432G-21 Federal law compliance.
§432G-21 Federal law compliance. All dental insurers shall comply with applicable federal law. The commissioner shall enforce the consumer protections and market reforms relating to insurance as set forth in the federal Patient Protection and Affordable Care Act, Public Law 111-148. [L 2013, c 191, pt of §1]
432G-22 Rules; adoption by commissioner.
§432G-22 Rules; adoption by commissioner. The commissioner may adopt rules under chapter 91 for the implementation and administration of this chapter. [L 2013, c 191, pt of §1] Revision Note This section, enacted as §432G-2(e), was redesignated pursuant to §23G-15.
432G-9 Replacement coverage.
§432G-9 Replacement coverage. (a) Any carrier providing replacement coverage with respect to group dental benefits within a period of sixty days from the date of discontinuance of a prior dental insurer contract or policy providing such dental benefits shall immediately cover all enrollees who were validly covered under the previous dental insurer contract or policy […]
432G-10 Powers of insurers and hospital and medical service corporations.
§432G-10 Powers of insurers and hospital and medical service corporations. (a) An insurance company licensed in this State, or a hospital or medical service corporation authorized to do business in this State, either directly or through a subsidiary or affiliate, may organize and operate a dental insurer under the provisions of this chapter. Notwithstanding any […]
432G-1 Definitions.
§432G-1 Definitions. As used in this chapter: “Capitated basis” means fixed per member per month payment or percentage of premium payment wherein the provider assumes the full risk for the cost of contracted services without regard to the type, value, or frequency of services provided. For purposes of this chapter, “capitated basis” includes the cost […]
432G-2 Establishment of a dental insurer; certificate of authority.
§432G-2 Establishment of a dental insurer; certificate of authority. (a) Any person may apply to the commissioner for a certificate of authority to establish and operate a dental insurer in compliance with this chapter and chapter 423. No person shall establish or operate a dental insurer in this State without meeting the requirements of chapter […]
432G-3 Fiduciary responsibilities.
§432G-3 Fiduciary responsibilities. (a) Any director, officer, employee, or partner of a dental insurer who receives, collects, disburses, or invests funds in connection with the activities of an organization shall be responsible for the funds in a fiduciary relationship to the organization. (b) A dental insurer shall maintain in force a fidelity bond or fidelity […]
432G-4 Annual reports.
§432G-4 Annual reports. (a) Each dental insurer shall file with the commissioner: (1) An audit, by an independent certified public accountant or an accounting firm designated by the dental insurer of the financial statements, reporting the financial condition and results of operations of the dental insurer, annually on or before June 1, or a later […]
432G-5 Information to subscribers.
§432G-5 Information to subscribers. (a) The dental insurer shall provide to its subscribers a list of providers and participating providers, upon enrollment and reenrollment. (b) Every dental insurer shall provide to its subscribers notice of any material change in the operation of the organization that will affect them directly within thirty days of the material […]
432G-6 Protection against insolvency; net solvency report.
§432G-6 Protection against insolvency; net solvency report. (a) Net worth requirements are as follows: (1) Before issuing any certificate of authority, the commissioner shall require that the dental insurer has an initial net worth of $2,000,000 and shall thereafter maintain the minimum net worth required under paragraph (2); (2) Except as provided in paragraphs (3) […]