating to annual audit).
(2)Reinsurance payments for coverage of reinsurance-eligible enrollees.
(b)Operations.-- The department may promulgate regulations necessary and appropriate to establish processes for the settlement of reinsurance coverage claims and disbursement of reinsurance money.
(c)Request for review.-- An insurer that is aggrieved by a determination of the department relating to the amount of reinsurance payments due to the insurer may file a request for administrative review of the decision. The procedures and requirements of 2 Pa.C.S. Ch. 5 Subch. A (relating to practice and procedure of Commonwealth agencies) shall apply to requests for review filed under this section. Notwithstanding otherwise applicable time limitations, in order to permit timely finalization of rates for the open enrollment period for the exchange, a challenge to the department's determination of the attachment point, reinsurance cap and coinsurance rate published in the Pennsylvania Bulletin under section 9504(c) (relating to reinsurance parameters) must be made within 10 business days of the date of publication.
40c9507s