(a) In each pool area, a specified medical condition pooling fund is established. Each pool operates independently; that is, all calculations and payments described below are made for each pool independently of any other pool.

(b) Each carrier shall pay to the pooling fund each quarter, beginning with the second quarter of 1993, and ending December 31, 1998, an amount determined as the product of paragraphs (1), (2), and (3) of this subdivision:

(c) Each carrier may collect from the pooling fund in lump sum an amount listed in Table 1, subdivision (e) of this section, for claims incurred prior to January 1, 1997 and in lump sum an amount listed in Table 3, subdivision (e) of this section for claims incurred between January 1, 1997 and December 31, 1997 (but in no event more than the carrier is required to pay for the care of the listed medical condition), by submitting a claim in the calendar year following the calendar year in which the claim was incurred except that the deadline for filing 1997 claims is extended from December 31, 1998 to July 31, 2000, upon certification to the superintendent by the carrier that:

In the event that the individual changes carriers or is covered by more than one carrier under pooled insurance contracts or policies, other than a Medicare supplement insurance policy, during the course of the identified medical care, payment from the pooling fund of the amount listed in Table 1 or Table 3, subdivision (e) of this section, shall be pro-rated among the carriers based upon each carrier's proportionate share of the cost of the identified medical care. Insurers and HMOs may not base decisions as to whether a course of medical care is covered by an insurance or HMO policy or contract on the presence of that course of medical care in Table 1 or Table 3, subdivision (e) of this section, or the absence of that course of medical care from Table 1 or Table 3.

Distributions from the pooling fund of the amounts listed in Table 1 or Table 3, subdivision (e) of this section, shall be made based upon the month in which the claim attributable to expenses was incurred by the carrier. Older claims, based on the date the medical service was provided, will be given priority for payment over more recent claims.

(d) Each carrier may collect from the pooling fund each month an amount listed in Table 2, subdivision (e) of this section, for claims incurred prior to January 1, 1997 and each month an amount listed in Table 4, subdivision (e) of this section for claims incurred between January 1, 1997 and December 31, 1997, but in no event more than the carrier is required to pay for the care of the listed medical condition, by submitting a claim in the calendar year following the calendar year in which the claim was incurred except that the deadline for filing 1997 claims is extended from December 31, 1998 to July 31, 2000, upon certification to the superintendent by the carrier that:

In the event that the individual is covered by more than one carrier under a pooled insurance contract or policy, other than a Medicare supplement insurance policy, payments from the pooling fund of the amount listed in Table 2 or Table 4, subdivision (e) of this section, shall be pro-rated among the carriers based upon each carrier's proportionate share of the cost of medical care for the identified medical condition.

Distributions from the pooling fund of the amounts listed in Table 2 or Table 4, subdivision (e) of this section, shall be made based upon the month in which the claim attributable to expenses was incurred by the carrier. Older claims, based on the date the medical service was provided, will be given priority for payment over more recent claims.

(f) The pooling of the cost of treating specified medical conditions for claims incurred in 1998 shall occur as follows:

(g) A carrier must report the number of claims that have been incurred for 1998 separately for each category listed in Table 3, subdivision (e) of this section and Table 4, subdivision (e) of this section in a manner prescribed by the superintendent.