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33-22-1314. Payment parameters

MT Code § 33-22-1314 (2019) (N/A)
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33-22-1314. (Temporary) Payment parameters. (1) The board shall design and adjust the payment parameters to ensure that the payment parameters will:

(a) stabilize or reduce premium rates in the individual market;

(b) increase or maintain participation in the individual market;

(c) mitigate the impact high-cost individuals have on premium rates in the individual market;

(d) consider any federal funding available for the plan; and

(e) consider the total amount available to fund the plan.

(2) The attachment point must be set by the board at $40,000 or more but may not exceed the reinsurance cap.

(3) The coinsurance rate must be set by the board between 50% and 80%.

(4) The reinsurance cap must be set by the board at $1 million or less.

(5) The board may adjust the payment parameters annually to the extent necessary to secure federal approval of the state innovation waiver. (Void on occurrence of contingency--sec. 18, Ch. 210, L. 2019--see part compiler's comments.)

History: En. Sec. 9, Ch. 210, L. 2019.

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