Current through Chapter 61 of the 2024 Legislative Session and 2024 Executive Orders 125, 133 through 135
Section 21.85.500 - DefinitionsIn 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.Amended by SLA 2016, ch. 41,sec. 60, eff. 10/16/2016.