Alabama Administrative Code › Title 482 - ALABAMA DEPARTMENT OF INSURANCE › Chapter 482-1-115 - ALABAMA HEALTH INSURANCE PLAN › Section 482-1-115-.04 - Board Of Directors

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The
			 Plan shall operate subject to the supervision and control of a Board of
			 Directors. The Board, which shall be the Plan Administrator, shall consist of
			 the Commissioner, or his or her designated representative, who shall serve as
			 an ex officio member of the Board and shall be its chairman, and eight members
			 appointed by the Commissioner. At least two (2) Board members shall be
			 individuals not representing insurers or health care providers. At least two
			 (2) Board members shall be representatives of insurers.
(2) The initial Board members shall be
			 appointed as follows: two members to serve a term of one (1) year; three
			 members to serve a term of two (2) years; and three members to serve a term of
			 three (3) years. Subsequent Board members shall serve for a term of three (3)
			 years. A Board member's term shall continue until his or her successor is
			 appointed.
(3) Vacancies in the
			 Board shall be filled by the Commissioner. Board members may be removed by the
			 Commissioner for cause.
(4) Board
			 members shall not be compensated in their capacity as Board members but may be
			 reimbursed for reasonable expenses incurred in the necessary performance of
			 their duties.
(5) The Board shall
			 submit to the Commissioner a plan of operation for the Plan and any amendments
			 thereto necessary or suitable to assure the fair, reasonable and equitable
			 administration of the Plan. The plan of operation shall become effective upon
			 approval in writing by the Commissioner consistent with the date on which the
			 coverage under this Plan must be made available. If the Board fails to submit a
			 suitable plan of operation within 180 days after the appointment of the Board
			 of directors, or at any time thereafter fails to submit suitable amendments to
			 the plan of operation, the Commissioner shall adopt and promulgate such rules
			 as are necessary or advisable to effectuate the provisions of this rule. Such
			 rules shall continue in force until modified by the Commissioner or superseded
			 by a plan of operation submitted by the Board and approved by the
			 Commissioner.
(6) The plan of
			 operation shall include, but not be limited to, the following:
(a) Procedures for Board meetings.
(b) Procedures for operation of the
			 Plan.
(c) Procedures for selecting
			 an Operations Administrator and a Claims Administrator or
			 Administrators.
(d) Procedures to
			 create a fund, under management of the Board, for administrative
			 expenses.
(e) Procedures for
			 premium and assessment billings.
(f) Procedures for the managing, accounting
			 and auditing of assets, monies and claims of the Plan.
(g) Procedures to publicize the existence of
			 the Plan, the eligibility requirements, and procedures for enrollment; and to
			 maintain public awareness of the Plan.
(h) Procedures under which applicants and
			 participants may have grievances reviewed by a grievance committee appointed by
			 the Board.
(i) Procedures for other
			 matters as may be necessary and proper for the execution of the Board's powers,
			 duties and obligations under this chapter.