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§ 45-18-19. Confidentiality of Claim Forms and Records

Claim forms and other records which would disclose the nature of the health services provided to an insured shall be maintained on a confidential basis by the health insurance plan. No person shall disclose such records or information to any other person except as necessary for the proper administration of the health insurance plan. History. […]

§ 45-18-24. Definitions

As used in this part, the term: “Actuarial accrued liability” means that portion, as determined by a particular actuarial cost method, of the actuarial present value of fund obligations and administrative expenses which is not provided for by future normal costs. “Actuarial assumptions” means assumptions regarding the occurrence of future events affecting costs of the […]

§ 45-18-25. Creation of Georgia State Employees Post-Employment Health Benefit Fund; Identification and Transfer of Funds From Georgia Retiree Health Benefit Fund; How Funds Used

There is created the Georgia State Employees Post-employment Health Benefit Fund to provide for the costs of post-employment health insurance benefits. The fund shall be a trust fund of public funds; the board in its official capacity shall be the fund’s trustee; and the commissioner in his or her official capacity shall be its administrator. […]

§ 45-18-25.1. Responsibilities and Procedures for Fund Operation; Rules and Regulations; Employment of Personnel and Professionals; Maintenance of Records; Collection of Moneys; Report

Responsibility for the proper operation of the fund is vested in the department. The board shall adopt actuarial assumptions as it deems necessary and prudent. The board may adopt any rules and regulations that it finds necessary to properly administer the fund. The board shall adopt rules and regulations to account for employer contributions and […]

§ 45-18-26. Technical Advice; Annual Actuarial Valuations

The actuary employed or retained by the department shall provide technical advice to the department and to the board regarding the operation of the fund. Utilizing the actuarial assumptions most recently adopted by the board, the actuary shall set annual actuarial valuations of normal cost, actuarial liability, actuarial value of assets, and related actuarial present […]

§ 45-18-11. Procedure for Presentation of Claims and Payment of Benefits

Any benefits payable under the plan may be made either directly to the attending physicians, hospitals, medical groups, or others furnishing the services upon which a claim is based or to the covered employee, upon presentation of valid bills for such services, subject to such provisions to facilitate payment as may be made by the […]