§2088. Assessments
A. For the purpose of providing the funds necessary to carry out the powers and
duties of the association, the board of directors shall assess the member insurers, separately
for each account, at such time and for such amounts as the board finds necessary for the
administration of the provisions of this Part. Assessments shall be due not less than thirty
days after prior written notice to the member insurers and shall accrue interest at ten percent
per annum on and after the due date.
B. There shall be two assessments, as follows:
(1) Class A assessments shall be made for the purpose of meeting administrative and
legal costs and other expenses and examinations conducted under the authority of R.S.
22:2091. Class A assessments may be made whether or not related to a particular impaired
or insolvent insurer and their administration thereof.
(2) Class B assessments shall be made to the extent necessary to carry out the powers
and duties of the association pursuant to R.S. 22:2087 with regard to an impaired or an
insolvent insurer.
C.(1) The amount of any Class A assessment shall be determined by the board. The
amount of any Class B assessment, except for assessments related to long-term care
insurance, shall be allocated for assessment purposes among the accounts pursuant to an
allocation formula which may be based on the premiums or reserves of the impaired or
insolvent insurer or any other standard deemed by the board in its sole discretion as being fair
and reasonable under the circumstances and established in the plan of operation.
(2) The amount of the Class B assessment for long-term care insurance written by
the impaired or insolvent insurer shall be allocated according to a methodology included in
the plan of operation and approved by the commissioner. The methodology shall provide for
fifty percent of the assessment to be allocated to accident and health member insurers and
fifty percent to be allocated to life and annuity member insurers.
(3) Class B assessments against member insurers for each account shall be in the
proportion that the premiums received on business in this state by each assessed member
insurer on policies or contracts covered by each account for the three most recent calendar
years for which information is available preceding the year in which the member insurer
became impaired or insolvent, as the case may be, bears to such premiums received on
business in this state for such calendar years by all assessed member insurers.
(4) Assessments for funds to meet the requirements of the association with respect
to an impaired or insolvent insurer shall not be commenced by the board of directors until
necessary to implement the purposes of this Part. Classification of assessments pursuant to
Subsection B of this Section and computation of assessments pursuant to this Subsection
shall be made with a reasonable degree of accuracy.
D. The association may abate or defer, in whole or in part, the assessment of an
insurer if, in the opinion of the board, payment of the assessment would endanger the ability
of the insurer to fulfill its contractual obligations. In the event an assessment against an
insurer is abated, or deferred in whole or in part, the amount by which such assessment is
abated or deferred may be assessed against the other insurers in a manner consistent with the
basis for assessments set forth in this Section. Once the conditions that caused a deferral
have been removed or rectified, the member insurer shall pay all assessments that were
deferred pursuant to a repayment plan approved by the association.
E.(1)(a) The total of all assessments upon an insurer for each account shall not in any
one calendar year exceed two percent of such average premiums received of the insurers in
this state on the policies and contracts covered by the account during the three calendar years
preceding the year in which the member insurer became an impaired or insolvent insurer.
(b) With respect to member insurers that become impaired or insolvent in different
calendar years, if two or more assessments are authorized in one calendar year, the average
annual premiums for purposes of the aggregate assessment percentage limitation referenced
in Subparagraph (a) of this Paragraph shall be equal and limited to the higher of the three-year average annual premiums for the applicable account as calculated pursuant to this
Section.
(c) If the maximum assessment, together with the other assets of the association in
any account, does not provide in any one year in either account an amount sufficient to carry
out the obligations of the association, the necessary additional funds shall be assessed as
permitted by this Part.
(2) The board may provide in the plan of operation a method of allocating funds
among claims, whether relating to one or more impaired or insolvent insurers, when the
maximum assessment will be insufficient to cover anticipated claims.
F. The board may, by an equitable method as established in the plan of operation,
refund to member insurers, in proportion to the contribution of each member insurer to that
account, the amount by which the assets of that account exceed the amount the board finds
is necessary to carry out during the coming year the obligations of the association with regard
to that account, including assets accruing from assignment, subrogation, net realized gains,
and income from investments. A reasonable amount may be retained in any account to
provide funds for the continuing expenses of the association and for future losses.
G. It shall be proper for any member insurer, in determining its premium rates and
policy owner dividends as to any kind of insurance or health maintenance organization
business within the scope of this Part, to consider the amount reasonably necessary to meet
its assessment obligations under this Part.
H. The association shall issue to each member insurer paying an assessment under
this Part, other than Class A assessments, a certificate of contribution for Class B
assessments, in a form prescribed by the commissioner for the amount of the assessment so
paid. All outstanding certificates shall be of equal dignity and priority without reference to
amounts or dates of issue. A certificate of contribution may be shown by the insurer in its
financial statement as an asset in such form and for such amount, if any, and period of time
as the commissioner may approve.
I.(1) A member insurer that wishes to protest all or part of an assessment shall pay
when due the amount of the assessment as set forth in the notice provided by the association.
The payment shall be available to meet association obligations during the pendency of the
protest or any subsequent appeal. Payment shall be accompanied by a statement in writing
that the payment is made under protest and setting forth a brief statement of the grounds for
the protest.
(2) Within sixty days following the payment of an assessment under protest by a
member insurer, the association shall notify the member insurer in writing of its
determination with respect to the protest unless the association notifies the member insurer
that additional time is required to resolve the issues raised by the protest.
(3) Within thirty days after the final decision has been made, the association shall
notify the protesting member insurer in writing of that final decision. Within sixty days of
receipt of notice of the final decision, the protesting member insurer may appeal that final
action to the commissioner.
(4) In the alternative to rendering a final decision with respect to a protest based on
a question regarding the assessment base, the association may refer protests to the
commissioner for a final decision, with or without a recommendation from the association.
(5) If the protest or appeal on the assessment is upheld, the amount paid in error or
excess shall be returned to the member insurer. Interest on a refund due a protesting member
insurer shall be paid at the rate actually earned by the association.
J. The association may request information of member insurers in order to aid in the
exercise of its powers under this Section and member insurers shall promptly comply with
a request.
Acts 1991, No. 998, §1, eff. Sept. 30, 1991; Redesignated from R.S. 22:1395.8 by
Acts 2008, No. 415, §1, eff. Jan. 1, 2009; Acts 2009, No. 258, §1; Acts 2012, No. 271, §1;
Acts 2018, No. 97, §1.