Sec. 21.87.100. Continuance or expiration of certificate of authority.
(a) A certificate of authority issued to a service corporation shall continue in force as long as the corporation is entitled to it under this chapter, and until suspended or revoked by the director or terminated at the request of the corporation; subject, however, to continuance of the certificate by the corporation each year by […]
Sec. 21.87.110. Suspension or revocation of certificate of authority.
(a) The director shall suspend or revoke the certificate of authority of a service corporation that the director finds, after a hearing, is no longer qualified under this chapter. (b) The director may after a hearing, suspend or revoke the certificate of authority for a violation by the service corporation of a provision of this […]
Sec. 21.87.120. Services and benefits that may be provided by medical service corporations.
(a) A medical service corporation shall have the right to provide to its subscribers part or all of the following services and benefits only: (1) medical and surgical services furnished to the subscriber by participant providers; (2) indemnity in reasonable amount with respect to medical and surgical services furnished to the subscriber by nonparticipant providers, […]
Sec. 21.87.130. Services and benefits that may be provided by hospital service corporations.
(a) A hospital service corporation shall have the right to provide to its subscribers part or all of the following services and benefits only: (1) hospital services furnished to the subscriber by participant hospitals; (2) indemnity in a reasonable amount with respect to hospital services furnished to the subscriber by nonparticipant hospitals, but subject to […]
Sec. 21.87.140. Medical service agreements.
(a) A medical service corporation shall enter into service agreements with providers licensed by the state only. (b) Each service agreement shall require the participant providers to furnish to subscribers of the service corporation the medical or surgical services, or both, that are, under the subscriber’s contract, to be furnished by participant providers. This obligation […]
Sec. 21.87.150. Hospital service agreements.
(a) A hospital service corporation shall enter into service agreements with hospitals approved or licensed by the state only. (b) Each service agreement must require the participant hospital to furnish to subscribers of the service corporation the hospital services that are, under the subscriber’s contract, to be furnished by participant hospitals; and this obligation to […]
Sec. 21.87.160. Subscriber’s contracts.
(a) Each subscriber’s contract issued after July 1, 1966, by a service corporation constitutes a direct obligation of the participant providers or participant hospitals of the service corporation to render the medical or hospital services, as the case may be, as agreed to be rendered by the participants in the subscriber’s contract. (b) Each subscriber’s […]
Sec. 21.87.170. Minimum service benefits.
(a) Each service agreement and subscriber’s contract entered into or issued by a service corporation must provide for health care services of a substantial and broad character to be rendered to subscribers on a service basis by participant providers or participant hospitals. (b) The director may, after a hearing, by regulation establish certain minimums of […]
Sec. 21.87.180. Filing and approval of agreements and contracts.
(a) A service corporation may not issue or use a basic form of service agreement or subscriber’s contract, or application, identification, supplement, or endorsement to be connected with the agreement or contract, until the form has been filed with and approved by the director. This provision does not apply to riders, endorsements, or other forms […]
Sec. 21.87.190. Charges and rates; rating methods.
(a) Subscription rates, fees, and payments to be charged by a service corporation to or on account of its subscribers may not be excessive, inadequate, or unfairly discriminatory; and rates of payments to be made to participant providers and participant hospitals for services rendered under a subscriber’s contract, shall be fair and reasonable. (b) [Repealed, […]