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- Alaska Statutes.
- Title 21. Insurance
- Chapter 85. Regulation of Multiple Employer Welfare Arrangements
- Section 500. Definitions.
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Section 100. Applicability of Other Provisions.
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Chapter 86. Health Maintenance Organizations
AS 21.85.500. Definitions.
In 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; "multiple employer welfare
arrangement" does not include a group that the director designates under AS 21.54.060
(5) as subject to issuance of a group health insurance policy;
- (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.
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