Sec. 21.27.730. Reinsurance intermediary manager qualifications.
In addition to the general qualifications under AS 21.27.020, the director may require that a reinsurance intermediary manager maintain (1) a bond in an amount acceptable to the director that requires the reinsurance intermediary manager to conduct business under this title; and (2) an errors and omissions insurance policy acceptable to the director.
Sec. 21.27.920. Recoupment.
(a) When a pharmacy benefits manager conducts an audit of a pharmacy, the pharmacy benefits manager shall base the recoupment of overpayments on the actual overpayment of the claim, except as provided in AS 21.27.915(b). (b) A pharmacy benefits manager conducting an audit of a pharmacy may not (1) use extrapolation in calculating recoupments or […]
Sec. 21.27.750. Authority of reinsurance intermediary managers.
A reinsurance intermediary manager has only the authority that is consistent with this title and that is conferred by the reinsurer. A reinsurance intermediary manager, resident or nonresident, qualified and licensed under this chapter, may exercise the powers conferred by this title upon insurance producers and independent adjusters only for the kinds or classes of […]
Sec. 21.27.925. Pharmacy audit reports.
(a) A pharmacy benefits manager shall deliver a preliminary audit report to the pharmacy audited within 60 days after the conclusion of the audit. (b) A pharmacy benefits manager shall allow the pharmacy at least 30 days following receipt of the preliminary audit report to provide documentation to the pharmacy benefits manager to address a […]
Sec. 21.27.760. Operating requirements for reinsurance intermediary managers; actions for loss.
(a) A reinsurer may not transact business with a reinsurance intermediary manager unless there is in effect a written contract approved by the reinsurer’s board of directors between the parties that establishes the responsibilities of each party, indicates each party’s share of responsibility for each particular function, and specifies the division of responsibilities. (b) The […]
Sec. 21.27.930. Pharmacy audit appeal; future repayment.
(a) A pharmacy benefits manager conducting an audit shall establish a written appeals process. (b) Recoupment of disputed funds or repayment of funds to the pharmacy benefits manager by the pharmacy, if permitted by contract, shall occur, to the extent demonstrated or documented in the pharmacy audit findings, after final internal disposition of the audit, […]
Sec. 21.27.770. Reinsurance intermediary manager records.
In addition to any other records requirements under this chapter, a reinsurance intermediary manager shall maintain in organized form a complete record of each transaction including (1) the type of contract, limits, underwriting restrictions, classes or risks, and territory; (2) the period of coverage, including effective and expiration dates, cancellation provisions, and required notice of […]
Sec. 21.27.935. Fraudulent activity.
When a pharmacy benefits manager conducts an audit of a pharmacy, the pharmacy benefits manager may not consider unintentional clerical or record-keeping errors, including typographical errors, writer’s errors, or computer errors regarding a required document or record, to be fraudulent activity. In this section, “fraudulent activity” means an intentional act of theft, deception, misrepresentation, or […]
Sec. 21.27.790. Surplus lines broker qualifications.
In addition to the general qualifications under AS 21.27.020, to qualify for issuance or for renewal of a resident surplus lines broker license, an applicant or licensee shall (1) be licensed as either an insurance producer or managing general agent for property and casualty lines of authority; (2) if required by the director by regulation, […]
Sec. 21.27.810. Surplus lines broker records.
In addition to any other records requirements under this chapter, a surplus lines broker shall maintain in organized form a complete record including (1) the amount of insurance and perils insured; (2) a complete description of property insured and the location of the property; (3) gross premium charged; (4) a return premium paid; (5) the […]