§ 1–307.87. Plan of operation for the Agency.

(a) The captive manager shall submit to the Risk Officer a plan of operation for the Agency that has been approved by the Commissioner and any amendments to the plan necessary or suitable to assure the fair, reasonable, and equitable administration of the Agency.

(b) The plan of operation shall:

(1) Become effective upon approval in writing by the Commissioner and the Risk Officer;

(2) Establish procedures for the operation of the Agency;

(3) Establish procedures for health centers to qualify to purchase medical malpractice insurance from the Agency;

(4) Establish procedures for offering gap coverage for the District’s Federally Qualified Health Centers;

(4A) Repealed.

(5) Establish procedures, under the management of the Risk Officer, for the payment of administrative expenses;

(6) Establish procedures for adjustment and payment of claims made under the policies issued by the Agency, including procedures for administrative review and resolution of disputes arising over such claims;

(7) Establish procedures for tail coverage to health centers purchasing medical malpractice liability coverage through the Agency;

(8) Develop standards for the level of subsidies that shall be provided to health centers to offset premiums due to the Agency;

(9) Establish rules, conditions, and procedures for facilitating the reinsurance of risks of participating health centers;

(10) Establish risk management standards to which the health centers shall adhere and auditing procedures for the compliance of risk management standards by health centers;

(11) Establish underwriting guidelines for policyholders; and

(12) Provide for other matters as may be necessary and proper for the execution of the Risk Officer’s and the captive manager’s respective powers, duties, and obligations under this part.