Bill > S510

This bill, related to insurer reserve requirements, mandates that insurance carriers submit an annual comprehensive financial statement to the division detailing their costs from the previous year, itemized by market group size and line of business, and including specific financial information such as direct premiums earned, claims incurred, medical loss ratio, number of members, realized capital gains and losses, net income, accumulated surplus, accumulated reserves, downside risk transferred to other organizations, risk-based capital ratio, and various expense categories like financial administration, marketing, claims operations, and charitable expenses. The bill also defines "carrier" broadly to include various types of health insurance providers, third-party administrators, and pharmacy benefit managers, and requires carriers that provide administrative services to self-insured groups to include additional financial and operational data for those groups in their reports. Furthermore, it establishes penalties for late filings, mandates that the division make all collected information public, and requires the division to issue an annual summary report to legislative committees. The bill also allows the commissioner to waive reporting requirements under certain conditions and requires the commissioner to establish a formula for determining reserves allocated to risk-bearing provider organizations and to adopt regulations within 90 days of the bill's effective date. Finally, if a carrier's risk-based capital ratio exceeds 600%, the division must hold a public hearing and the carrier must provide testimony on its financial condition and how it will use surplus to reduce health plan costs.