§ 56-51-108. Continued Eligibility for Certificate of Authority
In order to maintain its eligibility for a certificate of authority, a prepaid limited health service organization must continue to meet all conditions required to be met under this chapter and the rules adopted under this chapter for the initial application for and issuance of its certificate of authority under §§ 56-51-106 and 56-51-107.
§ 56-51-109. Certain Entities Contracting With State Title Xix Agency
Any entity licensed under this chapter that provides services solely to Title XIX program recipients under a contract with the state shall be exempt from §§ 56-51-106(12), 56-51-112(e) and (k), 56-51-113, 56-51-117, 56-51-123, 56-51-127, and 56-51-134(b)(5)(A) and (B). Further, the commissioner may by rule exempt the entities from other provisions of this chapter where determined […]
§ 56-51-110. Use of English Required in Contracts and Forms
All contracts or forms utilized by the prepaid limited health services organization, whether directed to providers or enrollees, shall be written in the English language.
§ 56-51-111. Language Used in Contracts and Marketing Materials
All prepaid limited health services contracts, marketing materials, and literature must disclose in boldfaced type the name of the organization and disclose that the organization is a prepaid limited health service organization licensed under this chapter.
§ 56-51-112. Prepaid Limited Health Service Contracts
Any entity issued a certificate of authority and otherwise in compliance with this chapter may enter into contracts in this state to provide an agreed-upon set of limited health services to subscribers in exchange for a prepaid per capita sum or a prepaid aggregate fixed sum from a health maintenance organization or a state or […]
§ 56-51-113. Rates for Subscribers — Requirements
The rates charged by any prepaid limited health service organization to its subscribers shall not be excessive, inadequate, or unfairly discriminatory. The department may require whatever information it deems necessary to determine that a rate or proposed rate meets the requirements of this section. In determining whether a rate is in compliance with subsection (a), […]
§ 56-51-114. Changes in Rates and Benefits — Material Modifications — Addition of Limited Health Services
No prepaid limited health services contract, certificate of coverage, application, enrollment form, rider, endorsement, and applicable rates to be charged may be delivered in this state unless the forms and rates have been filed with the department by or on behalf of the prepaid limited health service organization and have been approved by the department. […]
§ 56-51-115. Additional Contract Contents
A prepaid limited health services contract may contain additional provisions not inconsistent with this chapter that are: Necessary because of the manner in which the organization is constituted or operated in order to state the rights and obligations of the parties to the contract; or Desired by the organization and neither prohibited by law nor […]
§ 56-51-116. Genetic Information Restrictions
A prepaid limited health service organization must comply with chapter 7, part 27 of this title.
§ 56-51-117. Restrictions Upon Expulsion or Refusal to Issue or Renew Contract
A prepaid limited health service organization may not expel or refuse to renew the coverage of or refuse to enroll any individual member of a subscriber group through a health maintenance organization or a state or federal agency on the basis of the race, color, creed, disability, marital status, sex, or national origin of the […]