§ 33-20-1. Short Title
This chapter shall be known and may be cited as the “Health Care Plan Act.” History. Code 1933, § 56-1700a, enacted by Ga. L. 1976, p. 1461, § 1.
§ 33-20-10. Expiration, Renewal, and Amendment of Certificate of Authority
All certificates of authority shall expire at 12:00 Midnight on June 30 following the date of issuance or renewal. A health care corporation desiring renewal shall file on March 1 preceding expiration a copy of its annual statement as of December 31 of the preceding year in a form approved for current use by the […]
§ 33-20-11. Refusal, Revocation, or Suspension of Certificate of Authority Generally
The Commissioner may refuse to issue, or after a hearing refuse to renew, or revoke or suspend a health care corporation’s certificate of authority in addition to other grounds provided for in this title if the corporation: Violates any provision of this title other than the provisions of Code Section 33-20-12 as to which refusal, […]
§ 33-20-12. Mandatory Refusal, Revocation, or Suspension
The Commissioner shall refuse to issue or to renew or shall revoke or suspend a health care corporation’s certificate of authority: If such action is required by any provision of this title; or If the health care corporation no longer meets the requirements for the authority originally granted on account of deficiency in assets or […]
§ 33-20-13. Management of Corporations; General Powers; Requirements as to Reserves, Minimum Subscriber’s Surpluses, and Charges
Health care corporations shall be governed and conducted as corporations and the necessary expenses of administering the affairs of the corporations may be paid from the payments collected from subscribers. A health care corporation may in its discretion limit the benefits that it will furnish, may divide such benefits as it elects to furnish into […]
§ 33-20-14. Acceptance of Applications
When organized, health care corporations shall be authorized to accept applicants individually or in groups who may become subscribers of the corporation furnishing health care services under a contract which shall entitle each subscriber, beneficiary, and covered dependent to the health care services for such period of time as is provided in the contract. History. […]
§ 33-20-15. Issuance and Contents of Membership Certificates
Every health care corporation shall issue to its subscribers a membership certificate which shall describe the health care plan under which the subscriber is enrolled and shall specify how the holder of such contract may obtain the name or names and addresses of participating providers of health care services upon whom the subscriber shall have […]
§ 33-20-16. Right to Become Participating Physician or Approved Health Care Provider
Every doctor of medicine, every doctor of dental surgery, every podiatrist, and every health care provider within a class approved by the health care corporation who is appropriately licensed to practice and who is reputable and in good standing shall have the right to become a participating physician or approved health care provider for medical […]
§ 33-20-17. Powers of Corporations to Contract for Provision of Health Care Services; Receipt of Payments
Any health care corporation organized or operated under this chapter and engaged in the operation of a health care plan may contract with any agency, instrumentality, or political subdivision of the United States of America or of this state for the furnishing of health care services and in aid or furtherance of said contract, may […]
§ 33-20-18. Sale of Contracts Providing for Payment of Specified Charges Made by Participating Physicians; Right of Subscribers to Select Physicians; Liability of Corporations for Negligence of Physicians
Health care corporations shall have the right to sell contracts providing for the payment of specified charges made by participating physicians furnishing medical or surgical care, or both, to the holders of such contracts, their beneficiaries, and covered dependents as provided for in this Code section. The contracts shall not in any manner restrict the […]
§ 33-20-19. Regulation and Supervision of Corporations by Commissioner Generally; Payment of Fees and Taxes by Corporations Generally
Health care corporations shall be subject to regulation and supervision by the Commissioner and shall be required to pay any fees and taxes, including premium taxes, as are now or may hereafter be required of life insurers under this title in accordance with Chapters 2, 3, 8, and 12 of this title and the other […]
§ 33-20-2. Purpose and Construction of Chapter
It is the purpose and intent of this chapter and the policy of this state to promote and finance quality health care services of demonstrated need, efficiently provided and properly utilized at a reasonable cost, in order to maintain the standing and promote the progress of comprehensive health care services in this state. This chapter […]
§ 33-20-20. Submission to Commissioner of Operating Plan, Schedule of Rates, and Amount of Service; Approval by Commissioner
Except for corporations subject to this chapter which are surviving corporations, health care corporations shall before accepting applications from subscribers in a nonprofit health care plan submit to the Commissioner a plan of operating and overhead expenses, operation cost, and salaries paid or to be paid during any current year together with a schedule of […]
§ 33-20-21. Approval of Commissioner of Rates to Be Paid to Providers of Services
Except for corporations subject to this chapter which are surviving corporations, the Commissioner shall first approve the rates of payment to be made by health care corporations to providers of health care services on behalf of said corporation, its subscribers, beneficiaries, and covered dependents as being fair and reasonable before said corporation shall engage in […]
§ 33-20-22. Investment of Funds of Corporations
Health care corporations shall invest in or lend their funds on security of and shall hold as invested assets only such assets as are authorized by Articles 1 and 3 of Chapter 11 of this title for the investments of assets of domestic insurance companies and such investments shall be subject to the same requirements, […]
§ 33-20-23. Maintenance of Books and Records Showing Funds Collected and Disbursed; Examination of Books and Records by Commissioner
Every health care corporation shall keep complete books and records in accordance with the requirements of the Commissioner showing all funds collected and disbursed. All books and records shall be subject to examination by the Commissioner in accordance with Chapter 2 of this title applicable to life insurers and the expenses of the examination borne […]
§ 33-20-24. Filing of Reports With Commissioner
Every health care corporation shall on or before March 1 in each year after it shall have commenced to do business pursuant to a certificate of authority make and file with the Commissioner a report of its affairs and operations during the year ending December 31 of the preceding year. The annual report shall be […]
§ 33-20-25. Liability for Expenses of Commissioner’s Supervisory and Other Activities
Any and all supervision, conservation, rehabilitation, liquidation, or examination of the affairs of any corporation by the Commissioner shall be at the expense of the corporation. History. Code 1933, § 56-1729a, enacted by Ga. L. 1976, p. 1461, § 1; Ga. L. 1995, p. 745, § 1.9.
§ 33-20-26. Powers of Commissioner as to Protection of Subscribers and Public Health and Welfare
The Commissioner shall have the authority to take appropriate actions authorized by this title for the protection of a health care corporation’s subscribers and the public health and welfare, including but not limited to those authorized in Code Section 33-2-24, and shall have authority to institute civil actions and other appropriate proceedings authorized by and […]
§ 33-20-27. Imposition by Commissioner of Administrative Fine for Certain Acts of Officers, Employees, Agents, or Representatives of Corporations
The Commissioner may after a hearing impose upon a health care corporation an administrative fine if he finds that the corporation through the acts of its officers, employees, agents, or representatives has with such frequency as to indicate its general business practice in this state: Refused without just cause to pay proper claims arising under […]