20-25-1403. Authorization to establish self-insured health plan for students — requirements — exemption. (1) The commissioner may establish a self-insured student health plan for enrolled students of the system and their dependents, including students of a community college district. In developing a self-insured student health plan, the commissioner shall:

Terms Used In Montana Code 20-25-1403

  • Board of regents: means the board of regents of higher education created by Article X, section 9, subsection (2), of the Montana constitution and 2-15-1505. See Montana Code 20-1-101
  • Commissioner: means the commissioner of higher education created by Article X, section 9, subsection (2), of the Montana constitution and 2-15-1506. See Montana Code 20-1-101
  • district: means the territory, regardless of county boundaries, organized under the provisions of this title to provide public educational services under the jurisdiction of the trustees prescribed by this title. See Montana Code 20-6-101
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • System: means the Montana university system. See Montana Code 20-1-101

(a)maintain the plan on an actuarially sound basis;

(b)maintain reserves sufficient to liquidate the unrevealed claims liability and other liabilities of the plan; and

(c)deposit all reserve funds, contributions and payments, interest earnings, and premiums paid to the plan. The deposits must be expended for claims under the plan and for the costs of administering the plan, including but not limited to the costs of hiring staff, consultants, actuaries, and auditors, purchasing necessary reinsurance, and repaying debts.

(2)Prior to the implementation of a self-insured student health plan, the commissioner shall consult with affected parties, including but not limited to the board of regents and representatives of enrolled students of the system.

(3)A self-insured student health plan developed under this part is not responsible for and may not cover any services or pay any expenses for which payment has been made or is due under an automobile, premises, or other private or public medical payment coverage plan or provision or under a workers’ compensation plan or program, except when the other payor is required by federal law to be a payor of last resort. The term “services” includes but is not limited to all medical services, procedures, supplies, medications, or other items or services provided to treat an injury or medical condition sustained by a member of the plan.

(4)The provisions of 20-25-1315 through 20-25-1320 apply to any self-insured student health plan developed under this part.

(5)(a) Except as provided in subsection (5)(b), the provisions of Title 33 do not apply to the commissioner when exercising the duties provided for in this part.

(b)A self-insured student health plan established under this part must include coverage for telehealth services as provided in 33-22-138.