Laws of North Carolina (Last Updated: May 12, 2015) |
Chapter58. Insurance. |
Article50. General Accident and Health Insurance Regulations |
Part6. North Carolina Health Insurance Risk Pool |
§58-50-260. (Repealed effective January 1, 2017 - see note) Dissolution of Pool
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(a) Insurance operations of the Pool under this Part shall sunset on January 1, 2014.
(b) In order to be handled in the regular course of business, rather than under subsection (f) of this section, all invoices for medical, pharmacy, and any other services provided under this Part must be submitted no later than 90 days after the sunset of insurance operations of the Pool under subsection (a) of this section.
(c) In order to be handled in the regular course of business, rather than under subsection (f) of this section, all appeals and grievances under this Part must be submitted no later than 90 days after the sunset of insurance operations of the Pool under subsection (a) of this section.
(d) On or before September 1, 2013, the Pool shall submit to the Commissioner a plan for dissolution of the Pool. The plan shall address the following:
(1) Continuity of care for those participants in the Pool that are inpatient at the time of sunset of insurance operations of the Pool under subsection (a) of this section.
(2) Continuation of administrative services following the sunset of the Pool's insurance operations.
(3) Closing the Pool's bank and investment accounts.
(4) Cessation of premium subsidy programs.
(5) Performance and completion by June 30, 2014, of a final audit by the State Auditor and submission of the Pool's annual report to the State.
(6) A plan for maintenance of the Pool's books and records pursuant to G.S. 58-56-16 by the Pool's final third-party administrator.
(7) Efforts to secure contingency funding should the Pool's operations so require.
(8) Final dissolution of the Pool.
(9) The deposit and management of funding held in reserve following final dissolution of the Pool to be used in connection with actions by or against the Pool that are timely filed, as provided in subsection (f) of this section.
(10) Other matters that the Commissioner may reasonably require.
(e) The plan of dissolution for the Pool shall become effective upon approval in writing by the Commissioner. The Commissioner shall approve the plan of dissolution if he or she determines that the plan is suitable to assure the fair, reasonable, and equitable dissolution of the Pool and that the plan complies with subsection (d) of this section.
(f) Notwithstanding any longer statute of limitations provided under law for an action, all actions by or against the Pool must be filed on or before one year following the sunset of insurance operations of the Pool under subsection (a) of this section. After final dissolution of the Pool, the Pool's liability for insurance benefits, provider or vendor invoices, and all other matters shall be limited to the reserve amount established under subdivision (9) of subsection (d) of this section, less the costs of resolving the claims by or against the Pool.
(g) Any funds in excess of the reserve amount established under subdivision (9) of subsection (d) of this section that remain in the North Carolina Health Insurance Risk Pool Fund at the time of final dissolution shall be paid into the General Fund. After the resolution of timely filed actions against the Pool, any reserve funds remaining in the Risk Pool Fund shall be paid into the General Fund.