Automatic Reinsurance For automatic reinsurance, the Reinsurer's liability will commence at the same time as the Ceding Company's liability, including liability under any conditional receipt or temporary insurance provision.
Benefit Coverage The Company agrees to provide pension and welfare benefits as described in the Company Booklets, benefit plan documents or policies of insurance for the duration of the Agreement.
BASIS OF REINSURANCE Reinsurance under this Agreement will be on the Yearly Renewable Term basis on the portion of each policy that is reinsured as described in Schedule A.
Insured Benefits A transferring employee will be covered by the benefit plans at the designated Employer. There will be no break in coverage and/or no waiting period prior to being able to receive benefits so long as the waiting period has already been served, subject to the requirements of the carrier.
BUSINESS REINSURED 19 SCHEDULE B................................................................. 20
Reinsurance The Contractor shall purchase reinsurance from a commercial reinsurer and shall establish reinsurance agreements meeting the requirements listed below. The Contractor shall submit new policies, renewals or amendments to OMPP for review and approval at least one hundred and twenty (120) calendar days before becoming effective. Agreements and Coverage The attachment point shall be equal to or less than $200,000 and shall apply to all services, unless otherwise approved by OMPP. The Contractor electing to establish commercial reinsurance agreements with an attachment point greater than $200,000 must provide a justification in its proposal or submit justification to OMPP in writing at least one hundred and twenty (120) calendar days prior to the policy renewal date or date of the proposed change. The Contractor must receive approval from OMPP before changing the attachment point. The Contractor’s co-insurance responsibilities above the attachment point shall be no greater than twenty percent (20%). Reinsurance agreements shall transfer risk from the Contractor to the reinsurer. The reinsurer's payment to the Contractor shall depend on and vary directly with the amount and timing of claims settled under the reinsured contract. Contractual features that delay timely reimbursement are not acceptable. The Contractor shall maintain a plan acceptable to the IDOI commissioner for continuation of benefits in the event of receivership. The Contractor must finance the greater of $1,000,000 or total projected costs as calculated by the form set forth in 760 IAC 1-70-8. The Contractor shall obtain continuation of coverage insurance (insolvency insurance) to continue plan benefits for members until the end of the period for which premiums have been paid. This coverage shall extend to members in acute care hospitals or nursing facility settings when the Contractor’s insolvency occurs during the member’s inpatient stay. The Contractor shall continue to reimburse for its member’s care under those circumstances (i.e., inpatient stays) until the member is discharged from the acute care setting or nursing facility. Requirements for Reinsurance Companies The Contractor shall submit documentation that the reinsurer follows the National Association of Insurance Commissioners' (NAIC) Reinsurance Accounting Standards. The Contractor shall be required to obtain reinsurance from insurance organizations that have Standard and Poor's claims- paying ability ratings of "AA" or higher and a Xxxxx’x bond rating of “A1” or higher, unless otherwise approved by OMPP. Subcontractors Subcontractors’ reinsurance coverage requirements must be clearly defined in the reinsurance agreement. Subcontractors should be encouraged to obtain their own stop-loss coverage with the above-mentioned terms. If subcontractors do not obtain reinsurance on their own, the Contractor is required to forward appropriate recoveries from stop- loss coverage to applicable subcontractors.
Other Reinsurance The Company shall be permitted to carry other reinsurance, recoveries under which shall inure solely to the benefit of the Company and be entirely disregarded in applying all of the provisions of this Contract.
Plan of Reinsurance A. Reinsurance of Life risks shall be on the risk premium basis. The risk amount on the policy reinsured shall be calculated monthly and shall be equal to the death benefit less the cash value. At the time of issue, the Ceding Company shall cede to the North American Re the portion of the initial risk amount in excess of its retention thereafter, the Ceding Company and the North American Re shall keep the same proportionate shares of the risk amount developed each month.
REINSURANCE COVERAGE Reinsurance under this Agreement will apply to insurance issued by the Ceding Company on the Plans of Insurance shown in Schedule A. Such Plans of Insurance shall be reinsured with the Reinsurer on an automatic basis, subject to the requirements set forth in Section A below, or on a facultative basis, subject to the requirements set forth in Section B below, or on a facultative obligatory basis, subject to the requirements set forth in Section C below. The specifications for all reinsurance under this Agreement are provided in Schedule B.
FACULTATIVE REINSURANCE For Facultative reinsurance, the Reinsurer’s liability will commence at the same time as the Ceding Company’s liability, provided that the Reinsurer has made a binding Facultative offer and that offer was accepted, during the lifetime of the insured, in accordance with the terms of this Agreement.
