Application To Become A Risk-Assuming Carrier

TITLE 41 INSURANCE CHAPTER 52 INDIVIDUAL HEALTH INSURANCE AVAILABILITY ACT 41-5210. Application to become a risk-assuming carrier. (1) An individual carrier may apply to become a risk-assuming carrier by filing an application with the director in a form and manner prescribed by the director. (2)  The director shall consider the following factors in evaluating an application filed under the provisions of subsection (1) of this section: (a)  The carrier’s financial condition; (b)  The carrier’s history of rating and underwriting individuals; (c)  The carrier’s commitment to market fairly to all individuals in the state or its established geographic service area, as applicable; (d)  The carrier’s experience with managing the risk of individuals; and (e)  The extent to which a carrier has and will be able to maintain reinsurance pursuant to the provisions of subsection (3) of section 41-5204 , Idaho Code. (3)  The director shall provide public notice of an application by an individual carrier to be a risk-assuming carrier and shall provide at least a sixty (60) day period for public comment prior to making a decision on the application. If the application is not acted on within ninety (90) days of the receipt of the application by the director, the carrier may request a hearing. (4)  The director may rescind the approval granted to a risk-assuming carrier under the provisions of this section if the director finds that: (a)  The carrier’s financial condition will no longer support the assumption of risk from issuing coverage to individuals in compliance with the provisions of section 41-5208 , Idaho Code, without the protection afforded by the program; (b)  The carrier has failed to market fairly to all individuals in the state or its established geographic service area, as applicable; or (c)  The carrier has failed to provide coverage to eligible individuals as required in section 41-5208 , Idaho Code.