reglab/housing_qa huggingface dataset:
NE Code § 44-4222 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4222 - Purchase of pool coverage; ineligibility.

44-4222.  Purchase of pool coverage; ineligibility.(1) An individual shall not be eligible for initial or continued pool coverage if:(a) He or she is eligible for medicare benefits by reason of age or medical assistance established pursuant to the Medical Assistance Act;(b) He or she is a resident or inmate of a correctional facility, except that this subdivision shall not apply if such individual is eligible for pool coverage under subdivision (1)(b) of section 44-4221;(c) He or she has terminated pool coverage unless twelve months have elapsed since such termination, except that this subdivision shall not apply if such individual has received and become ineligible for medical assistance pursuant to the Medical Assistance Act during the immediately preceding twelve months, if such individual is eligible for pool coverage under subdivision (1)(b) of section 44-4221, or if such individual is eligible for waiver of any waiting period or preexisting condition exclusions pursuant to section 44-4228;(d) The pool has paid out one million dollars in claims for the individual;(e) He or she is no longer a resident of Nebraska; or(f) The premium for his or her pool coverage is paid for by a person other than the following:(i) The individual;(ii) An individual related to the individual by blood, marriage, or adoption; or(iii) An entity operating under the federal Ryan White HIV/AIDS Treatment Modernization Act of 2006, Public Law 109-415, as such act existed on August 30, 2009.(2) Pool coverage shall terminate for any individual on the date the individual becomes ineligible under subsection (1) of this section.Source   Laws 1985, LB 391, § 22;   Laws 1987, LB 319, § 2;   Laws 1989, LB 279, § 8;   Laws 1990, LB 1136, § 106;   Laws 1992, LB 1006, § 36;   Laws 1997, LB 862, § 27;   Laws 1998, LB 1035, § 8;  Laws 2000, LB 1253, § 25;  Laws 2006, LB 1248, § 62;  Laws 2009, LB358, § 5. Cross References  Medical Assistance Act, see section 68-901.
NE Code § 44-4222.01 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4222.01 - Insurer, agent, broker, or third-party administrator; prohibited acts; violation; unfair trade practice.

44-4222.01.  Insurer, agent, broker, or third-party administrator; prohibited acts; violation; unfair trade practice.(1) No insurer, agent, broker, or third-party administrator shall refer an individual employee to the pool or arrange for an individual employee to apply for pool coverage for the purpose of separating that individual employee from group health insurance coverage in connection with the individual employee's employment.(2) Any violation of this section shall be an unfair trade practice in the business of insurance subject to the Unfair Insurance Trade Practices Act.Source Laws 2009, LB358, § 6.Cross References  Unfair Insurance Trade Practices Act, see section 44-1521.
NE Code § 44-4223 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4223 - Selection of pool administrator; procedure.

44-4223.  Selection of pool administrator; procedure.(1) The board shall select a pool administrator through a competitive bidding process to administer the pool. The pool administrator may be an insurer or a third-party administrator authorized to transact business in this state. The board shall evaluate bids submitted on the basis of criteria established by the board which shall include:(a) The applicant's proven ability to handle individual sickness and accident insurance;(b) The efficiency of the applicant's claim-paying procedures;(c) The applicant's estimate of total charges for administering the pool;(d) The applicant's ability to administer the pool in a cost-effective manner; and(e) The applicant's ability to negotiate reduced health care provider reimbursement rates for benefits payable under pool coverage for covered services.(2) The pool administrator shall serve for a period of three years subject to removal for cause. At least one year prior to the expiration of each three-year period of service by a pool administrator, the board shall invite all insurers and third-party administrators authorized to transact business in this state, including the current pool administrator, to submit bids to serve as the pool administrator for the succeeding three-year period. Selection of the pool administrator for the succeeding period shall be made at least six months prior to the end of the current three-year period.Source   Laws 1985, LB 391, § 23;   Laws 1992, LB 1006, § 37;  Laws 2011, LB73, § 4.
NE Code § 44-4224 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4224 - Pool administrator; duties.

44-4224.  Pool administrator; duties.The pool administrator shall:(1) Perform all eligibility verification functions relating to the pool;(2) Establish a premium billing procedure for collection of premiums from covered individuals on a periodic basis as determined by the board;(3) Perform all necessary functions to assure timely payment of benefits to covered individuals, including:(a) Making available information relating to the proper manner of submitting a claim for benefits to the pool and distributing forms upon which submission shall be made; and(b) Evaluating the eligibility of each claim for payment by the pool;(4) Submit regular reports to the board regarding the operation of the pool. The frequency, content, and form of the reports shall be determined by the board;(5) Following the close of each calendar year, report such income and expense items as directed by the board to the board and the department on a form prescribed by the director; and(6) Be paid as provided in the plan of operation for its expenses incurred in the performance of its services to the pool.Source   Laws 1985, LB 391, § 24;  Laws 2000, LB 1253, § 26;  Laws 2011, LB73, § 5.
NE Code § 44-4225 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4225 - Board; report; Comprehensive Health Insurance Pool Distributive Fund; created; use; investment; director; funding powers.

