§33-15E-1. Short Title
This article shall be cited as the "Discount Medical Plan Organizations and Discount Prescription Drug Plan Organizations Act."
§33-15E-10. Provider Agreements; Provider Listing Requirements
(a) (1) A discount medical plan organization shall have a written provider agreement with all providers offering medical or ancillary services to its members. The written provider agreement may be entered into directly with the provider or indirectly with a provider network to which the provider belongs. (2) A provider agreement between a discount medical […]
§33-15E-11. Marketing Requirements
(a) A discount medical plan organization may market directly or contract with other marketers for the distribution of its product. (b) (1) A discount medical plan organization shall have a written agreement with a marketer prior to the marketer's marketing, promoting, selling or distributing the discount medical plan. (2) The agreement between the discount medical […]
§33-15E-12. Annual Reports
(a) If the information required in subsection (b) of this section is not provided at the time of renewal of a license under section four of this article, a discount medical plan organization shall file an annual report with the commissioner in the form prescribed by the commissioner, within three months after the end of […]
§33-15E-13. Discount Prescription Drug Plan Organizations
(a) A discount prescription drug plan organization shall comply with sections eight, nine, ten and eleven of this article and shall report any of the information described in section twelve of this article in the form and manner as the commissioner may require. A discount prescription drug plan organization is also subject to sections fourteen, […]
§33-15E-14. Administrative Enforcement Actions; Injunctions
(a) The commissioner may investigate the business affairs and conduct of every person applying for or holding a discount medical plan organization license and the operational affairs of a discount prescription drug plan organization to determine whether a violation of this article or any rule promulgated hereunder has occurred or is occurring. (b) If the […]
§33-15E-15. Criminal Penalties
(a) A person that willfully operates as or aids and abets another operating as a discount medical plan organization in violation of subsection (a), section four of this article is guilty of a felony and, upon conviction thereof, shall be fined not more than $20,000 for each unauthorized act or imprisoned in the state correctional […]
§33-15E-16. Insurance Fraud Unit
The insurance fraud unit created pursuant to the provisions of section eight, article forty-one of this chapter may investigate suspected violations of this article.
§33-15E-17. Rules
The commissioner may propose rules for legislative approval in accordance with the provisions of article three, chapter twenty-nine-a of this code to carry out the provisions of this article. The commissioner may also promulgate emergency legislative rules to carry out the provisions of this article, including rules setting forth the requirements and prohibited practices with […]
§33-15E-2. Purpose
The purpose of this article is to establish standards for discount medical plan organizations and discount prescription drug plan organizations in order to better protect consumers from unfair or deceptive marketing, sales and enrollment practices and to facilitate consumer understanding of the role and function of the organizations in providing access to medical or ancillary […]
§33-15E-3. Definitions
For purposes of this article: (1) "Affiliate" means a person that directly, or indirectly through one or more intermediaries, controls, is controlled by, or is under common control with, the specified person.
§33-15E-4. Licensing Requirements
(a) A person is required to obtain a license prior to doing business in this state as a discount medical plan organization. (b) The commissioner shall propose rules for legislative approval in accordance with the provisions of article three, chapter twenty-nine-a of this code, as well as emergency rules in accordance with section fifteen of […]
§33-15E-5. Minimum Capital Requirements
(a) Before the commissioner issues a license to any person required to obtain a license under section four of this article, the person seeking to operate a discount medical plan organization shall demonstrate that it has a positive net worth of at least $150,000. (b) Each discount medical plan organization shall at all times maintain […]
§33-15E-6. Surety Bond Requirements
Each licensed discount medical plan organization shall maintain in force a surety bond in its own name, in an amount not less than $35,000, in favor of the commissioner for the benefit of any person who is damaged by any violation of this article. The bond shall cover any violation occurring during the time period […]
§33-15E-7. Examinations
The commissioner may examine the business and affairs of any discount medical plan organization to protect the interests of the residents of this state based on the following reasons, including complaint indices, recent complaints or information from other states, or as he or she deems necessary. An examination shall be performed in accordance with the […]
§33-15E-8. Charges and Fees; Refund Requirements; Bundling of Services
(a) A discount medical plan organization may charge a periodic charge as well as a reasonable one-time processing fee for a discount medical plan. (b)(1) All discount medical plan certificates or other document demonstrating membership in the plan issued to persons in this state shall have a notice, prominently printed on the first page of […]
§33-15E-9. Record Filing and Retention Requirements
(a) (1) Upon demand by the commissioner, a discount medical plan organization shall file with the commissioner a list of prospective member fees and charges associated with the discount medical plan. (b) A copy of every form to be used by a discount medical plan organization, including the form for the written document demonstrating membership […]