Section 26-53-102 – Registration of Third Party Administrators; Rulemaking Authority.
26-53-102. Registration of third party administrators; rulemaking authority. No person shall act as a third party administrator in this state without a certificate of registration issued by the commissioner. The commissioner in compliance with the Wyoming Administrative Procedure Act shall promulgate reasonable rules and regulations necessary to implement this chapter.
Section 26-53-103 – Third Party Administrator Fee.
26-53-103. Third party administrator fee. Every third party administrator registered with the department shall pay the fee provided for in W.S. 26-4-101(a)(xix).
Section 26-51-109 – Sanctions.
26-51-109. Sanctions. Any insurer failing, without just cause, to timely file the ORSA summary report as required in this chapter shall be required, after notice and hearing, to pay a penalty of two thousand five hundred dollars ($2,500.00) for each day’s delay, to be recovered by the commissioner. The maximum penalty under this section is […]
Section 26-51-110 – Applicability.
26-51-110. Applicability. The requirements of this chapter shall become effective on January 1, 2015. The first filing of the ORSA summary report shall be in 2015 pursuant to W.S. 26-51-105.
Section 26-52-101 – Licensure of Pharmacy Benefit Managers.
26-52-101. Licensure of pharmacy benefit managers. No person shall act or hold himself out as a pharmacy benefit manager in this state unless he obtains a license from the department. The department shall through rules establish license requirements and procedures for the licensing of pharmacy benefit managers consistent with this article. The requirements shall only […]
Section 26-52-102 – Definitions.
26-52-102. Definitions. (a) As used in this article: (i) “Claim” means a request from a pharmacy or pharmacist to be reimbursed for the cost of filling or refilling a prescription for a drug or for providing a medical supply or device; (ii) “Insurer” means the entity defined in W.S. 26-1-102(a)(xvi) and who provides health insurance […]
Section 26-52-103 – Pharmacy Benefit Manager Audits.
26-52-103. Pharmacy benefit manager audits. (a) Any pharmacy benefit manager or person acting on behalf of a pharmacy benefit manager who conducts an audit of a pharmacy shall follow the following procedures: (i) Provide written notice to the pharmacy not less than ten (10) business days before conducting any on-site, initial audit; (ii) Conduct any […]
Section 26-51-104 – Orsa Requirement.
26-51-104. ORSA requirement. Subject to W.S. 26-51-106, an insurer, or the insurance group of which the insurer is a member, shall regularly conduct an ORSA consistent with a process comparable to the ORSA guidance manual. The ORSA shall be conducted no less than annually but also at any time when there are significant changes to […]
Section 26-51-105 – Orsa Summary Report.
26-51-105. ORSA summary report. (a) Upon the commissioner’s request, and no more than once each year, an insurer shall submit to the commissioner an ORSA summary report or any combination of reports that together contain the information described in the ORSA guidance manual, applicable to the insurer and the insurance group of which it is […]
Section 26-51-106 – Exemption.
26-51-106. Exemption. (a) An insurer shall be exempt from the requirements of this chapter, if: (i) The insurer has annual direct written and unaffiliated assumed premium, including international direct and assumed premium but excluding premiums reinsured with the federal crop insurance corporation and federal flood program, of less than five hundred million dollars ($500,000,000.00); and […]