Current through Register Vol. 50, No. 9, March 1, 2024
RELATES TO:
KRS
216.941,
304.40-075
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
304.2-110(1) authorizes the
Commissioner of Insurance to promulgate administrative regulations necessary
for or as an aid to the effectuation of any provision of the Kentucky Insurance
Code.
KRS
304.40-075(3)(b) requires
the department to promulgate administrative regulations to establish reasonable
guidelines for the registration of charitable health care providers.
KRS
304.40-075(6) requires the
department to determine if the profits made for medical professional liability
insurance risks covered by that section are consistent with reasonable loss
ratio guidelines. This administrative regulation establishes guidelines for the
registration of charitable health care providers who seek to obtain
reimbursement of paid premium for medical professional liability insurance, and
also establishes reporting requirements for medical professional liability
insurers for the purpose of determining reasonable loss ratios.
Section 1. To request reimbursement of paid
premium for medical professional liability insurance, a charitable health care
provider shall supply to the Department of Insurance the following information:
(1) The name and address of the
provider;
(2) The license number of
the provider;
(3) The source of
funding for the provider of charitable health care service;
(4) The number of employees who render
medical care without compensation or charge and without expectation of
compensation or charge and who shall be covered under the medical professional
liability insurance;
(5) The
expected number of patients who may be provided charitable health care services
in the year for which the insurer offers malpractice coverage;
(6) The health services provided by the
charitable health care provider;
(7) The following information regarding the
provider's medical professional liability insurance policy for which
reimbursement is being requested:
(a) A copy
of the entire policy, including the declarations page showing:
1. The name and address of the
insurer;
2. The effective date of
the policy;
3. The policy
number;
4. The total amount of
premium due; and
(b) The
itemized billing and proof of payment of the requested reimbursement
amount;
(8) A copy of
the registration filed with the Cabinet for Health and Family Services under
KRS
216.941; and
(9) Acknowledgment that the provider will
follow the risk management and loss prevention policies and procedures
established by the insurer.
Section
2. If any of the information provided in Section 1 of this
administrative regulation changes or is incorrect, the charitable health care
provider shall provide the correct information immediately to the Department of
Insurance.
Section 3. Any premium
refund received by the charitable health care provider and remitted to the
Department of Insurance, pursuant to
KRS
304.40-075(3)(d), shall be
accompanied by the following:
(1) A copy of
the previous request;
(2) An
explanation of the events prompting the refund; and
(3) Copies of all documents from the insurer
regarding the refund and its amount.
Section 4.
(1) An insurer who offers medical
professional liability insurance shall provide information regarding the
premium paid, any expenses incurred by the insurer, and the profits made for
all risk covered pursuant to
KRS
304.40-075. The information required by
Section 1 of this administrative regulation shall be provided to the Department
of Insurance by March 1 and shall include premium, expense, and profit
information from the preceding calendar year and shall be submitted on Form
CHP-2B P & C.
(2) For the
department to determine reasonable loss ratio guidelines, upon request by the
department, an insurer who offers medical professional liability insurance
shall provide premium, profit, and expense information related to the entirety
of the medical professional liability insurance business of the
insurer.
Section 5.
Incorporation by Reference.
(1) The following
material is incorporated by reference:
(a)
Form CHP-2A P & C, "Commonwealth of Kentucky Department of Insurance
Property and Casualty Division Medical Professional Liability Insurance Annual
Call for Data Instructions", 11/2020 edition; and
(b) Form CHP-2B P & C, "Commonwealth of
Kentucky Department of Insurance Property and Casualty Division Liability
Insurance Annual Call for Data", 11/2020 edition.
(2) This material may be inspected, copied,
or obtained, subject to applicable copyright law, from the Department of
Insurance, Mayo-Underwood Building, 500 Mero Street, Frankfort, Kentucky 40601,
Monday through Friday, 8 a.m. to 4:30 p.m. This material is also available on
the office's Web site at
www.insurance.ky.gov.
STATUTORY AUTHORITY:
KRS
304.2-110(1),
304.40-075(3)(b),
(6)
