§ 83-41-363. Proceedings upon insolvency of health maintenance organization
When a health maintenance organization in this state is declared insolvent by a court of competent jurisdiction, the commissioner may levy an assessment on health maintenance organizations doing business in this state to pay claims for uncovered expenditures for enrollees who are residents of this state and to provide continuation of coverage for subscribers or […]
§ 83-41-333. Rules and regulations generally; exemptions from certification requirement
The commissioner may, after notice and hearing, promulgate rules and regulations as are necessary to provide for the licensing of health maintenance organization producers. The rules shall establish: The requirements for licensure of resident health maintenance organization producers; The conditions for entering into reciprocal agreements with other jurisdictions for the licensure of nonresident health maintenance […]
§ 83-41-335. Operation of health maintenance organizations by insurance companies and medical service corporations
An insurance company licensed in this state, or a hospital or medical service corporation authorized to do business in this state, may either directly or through a subsidiary or affiliate organize and operate a health maintenance organization under the provisions of this article. Any two (2) or more insurance companies, hospital or medical service corporations, […]
§ 83-41-337. Examination of health maintenance organizations and providers; acceptance of reports in lieu of examinations
The commissioner shall make an examination of the affairs of any health maintenance organization and providers with whom such organization has contracts, agreements or other arrangements as often as is reasonably necessary for the protection of the interests of the people of this state but not less frequently than once every five (5) years at […]
§ 83-41-339. Grounds and procedure for revocation, suspension or denial of certificate of authority; administrative penalty generally; correction of deficiencies in net worth; proceedings upon suspension or revocation of certificate of authority; appeals
Any certificate of authority issued under this article may be suspended or revoked, and any application for a certificate of authority may be denied, if the commissioner after a hearing finds that any of the conditions listed below exist: The health maintenance organization is operating significantly in contravention of its basic organizational document or in […]
§ 83-41-341. Rehabilitation, liquidation or administrative supervision of health maintenance organizations
Any rehabilitation, liquidation or administrative supervision of a health maintenance organization shall be deemed to be the same as the rehabilitation, liquidation or administrative supervision of an insurance company and shall be conducted under the supervision of the commissioner pursuant to the law governing the rehabilitation, liquidation, and administrative supervision of insurance companies. The commissioner […]
§ 83-41-343. Remedies for correction of financial conditions of health maintenance organizations deemed hazardous to enrollees, creditors, or general public and violations of article
Whenever the commissioner determines that the financial condition of any health maintenance organization is such that its continued operation might be hazardous to its enrollees, creditors, or the general public, or that it has violated any provision of this article, he may, after notice and hearing, order the health maintenance organization to take such action […]
§ 83-41-325. Minimum net worth requirement; deposits generally; computation of liabilities; contracts between health maintenance organizations and participating providers of services; insolvency plans
Before issuing any certificate of authority, the commissioner shall require that the health maintenance organization have an initial net worth of One Million Five Hundred Thousand Dollars ($1,500,000.00) and shall thereafter maintain the minimum net worth required under subsection (2). Except as provided in subsections (3) and (4) of this section, every health maintenance organization […]
§ 83-41-327. Uncovered expenditures insolvency deposits
If at any time uncovered expenditures exceed ten percent (10%) of total health care expenditures, a health maintenance organization shall place an uncovered expenditures insolvency deposit with the commissioner, with any organization or trustee acceptable to the commissioner through which a custodial or controlled account is maintained, cash or securities that are acceptable to the […]
§ 83-41-329. Proceedings upon insolvency of health maintenance organization; terms and conditions of replacement coverage
In the event of an insolvency of a health maintenance organization, upon order of the commissioner all other carriers that participated in the enrollment process with the insolvent health maintenance organization at a group’s last regular enrollment period shall offer such group’s enrollees of the insolvent health maintenance organization a thirty-day enrollment period commencing upon […]