44-4225.  Board; report; Comprehensive Health Insurance Pool Distributive Fund; created; use; investment; director; funding powers.(1) Following the close of each calendar year, the board shall report the board's determination of the paid and incurred losses for the year, taking into account investment income and other appropriate gains and losses. The board shall distribute copies of the report to the director, the Governor, and each member of the Legislature. The report submitted to each member of the Legislature shall be submitted electronically.(2) The Comprehensive Health Insurance Pool Distributive Fund is created. Commencing with the premium and related retaliatory taxes for the taxable year ending December 31, 2001, and for each taxable year thereafter, any premium and related retaliatory taxes imposed by section 44-150 or 77-908 paid by insurers writing health insurance in this state, except as otherwise set forth in subdivisions (1) and (2) of section 77-912, shall be remitted to the State Treasurer for credit to the fund. The fund shall be used for the operation of and payment of claims made against the pool. Any money in the fund available for investment shall be invested by the state investment officer pursuant to the Nebraska Capital Expansion Act and the Nebraska State Funds Investment Act.(3) The board shall make periodic estimates of the amount needed from the fund for payment of losses resulting from claims, including a reasonable reserve, and administrative, organizational, and interim operating expenses and shall notify the director of the amount needed and the justification of the board for the request.(4) The director shall approve all withdrawals from the fund and may determine when and in what amount any additional withdrawals may be necessary from the fund to assure the continuing financial stability of the pool.(5) No later than May 1, 2002, and each May 1 thereafter, after funding of the net loss from operation of the pool for the prior premium and related retaliatory tax year, taking into account the policyholder premiums, account investment income, claims, costs of operation, and other appropriate gains and losses, the director shall transmit any money remaining in the fund as directed by section 77-912, disregarding the provisions of subdivisions (1) through (3) of such section. Interest earned on money in the fund shall be credited proportionately in the same manner as premium and related retaliatory taxes set forth in section 77-912.Source   Laws 1985, LB 391, § 25;   Laws 1991, LB 419, § 3;   Laws 1992, LB 1006, § 38;  Laws 2000, LB 1253, § 27;  Laws 2011, LB73, § 6;  Laws 2012, LB782, § 54. Cross References   Nebraska Capital Expansion Act, see section 72-1269.  Nebraska State Funds Investment Act, see section 72-1260.
NE Code § 44-4226 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4226 - Major medical expense coverage required; considerations.

44-4226.  Major medical expense coverage required; considerations.(1) The pool shall offer major medical expense coverage to every eligible individual. The pool coverage, its schedule of benefits, and exclusions and other limitations shall be established through rules and regulations adopted and promulgated by the director taking into consideration the advice and recommendations of the members.(2) In establishing the pool coverage, the director shall take into consideration the levels of individual health insurance coverage provided in the state and such medical economic factors as may be deemed appropriate and shall determine benefit levels, deductibles, coinsurance and stop-loss factors, exclusions, and limitations determined to be generally reflective of and commensurate with individual health insurance coverage provided by the ten insurers writing the largest amount of individual health insurance coverage in the state.(3) Pool coverage established under this section shall provide both an appropriate high and low deductible to be selected by the pool applicant. The deductibles and coinsurance and stop-loss factors may be adjusted annually according to the medical component of the Consumer Price Index.Source   Laws 1985, LB 391, § 26;   Laws 1992, LB 1006, § 39;  Laws 2000, LB 1253, § 28;  Laws 2009, LB358, § 7.
NE Code § 44-4229 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4229 - Reduction of benefits; when.

44-4229.  Reduction of benefits; when.Benefits otherwise payable under pool coverage shall be reduced by all amounts paid or payable through any other health insurance or insurance arrangement and by all hospital and medical expense benefits paid or payable under any workers' compensation coverage, automobile medical payment or liability insurance whether provided on the basis of fault or nonfault, or any state or federal law or program.Source  Laws 1985, LB 391, § 29.
NE Code § 44-4230 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4230 - Recovery of noncovered expenses; cause of action; subrogation.

44-4230.  Recovery of noncovered expenses; cause of action; subrogation.The pool shall have a cause of action against a covered individual for the recovery of the amount of benefits paid which are not for covered expenses. Benefits due from the pool may be reduced or refused as a setoff against any amount recoverable under this section. The pool shall have a right of subrogation to any payments made to a covered individual by another person or his or her insurer on account of an injury caused by such other person's wrongful act or negligence.Source   Laws 1985, LB 391, § 30;   Laws 1990, LB 1136, § 109;  Laws 2000, LB 1253, § 31.
NE Code § 44-4231 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4231 - Pool; limitation on liability.

