Common use of Reinsurance Clause in Contracts

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  Agreements and Coverage  The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  Requirements for Reinsurance Companies  The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.  Subcontractors  Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  Agreements and Coverage  The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  Requirements for Reinsurance Companies  The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.  Subcontractors  Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  Agreements and Coverage  The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must shall provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must shall receive approval from OMPP before changing the attachment point.  The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must shall finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  Requirements for Reinsurance Companies  The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  The Contractor shall be is required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.  Subcontractors  Subcontractors’ reinsurance coverage requirements must shall be clearly defined in the reinsurance agreement.  Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  Agreements and Coverage  The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  Requirements for Reinsurance Companies  The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.  Subcontractors  Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP FSSA for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 500,000 and shall apply to all services, unless otherwise approved by OMPPFSSA. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must 500,000 shall provide a justification in its proposal or submit justification to OMPP FSSA in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must shall receive approval from OMPP FSSA before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be is required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPPFSSA.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must shall be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-stop- loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP FSSA for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  • Agreements and Coverage  ▪ The attachment point shall be equal to or less than $200,000 500,000 and shall apply to all services, unless otherwise approved by OMPPFSSA. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 500,000 must provide a justification in its proposal or submit justification to OMPP FSSA in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP FSSA before changing the attachment point.  ▪ The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  ▪ Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  ▪ The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  ▪ The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  • Requirements for Reinsurance Companies  The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.  Subcontractors  Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- loss coverage to applicable subcontractors.Companies

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  • The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments of reinsurance policies to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish amend commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement from the reinsurer are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPPOMPP in writing.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  Agreements and Coverage  The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must shall provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must shall receive approval from OMPP before changing the attachment point.  The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  Requirements for Reinsurance Companies  The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  The Contractor shall be is required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x Moody’s bond rating of “A1” or higher, unless otherwise approved by OMPP.  Subcontractors  Subcontractors’ reinsurance coverage requirements must shall be clearly defined in the reinsurance agreement.  Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  • The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.   Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  • The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.   Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x Moody’s bond rating of “A1” or higher, unless otherwise approved by OMPP.   Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments of reinsurance policies to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  • Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish amend commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement from the reinsurer are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  • Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x Moody’s bond rating of “A1” or higher, unless otherwise approved by OMPPOMPP in writing.  • Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  . A. SCOPE OF WORK • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP FSSA for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  ▪ The attachment point shall be equal to or less than $200,000 500,000 and shall apply to all services, unless otherwise approved by OMPPFSSA. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 500,000 must provide a justification in its proposal or submit justification to OMPP FSSA in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP FSSA before changing the attachment point.  ▪ The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  ▪ Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  ▪ The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  ▪ The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPPFSSA.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP FSSA for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 500,000 and shall apply to all services, unless otherwise approved by OMPPFSSA. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 500,000 must provide a justification in its proposal or submit justification to OMPP FSSA in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP FSSA before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPPFSSA.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.   Agreements and Coverage  The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.   Requirements for Reinsurance Companies  The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x Moody’s bond rating of “A1” or higher, unless otherwise approved by OMPP.   Subcontractors  Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP FSSA for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 500,000 and shall apply to all services, unless otherwise approved by OMPPFSSA. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must 500,000 shall provide a justification in its proposal or submit justification to OMPP FSSA in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must shall receive approval from OMPP FSSA before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be is required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPPFSSA.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must shall be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  • The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- paying ability ratings of "AA" or higher and a Xxxxx’x Moody’s bond rating of “A1” or higher, unless otherwise approved by OMPP.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.   Agreements and Coverage   The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must shall provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must shall receive approval from OMPP before changing the attachment point.   The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).   Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.   The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.   The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must shall finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.   The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.   Requirements for Reinsurance Companies   The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.   The Contractor shall be is required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.   Subcontractors   Subcontractors’ reinsurance coverage requirements must shall be clearly defined in the reinsurance agreement.   Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.   If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must shall provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must shall receive approval from OMPP before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be is required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must shall be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.   Agreements and Coverage  The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.   Requirements for Reinsurance Companies  The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" " EXHIBIT 1. M SCOPE OF WORK or higher and a Xxxxx’x Moody’s bond rating of “A1” or higher, unless otherwise approved by OMPP.   Subcontractors  Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.   Agreements and Coverage  The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.   Requirements for Reinsurance Companies  The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x Moody’s bond rating of “A1” or higher, unless otherwise approved by OMPP.  Subcontractors  Subcontractors EXHIBIT 1. M SCOPE OF WORK  Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments of reinsurance policies to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  • Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish amend commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement from the reinsurer are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  • Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPPOMPP in writing.  • Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP FSSA for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 500,000 and shall apply to all services, unless otherwise approved by OMPPFSSA. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 500,000 must provide a justification in its proposal or submit justification to OMPP FSSA in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP FSSA before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency insol vency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPPFSSA.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish est ablish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP FSSA for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 500,000 and shall apply to all services, unless otherwise approved by OMPPFSSA. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 500,000 must provide a justification in its proposal or submit justification to OMPP FSSA in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP FSSA before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPPFSSA.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments of reinsurance policies to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  • Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish amend commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement from the reinsurer are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  Requirements for Reinsurance Companies  The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.  Subcontractors  Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- loss coverage to applicable subcontractors.reimburse

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  • The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must shall provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must shall receive approval from OMPP before changing the attachment point.  • The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  • Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  • The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  • The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must shall finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  • The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be is required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must shall be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP FSSA for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  ▪ The attachment point shall be equal to or less than $200,000 500,000 and shall apply to all services, unless otherwise approved by OMPPFSSA. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 500,000 must provide a justification in its proposal or submit justification to OMPP FSSA in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP FSSA before changing the attachment point.  ▪ The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  ▪ Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  ▪ The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  ▪ The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPPFSSA.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  Agreements and Coverage  The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.  The Contractor’s co-insurance -insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  Requirements for Reinsurance Companies  The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.  Subcontractors  Subcontractors’ reinsurance e coverage requirements must be clearly defined in the reinsurance agreement.  Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP FSSA for review and approval at least one hundred and twenty (120) calendar days before becoming effective.  ▪ Agreements and Coverage  ▪ The attachment point shall be equal to or less than $200,000 500,000 and shall apply to all services, unless otherwise approved by OMPPFSSA. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 500,000 must provide a justification in its proposal or submit justification to OMPP FSSA in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP FSSA before changing the attachment point.  ▪ The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  ▪ Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.  ▪ The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.  The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.  ▪ The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the t he Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.  ▪ Requirements for Reinsurance Companies  • The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  • The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPPFSSA.  ▪ Subcontractors  • Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  • Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  • If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.   Agreements and Coverage   The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.   The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).  Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.   The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.   The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.   The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.   Requirements for Reinsurance Companies  The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.  The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.  Subcontractors  Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.  Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.  If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- loss coverage to applicable subcontractors.Companies

Reinsurance. The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective.   Agreements and Coverage   The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point.   The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%).   Reinsurance agreements shall transfer risk from the Contractor to the reinsurer.   The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable.   The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8.   The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility.   Requirements for Reinsurance Companies   The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards.   The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- claims-paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP.   Subcontractors   Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement.   Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms.   If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- stop-loss coverage to applicable subcontractors.