SECTION 13.560. Annual and Quarterly Reserves

The financial statements filed by an approved PEO under §13.570 of this title (relating to Financial Filing Requirements) must report the trust's reserves as described below:

(1) the trust's year-end reserves must be calculated as the difference between the trust's total claim distributions and the aggregate limit attachment point of its stop-loss insurance agreement for each plan year;

(2) the total claim distributions number used in paragraph (1) of this section must be the amount of paid claims reduced by any amount either received or recoverable by the trust associated with the specific attachment point included in its stop-loss insurance agreement;

(3) the trust's quarterly reserves must equal the total amount of its known unpaid claims as the end of the respective calendar quarter; and

(4) the known unpaid claims number used in paragraph (3) of this section is the amount of reserve established for a claim when it is received, reduced by any amount recoverable by the trust associated with the specific attachment point included in its stop-loss insurance agreement.

Source Note: The provisions of this §13.560 adopted to be effective May 17, 2016, 41 TexReg 3479