§ 245.3. Applicability.
(a) Within 15 days of the date of the Commissioner’s written request, the following information shall be reported to the Commissioner in writing:
(1) Insurance carriers writing medical malpractice coverage on a Pennsylvania health care provider, as defined by the act, shall record the policy underwriting information in sufficient detail to identify the individual policyholder, the inforce policy as of August 31 of each year and the corresponding carrier’s annual premium for each policyholder.
(2) Each self-insured health care provider shall make available to the Fund sufficient details for the Fund to identify the Pennsylvania health care providers covered by an inforce self-insurance plan as of August 31 of each year.
(b) The emergency surcharge will be billed to and paid by health care providers who have an inforce policy or inforce self-insurance plan covered by the Fund as of August 31 of the emergency surcharge year. The emergency surcharge rate will be levied on the carrier’s annual premium for each inforce policy as of August 31 of the emergency surcharge year. The emergency surcharge rate will also be levied on the premium annually calculated by the Fund for each inforce self-insurance plan as of August 31 of the emergency surcharge year.
(c) Changes in policy information shall be handled as follows:
(1) Changes in inforce policy information recorded by the carrier on or after September 1 of the emergency surcharge year may not be the basis to recalculate the individual policyholder’s emergency surcharge. If, however, the health care provider can demonstrate that the carrier misrepresented a material fact, intentionally omitted or entered false information, or failed to act in good faith, the carrier shall recalculate the emergency surcharge and refund the overpayment, if any. If the carrier can demonstrate that the health care provider misrepresented a material fact, intentionally omitted or entered false information, or failed to act in good faith, the carrier shall recalculate the emergency surcharge and bill the additional emergency surcharge.
(2) A change in the inforce self-insurance plan information recorded by the self-insured health care provider on or after September 1 of the emergency surcharge year may not be the basis to recalculate the emergency surcharge levied on the self-insured health care provider.
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