Mont. Admin. r. 2.55.402

Current through Register Vol. 23, December 6, 2024
Rule 2.55.402 - MEDICAL DEDUCTIBLE
(1) The state fund offers an annual (fiscal year July l through June 30) medical deductible plan for policies with effective dates between each July 1 and June 30 inclusive, in increments of $500, $1,000, $1,500, $2,000 and $2,500 per claim. This plan allows qualified employers to reimburse the state fund for a selected deductible amount of the medical costs of each claim in exchange for a premium discount.
(2) To qualify for the plan for the next policy year, an employer must:
(a) file an endorsement form, provided by the state fund prior to the beginning of the next policy year;
(b) have estimated annual premium for the next policy year which equals or exceeds the chosen deductible amount; and
(c) demonstrate the ability to promptly pay the deductible amounts by not having a poor premium payment history with the state fund.
(3) The state fund is responsible for initial payment of medical benefits; then bills the employer for reimbursement up to the chosen deductible amount. The state fund may cancel the employer's policy for failure to reimburse the state fund for expended medical deductible amounts.

Mont. Admin. r. 2.55.402

EMERG, NEW, 1992 MAR p. 300, Eff. 2/28/92; AMD, 1993 MAR p. 340, Eff. 3/12/93; AMD, 1994 MAR p. 1423, Eff. 5/27/94; AMD, 1998 MAR p. 158, Eff. 1/16/98; AMD, 2000 MAR p. 1033, Eff. 4/28/00.

Sec. 39-71-2315 and 39-71-2316 MCA; IMP, Sec. 39-71-434, 39-71-2311, and 39-71-2316 MCA;