44-4231.  Pool; limitation on liability.Participation in the pool as members, the establishment of rates, forms, or procedures, or any other joint or collective action required by the Comprehensive Health Insurance Pool Act shall not be the basis of any cause of action, criminal or civil liability, or penalty against the pool or any of its members or the board.Source   Laws 1985, LB 391, § 31;   Laws 1992, LB 1006, § 41.
NE Code § 44-4232 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4232 - Pool; exempt from taxation.

44-4232.  Pool; exempt from taxation.The pool shall be exempt from any and all taxes assessed by the State of Nebraska.Source  Laws 1985, LB 391, § 32.
NE Code § 44-4233 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4233 - Member; offset tax liability.

44-4233.  Member; offset tax liability.(1) Any member subject to premium and related retaliatory tax liability imposed by section 44-150 or 77-908 may offset assessments paid to the pool by such member against its tax liability in the year of payment or subsequent years. The member may offset such paid assessments against (a) subsequent premium tax prepayments imposed by section 77-918, (b) subsequent premium tax payments imposed by section 77-908, and (c) related retaliatory tax liability imposed by section 44-150. Prior to January 1, 2004, no individual member shall be subject to any liability of the pool in excess of its premium and related retaliatory tax liability which may be offset under this section.(2) Commencing with assessments imposed or paid in 1991 and for all subsequent years prior to January 1, 2004, whenever it reasonably appears to the satisfaction of the board that a member has during a calendar year paid assessments that exceed that member's premium and related retaliatory tax liability for that calendar year, the board shall, upon request from such member, order the refund to that member of the amount of the assessment that exceeded that member's premium and related retaliatory tax liability. A member's request for a refund shall be filed with the board not later than thirty days after the due date of the member's premium tax return filed with the department. If the refund is not made by the board within thirty days after receipt of the refund request, the member may within thirty days thereafter initiate a suit in district court for the amount claimed. The suit shall be heard by the district court de novo. In the event that an assessment against a member is limited by reason of that member's premium and related retaliatory tax liability, the amount by which the assessment is limited may be assessed against the other members in a manner consistent with the basis for assessments specified in subsection (3) of section 44-4225.Source   Laws 1985, LB 391, § 33;   Laws 1986, LB 1114, § 8;   Laws 1987, LB 302, § 7;   Laws 1992, LB 835, § 2;   Laws 1992, LB 1006, § 42;   Laws 1993, LB 10, § 1;   Laws 1995, LB 837, § 1;   Laws 1997, LB 55, § 3;   Laws 1997, LB 862, § 29;  Laws 1999, LB 355, § 6;  Laws 2000, LB 1253, § 32.
NE Code § 44-4235 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4235 - Insurer; notice required.

44-4235.  Insurer; notice required.Every insurer shall include a notice of the existence of the pool in (1) any rejection of an application for health insurance coverage for reasons of the health of the applicant and (2) any restrictive health insurance rider issued on or after January 1, 1999.Source   Laws 1985, LB 391, § 35;   Laws 1992, LB 1006, § 43;   Laws 1998, LB 1063, § 4.
NE Code § 44-4301 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4301 - Act, how cited.

44-4301.  Act, how cited.Sections 44-4301 to 44-4339 shall be known and may be cited as the Intergovernmental Risk Management Act.Source  Laws 1987, LB 398, § 1.
NE Code § 44-4302 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4302 - Legislative findings.

44-4302.  Legislative findings.The Legislature hereby finds and declares that protection against losses due to liability and damage or loss of property and provision of employee benefit plans is essential to the proper functioning of state and local government. The resources of state and local governmental agencies are often burdened by the securing of necessary insurance protection and employee benefits through standard insurance carriers. In addition, the Legislature finds that benefits can be derived through pooling of purchasing by state and local government. Proper risk management requires the spreading of risk so as to minimize fluctuation in insurance needs. The Legislature further finds that all contributions of financial and administrative resources made by state and local governmental agencies pursuant to an agreement authorized by the Intergovernmental Risk Management Act are made for a public and governmental purpose.Source   Laws 1987, LB 398, § 2;  Laws 2001, LB 664, § 1.
NE Code § 44-4304 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4304 - Risk management pool; agreements authorized.

