(a) The ExecutiveDirector, with the approval or authorization of the Board, shall select througha competitive bidding process one or more insurers to administer the Pool. TheExecutive Director shall evaluate bids submitted based on criteria establishedby the Board. The criteria shall allow for the comparison of information abouteach bidding administrator and selection of a Pool Administrator based on atleast the following:
(1) Proven ability tohandle health insurance coverage to individuals.
(2) Efficiency andtimeliness of the claim processing procedures.
(3) Estimated totalcharges for administering the Pool.
(4) Ability to applyeffective cost containment programs and procedures and to administer the Poolin a cost‑efficient manner.
(5) Financial conditionand stability.
(6) Evidence ofauthority to provide third‑party administrative services in NorthCarolina.
(b) The Administratorshall serve for a period specified in the contract between the Pool and theAdministrator subject to removal for cause and subject to any terms,conditions, and limitations of the contract between the Pool and theAdministrator. At least one year before the expiration of each period ofservice by an Administrator, the Executive Director shall invite eligibleentities, including the current Administrator, unless the current Administratorwas removed for cause, to submit bids to serve as the Administrator. Selectionof the Administrator for the succeeding period shall be made at least six monthsbefore the end of the current period.
(c) The Administratorshall perform such functions relating to the Pool as may be assigned to it,including:
(1) Verification ofeligibility.
(2) Payment of claims.
(3) Establishment of apremium billing procedure for collection of premiums from individuals coveredunder the Pool.
(4) Other necessaryfunctions to assure timely payment of benefits to covered persons under thePool.
(d) The Administratorshall submit regular reports to the Executive Director and the Board regardingthe operation of the Pool. The contract between the Pool and the Administratorshall specify the frequency, content, and form of the report.
(e) Following the closeof each calendar year, the Administrator shall determine net written and earnedpremiums, the expense of administration, and the paid and incurred losses forthe year and report this information to the Executive Director and the Board ona form prescribed by the Executive Director.
(f) The Administratorshall be paid as provided in the contract between the Pool and theAdministrator. (2007‑532,s. 1.1; 2008‑124, s. 6.3.)
(a) The ExecutiveDirector, with the approval or authorization of the Board, shall select througha competitive bidding process one or more insurers to administer the Pool. TheExecutive Director shall evaluate bids submitted based on criteria establishedby the Board. The criteria shall allow for the comparison of information abouteach bidding administrator and selection of a Pool Administrator based on atleast the following:
(1) Proven ability tohandle health insurance coverage to individuals.
(2) Efficiency andtimeliness of the claim processing procedures.
(3) Estimated totalcharges for administering the Pool.
(4) Ability to applyeffective cost containment programs and procedures and to administer the Poolin a cost‑efficient manner.
(5) Financial conditionand stability.
(6) Evidence ofauthority to provide third‑party administrative services in NorthCarolina.
(b) The Administratorshall serve for a period specified in the contract between the Pool and theAdministrator subject to removal for cause and subject to any terms,conditions, and limitations of the contract between the Pool and theAdministrator. At least one year before the expiration of each period ofservice by an Administrator, the Executive Director shall invite eligibleentities, including the current Administrator, unless the current Administratorwas removed for cause, to submit bids to serve as the Administrator. Selectionof the Administrator for the succeeding period shall be made at least six monthsbefore the end of the current period.
(c) The Administratorshall perform such functions relating to the Pool as may be assigned to it,including:
(1) Verification ofeligibility.
(2) Payment of claims.
(3) Establishment of apremium billing procedure for collection of premiums from individuals coveredunder the Pool.
(4) Other necessaryfunctions to assure timely payment of benefits to covered persons under thePool.
(d) The Administratorshall submit regular reports to the Executive Director and the Board regardingthe operation of the Pool. The contract between the Pool and the Administratorshall specify the frequency, content, and form of the report.
(e) Following the closeof each calendar year, the Administrator shall determine net written and earnedpremiums, the expense of administration, and the paid and incurred losses forthe year and report this information to the Executive Director and the Board ona form prescribed by the Executive Director.
(f) The Administratorshall be paid as provided in the contract between the Pool and theAdministrator. (2007‑532,s. 1.1; 2008‑124, s. 6.3.)
(a) The ExecutiveDirector, with the approval or authorization of the Board, shall select througha competitive bidding process one or more insurers to administer the Pool. TheExecutive Director shall evaluate bids submitted based on criteria establishedby the Board. The criteria shall allow for the comparison of information abouteach bidding administrator and selection of a Pool Administrator based on atleast the following:
(1) Proven ability tohandle health insurance coverage to individuals.
(2) Efficiency andtimeliness of the claim processing procedures.
(3) Estimated totalcharges for administering the Pool.
(4) Ability to applyeffective cost containment programs and procedures and to administer the Poolin a cost‑efficient manner.
(5) Financial conditionand stability.
(6) Evidence ofauthority to provide third‑party administrative services in NorthCarolina.
(b) The Administratorshall serve for a period specified in the contract between the Pool and theAdministrator subject to removal for cause and subject to any terms,conditions, and limitations of the contract between the Pool and theAdministrator. At least one year before the expiration of each period ofservice by an Administrator, the Executive Director shall invite eligibleentities, including the current Administrator, unless the current Administratorwas removed for cause, to submit bids to serve as the Administrator. Selectionof the Administrator for the succeeding period shall be made at least six monthsbefore the end of the current period.
(c) The Administratorshall perform such functions relating to the Pool as may be assigned to it,including:
(1) Verification ofeligibility.
(2) Payment of claims.
(3) Establishment of apremium billing procedure for collection of premiums from individuals coveredunder the Pool.
(4) Other necessaryfunctions to assure timely payment of benefits to covered persons under thePool.
(d) The Administratorshall submit regular reports to the Executive Director and the Board regardingthe operation of the Pool. The contract between the Pool and the Administratorshall specify the frequency, content, and form of the report.
(e) Following the closeof each calendar year, the Administrator shall determine net written and earnedpremiums, the expense of administration, and the paid and incurred losses forthe year and report this information to the Executive Director and the Board ona form prescribed by the Executive Director.
(f) The Administratorshall be paid as provided in the contract between the Pool and theAdministrator. (2007‑532,s. 1.1; 2008‑124, s. 6.3.)
