Montana § 33-22-1315 Calculation Of Reinsurance Payments

Montana Statutes

§ 33-22-1315 — Calculation Of Reinsurance Payments

Montana § 33-22-1315

Title 33INSURANCE AND INSURANCE COMPANIES

Ch. 22DISABILITY INSURANCE

Part 13Montana Reinsurance Association Act

This text of Montana § 33-22-1315 (Calculation Of Reinsurance Payments) is published on Counsel Stack Legal Research, covering Montana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Mont. Code Ann. § 33-22-1315 (2026).

Text

33-22-1315 . Calculation of reinsurance payments.

(1)Each reinsurance payment must be calculated with respect to an eligible health insurer's incurred claims costs for an individual enrollee's covered benefits in the applicable benefit year. If the claims costs do not exceed the attachment point, the reinsurance payment is $0. If the claims costs exceed the attachment point, the reinsurance payment must be calculated as the product of the coinsurance rate and the less of:

(a)the claims costs minus the attachment point; or

(b)the reinsurance cap minus the attachment point.

(2)The board shall ensure that the reinsurance payments made to the eligible health insurer do not exceed the total amount paid by the eligible health insurer for any eligible claim.

(3)For purposes of this section,

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33-22-1315 . Calculation of reinsurance payments. (1) Each reinsurance payment must be calculated with respect to an eligible health insurer's incurred claims costs for an individual enrollee's covered benefits in the applicable benefit year. If the claims costs do not exceed the attachment point, the reinsurance payment is $0. If the claims costs exceed the attachment point, the reinsurance payment must be calculated as the product of the coinsurance rate and the less of:
(a) the claims costs minus the attachment point; or
(b) the reinsurance cap minus the attachment point.
(2) The board shall ensure that the reinsurance payments made to the eligible health insurer do not exceed the total amount paid by the eligible health insurer for any eligible claim.
(3) For purposes of this section, "total amount paid" means the amount paid by the eligible health insurer based on the allowed amount less any deductible, coinsurance, or copayment.