806 KAR 17:350. Guaranteed Acceptance Program (GAP) reporting requirements

      Section 1. Definitions. (1) “Office” is defined in KRS 304.1-050(2).

      (2) "Earned premium" is defined in KRS 304.17B-001(8).

      (3) "Guaranteed Acceptance Program" or "GAP" is defined in KRS 304.17B-001(11).

      (4) "Guaranteed Acceptance Program Electronic Report Format-A" or HIPMC-GAPERF-A-1 means a three and five-tenths (3.5) inch diskette in a Microsoft Excel spreadsheet format with written procedural instructions for reporting annual data pertaining to insurer premiums and GAP individuals.

      (5) "Guaranteed Acceptance Program Electronic Report Format-M" or HIPMC-GAPERF-M-1 means a three and five-tenths (3.5) inch diskette in a Microsoft Excel spreadsheet format with written procedural instructions for reporting monthly data pertaining to insurer premiums and GAP individuals.

      (6) "Guaranteed Acceptance Program participating insurer" is defined in KRS 304.17B-001(12).

      (7) "Health benefit plan" is defined in KRS 304.17A-005(22).

      (8) "Insurer" is defined in KRS 304.17A-005(27).

      (9) "Supporting Insurer" is defined in KRS 304.17B-001(27).

 

      Section 2. GAP Participating Insurer’s Monthly Report. A GAP participating insurer shall submit a HIPMC-GAPERF-M-1 (04/01), incorporated by reference in this administrative regulation, to the office within thirty (30) calendar days after the end of each calendar month.

 

      Section 3. Supporting Insurer’s and Stop-Loss Carrier’s Quarterly Reports. A supporting insurer and stop-loss carrier shall submit a HIPMC-GAPQR-2 (04/01), incorporated by reference in this administrative regulation, to the office within thirty (30) calendar days after the end of each calendar quarter.

 

      Section 4. GAP Participating Insurer’s Annual Reports. A GAP participating insurer shall submit a HIPMC-GAPERF-A-1 (12/00), incorporated by reference in this administrative regulation, to the office within forty-five (45) calendar days after the end of each calendar year.

 

      Section 5. Certification. A GAP participating insurer shall complete and attach a HIPMC-GAPC-1, incorporated by reference in this administrative regulation, to the following reports, when submitted to the office:

      (1) HIPMC-GAPERF-M-1 (04/01); and

      (2) HIPMC-GAPERF-A-1 (12/00).

 

      Section 6. Annual Premium Verification. (1) After the end of a calendar year, the office may request in writing that a supporting insurer verify the amount of premiums reported by the insurer for that calendar year.

      (2) If a premium verification is requested pursuant to subsection (1) of this section, a supporting insurer shall submit the following documentation:

      (a)1. Confirmation that the reported health benefit plan or stop-loss premium amounts are correct; or

      2. Corrections of reported health benefit plan or stop-loss premium amounts; and

      (b) A HIPMC-GAPAFF-1 (06/01), incorporated by reference into this administrative regulation.

 

      Section 7. Material Incorporated by Reference. (1) The following material is incorporated by reference:

      (a) Guaranteed Acceptance Program Affidavit, HIPMC-GAPAFF-1 (06/01);

      (b) Guaranteed Acceptance Program (GAP) Data Certification Form, HIPMC-GAPC-1 (12/00);

      (c) Guaranteed Acceptance Program Electronic Report Format - Annual for GAP Participating Insurers, HIPMC-GAPERF-A-1 (12/00);

      (d) Guaranteed Acceptance Program Electronic Report Format - Monthly for GAP Participating Insurers, HIPMC-GAPERF-M-1 (04/01); and

      (e) Supporting Insurer’s and Stop-Loss Carrier’s Quarterly Report, HIPMC-GAPQR-2 (04/01).

      (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Kentucky Office of Insurance, 215 West Main Street, Frankfort, Kentucky 40601, Monday through Friday, 8 a.m. to 4:30 p.m. Forms may also be obtained on the office’s Internet Web site at http://doi.ppr.ky.gov/kentucky/ (28 Ky.R. 203; eff. 9-10-2001; TAm eff. 8-9-2007.)

Notation

      RELATES TO: KRS 304.17B-021(2), 304.17B-023

      STATUTORY AUTHORITY: KRS 304.2-110(1), 304.17B-031(1)

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 304.2-110(1) provides that the executive director may promulgate administrative regulations necessary for or as an aid to the effectuation of any provision of the Kentucky Insurance Code. KRS 304.17B-023 establishes reporting requirements for the Guaranteed Acceptance Program. This administrative regulation prescribes the form and the time schedule for submitting reports to the office for each calendar year.