§463.  Annual reports; actuarial opinions

A.  Any plan established or maintained in the state to offer or provide health care services, indemnification, or payment for health care services, or health and accident benefits to employees under the provisions of the Employee Retirement Income Security Act of 1974 (29 U.S.C. §1001 et seq.) shall file, through the administrator or his designee, within two hundred ten days after the close of such year a certified copy of the annual report required pursuant to 29 U.S.C. §1023 with the commissioner. The filing required herein shall in no way purport to regulate or affect the plan or its benefits.

B.(1)  Each self-insurer shall file, within ninety days of the end of the fiscal year, an actuarial opinion prepared and certified by an actuary who meets the following requirements:

(a)  The actuary is not an employee of the self-insurer.

(b)  The actuary is a fellow of the Society of Actuaries, a member of the American Academy of Actuaries, or an enrolled actuary under the Employee Retirement Income Security Act of 1974 (29 U.S.C. §1001 et seq.).

(2)  The actuarial opinion required under this Subsection shall include the following items:

(a)  A description of the actuarial soundness of the self-insurer, including any actions recommended to improve the actuarial soundness of the arrangement.

(b)  The amount of reserves recommended to be maintained by the arrangement.

(c)  The level of specific and aggregate stop-loss insurance recommended to be maintained by the arrangement.

C.(1)  Reserves required by this Section shall be computed with proper actuarial regard for the following items:

(a)  Known claims, paid and outstanding.

(b)  A history of incurred but not reported claims.

(c)  Claims handling expenses.

(d)  Unearned premium.

(e)  An estimate for bad debts.

(f)  A trend factor.

(g)  A margin for error.

(2)  Reserves required by this Section shall be maintained in cash, cash equivalents, or bonds or evidences of indebtedness which are direct general obligations or which are secured or guaranteed as to principal and interest by the government of the United States, or any state of the United States.

Acts 1990, No. 902, §1; Acts 1992, No. 775, §1; Redesignated from R.S. 22:3013 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2012, No. 680, §1, eff. June 7, 2012.