Relating to health benefits offered by postsecondary educational institutions to students and their families.

Contracts

• Third-Party Administrators (TPAs): Master Services Agreements must be amended to:
• Enforce a maximum 6-month waiting period for pre-existing conditions.
• Mandate participation in Chapter 1275/1467 dispute resolutions (Surprise Billing).
• Actuarial Services: You must execute a contract with a Fellow of the Society of Actuaries or a member of the American Academy of Actuaries to provide the statutorily required solvency opinion.
• Stop-Loss Carriers: Policies must be reviewed to ensure coverage extends to the specific "student and family" population defined in the statute.

Hiring/Training

• Enrollment Staff: Staff must be trained that auto-enrollment into this specific plan is prohibited without a signed disclosure.
• Finance/Risk Management: Personnel must be assigned to monitor cash reserves against actuarial recommendations on a continuous basis, not just annually.

Reporting & Record-Keeping

• Mandatory Disclosure (The "Hard Stop"): You must implement a workflow requiring students to sign a written notice stating the benefits are not regulated insurance *before* enrollment is processed.
• *Retention:* This signed document must be retained for the duration of the student's coverage and be retrievable upon request.
• Actuarial Opinion: A formal opinion regarding reserves and stop-loss levels must be maintained on file and available for TDI inspection.
• TDI Registration: You must register the plan with TDI prior to offering benefits.

Fees & Costs

• Reserve Funding: Immediate liquidity is required to fund reserves to levels recommended by your actuary.
• Professional Fees: Budget for annual actuarial retainers and potential legal costs associated with surprise billing arbitrations.