44-4304.  Risk management pool; agreements authorized.(1) Any two or more public agencies may make and execute an agreement providing for joint and cooperative action in accordance with the Intergovernmental Risk Management Act to form, become members of, and operate a risk management pool for the purpose of providing to members risk management services and insurance coverages in the form of group self-insurance or standard insurance, including any combination of group self-insurance and standard insurance, to protect members against losses arising from any of the following:(a) General liability;(b) Damage, destruction, or loss of real or personal property, including, but not limited to, loss of use or occupancy, and loss of income or extra expense resulting from loss of use or occupancy;(c) Errors and omissions liability; and(d) Workers' compensation liability.(2) Any two or more public agencies, other than school districts and educational service units, may make and execute an agreement providing for joint and cooperative action in accordance with the act to form, become members of, and operate a risk management pool for the purpose of providing to members risk management services and insurance coverages in the form of group self-insurance or standard insurance, including any combination of group self-insurance and standard insurance, to provide health, dental, accident, and life insurance to member's employees and officers.Source   Laws 1987, LB 398, § 4;  Laws 2001, LB 664, § 3.
NE Code § 44-4305 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4305 - Risk management pool; powers.

44-4305.  Risk management pool; powers.(1) Any risk management pool organized pursuant to the Intergovernmental Risk Management Act, whether or not a body corporate, shall have the power to sue and be sued, make contracts, hold and dispose of real and personal property, borrow money, contract debt, and pledge any pool assets in the name of the pool.(2) The power to make contracts prescribed in subsection (1) of this section shall specifically include the power to establish the risk management pool as a separate legal or administrative entity.Source  Laws 1987, LB 398, § 5.
NE Code § 44-4306 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4306 - Risk management pool; agreement; contents.

44-4306.  Risk management pool; agreement; contents.Any agreement entered into for the purpose of establishing and operating a risk management pool shall provide:(1) A financial plan setting forth in general terms the:(a) Types of insurance coverage to be offered by the pool, applicable deductible levels, and maximum level of claims which the pool will self-insure;(b) Amount of cash reserves to be set aside for the payment of claims;(c) Amount of standard insurance to be purchased by the pool to provide coverage over and above the claims which are not to be satisfied directly from the pool's resources; and(d) Amount of aggregate excess insurance coverage and specific excess insurance coverage to be purchased in a given fiscal period; and(2) A plan of management setting forth:(a) The means of establishing the governing authority of the pool. (i) The governing authority shall be a board of directors who are elected or appointed officials of member public agencies. (ii) The number of members of the board who are either elected or appointed officials of member public agencies shall not be less than the requisite number of members needed to transact all the business of the pool;(b) The responsibility of the board of directors with regard to fixing annual contributions to the pool from members, maintaining reserves, levying and collecting from members assessments for deficiencies, disposing of surpluses, and administering the pool in the event of termination or insolvency;(c) A procedure by which new members may be admitted to and existing members may leave the pool. The procedure shall permit members to withdraw from participation in a pool. Withdrawal shall not affect the obligations of the withdrawing member under any contract or agreement with the pool or impair the payment of any outstanding bonds or any interest on such bonds;(d) The identification of funds and reserves by exposure area;(e) A provision requiring that all claims shall be paid promptly;(f) A provision requiring that no part of the net earnings or assets of the pool shall inure to the benefit of any private person;(g) A provision requiring that, upon dissolution of the pool, all of the assets of the pool will vest in member public agencies in the manner set forth in the plan of management;(h) A system or program of loss control; and(i) Any other standards, procedures, or practices necessary or desirable for the continued operation of the pool.Source  Laws 1987, LB 398, § 6.
NE Code § 44-4307 (2021)
2021 Nebraska Revised Statutes|Chapter 44 - Insurance|44-4307 - Certificate of authority; issuance; fee.

44-4307.  Certificate of authority; issuance; fee.(1) A risk management pool shall not provide any form of group self-insurance to its members until it has received a certificate of authority to do so from the Department of Insurance. Such certificate shall expire on the last day of April in each year and shall be renewed annually thereafter if the risk management pool has continued to comply with the Intergovernmental Risk Management Act and the rules and regulations of the Department of Insurance adopted and promulgated thereunder.(2) The Department of Insurance shall issue a certificate of authority to a risk management pool if the Director of Insurance determines:(a) That the pool's financial plan and plan of management and any amendments thereto satisfy the requirements of section 44-4306;(b) That the pool has adequate surplus and reserves and will receive adequate financial contributions from its members in order to operate in a manner which is not hazardous to the public; and(c) That any individual, corporation, partnership, limited liability company, or other entity engaged by the pool to provide services in connection with its management or operation is capable of running the affairs of the pool, is of good character and known business ability, and has a practical knowledge of the executive duties of conducting a risk management pool.(3) The filing fee for a certificate of authority issued pursuant to the Intergovernmental Risk Management Act shall be one thousand dollars.Source   Laws 1987, LB 398, § 7;   Laws 1989, LB 92, § 268;   Laws 1993, LB 121, § 253.