§ 131E-300. Continuation of benefits. - North Carolina Statutes

§ 131E‑300. Continuation of benefits.

The Division shall require that each PSO have a plan for handlinginsolvency, which plan allows for continuation of benefits for the duration ofthe contract period for which premiums have been paid and continuation ofbenefits to beneficiaries who are confined in an inpatient facility until theirdischarge or expiration of benefits. In considering such a plan, the Divisionmay require:

(1)        Insurance to cover the expenses to be paid for benefitsafter an insolvency;

(2)        Provisions in provider contracts that obligate the providerto provide services for the duration of the period after the PSO's insolvencyfor which premium payment has been made and until the beneficiaries' dischargefrom inpatient facilities;

(3)        Insolvency reserves as the Division may require;

(4)        Letters of credit acceptable to the Division;

(5)        Additional guaranties from a sponsoring provider of the PSOor from the parent of a sponsoring provider;

(6)        Legally binding obligations of sponsoring providers toforego payment from the PSO for services provided to beneficiaries in order toavoid the insolvency of the PSO; and

(7)        Any other arrangements to assure that benefits are continuedas specified. (1998‑227, s.1.)