Current through Register Vol. 54, No. 12, March 23, 2024
(a) Within 15 days
of the date of the Commissioner's written request, the following information
shall be reported to the Commissioner in writing:
(1) Insurance carriers writing medical
malpractice coverage on a Pennsylvania health care provider, as defined by the
act, shall record the policy underwriting information in sufficient detail to
identify the individual policyholder, the inforce policy as of August 31 of
each year and the corresponding carrier's annual premium for each
policyholder.
(2) Each self-insured
health care provider shall make available to the Fund sufficient details for
the Fund to identify the Pennsylvania health care providers covered by an
inforce self-insurance plan as of August 31 of each year.
(b) The emergency surcharge will be billed to
and paid by health care providers who have an inforce policy or inforce
self-insurance plan covered by the Fund as of August 31 of the emergency
surcharge year. The emergency surcharge rate will be levied on the carrier's
annual premium for each inforce policy as of August 31 of the emergency
surcharge year. The emergency surcharge rate will also be levied on the premium
annually calculated by the Fund for each inforce self-insurance plan as of
August 31 of the emergency surcharge year.
(c) Changes in policy information shall be
handled as follows:
(1) Changes in inforce
policy information recorded by the carrier on or after September 1 of the
emergency surcharge year may not be the basis to recalculate the individual
policyholder's emergency surcharge. If, however, the health care provider can
demonstrate that the carrier misrepresented a material fact, intentionally
omitted or entered false information, or failed to act in good faith, the
carrier shall recalculate the emergency surcharge and refund the overpayment,
if any. If the carrier can demonstrate that the health care provider
misrepresented a material fact, intentionally omitted or entered false
information, or failed to act in good faith, the carrier shall recalculate the
emergency surcharge and bill the additional emergency surcharge.
(2) A change in the inforce self-insurance
plan information recorded by the self-insured health care provider on or after
September 1 of the emergency surcharge year may not be the basis to recalculate
the emergency surcharge levied on the self-insured health care
provider.
