Mont. Code § 33-22-1314

Current through the 2023 Regular Session
Section 33-22-1314 - Payment parameters
(1) The board shall design and adjust the payment parameters to ensure that the payment parameters will:
(a) stabilize or reduce premium rates in the individual market;
(b) increase or maintain participation in the individual market;
(c) mitigate the impact high-cost individuals have on premium rates in the individual market;
(d) consider any federal funding available for the plan; and
(e) consider the total amount available to fund the plan.
(2) The attachment point must be set by the board at $40,000 or more but may not exceed the reinsurance cap.
(3) The coinsurance rate must be set by the board between 50% and 80%.
(4) The reinsurance cap must be set by the board at $1 million or less.
(5) The board may adjust the payment parameters annually to the extent necessary to secure federal approval of the state innovation waiver.

§ 33-22-1314, MCA

Added by Laws 2019, Ch. 471,Sec. 9, eff. 4/30/2019, and applicable retroactively, within the meaning of 1-2-109, to premiums collected from health insurers on or after January 1, 2019.