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23-76-122. Examinations.
Arkansas Code — all titles (historical 2020) · legal_authorities
23-76-122. Examinations.
(a) The Insurance Commissioner may make an examination of the affairs of any health maintenance organization as often as he or she deems it necessary for the protection of the interests of the people of this state but not less frequently than one (1) time every three (3) years.
(b) The commissioner may make an examination concerning the quality of healthcare services of any health maintenance organization as often as he or she deems it necessary for the protection of the interests of the people of this state but not less frequently than one (1) time every three (3) years.
(c)(1) Every health maintenance organization shall submit its books and records relating to the healthcare plan to the examinations and in every way facilitate them.
(2) For the purpose of examinations, the commissioner may administer oaths to and examine the officers and agents of the health maintenance organization.
(3) Medical records of individuals and records of physicians and hospitals providing services under a contract to the health maintenance organization shall be subject to the examination.
(d) The expenses of examinations under this section shall be assessed against the health maintenance organization being examined and remitted to the commissioner.
(e) In lieu of the examination, the commissioner may accept the report of an examination made by the insurance commissioner of another state or director of the department of health of another state.
(f)(1) Any examination under this section that is to commence within one (1) year prior to the date a health maintenance organization shall cease to provide healthcare services in this state, may be reduced in scope or waived in its entirety, upon application of the health maintenance organization and approval
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-76-122
Stored review status: Historical 2020-11-06 source release; later amendments not reconciled; machine-extracted, not independently legally reviewed; source heading status: text_in_historical_source. A text match is a research starting point; applicability is not established.
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Stable record: arkansas_code:legal_authorities:23-76-122
Source file: gov.ar.code.title.23.odt
Pages: Not recorded – Not recorded
Passage SHA-256: b6e4dd89ecc3e7eb10bc8e5ed6962d6ac21ae990d095e938a6448676709842ae
Source location: content.xml paragraph 43891
Stored source content
23-76-122. Examinations.
(a) The Insurance Commissioner may make an examination of the affairs of any health maintenance organization as often as he or she deems it necessary for the protection of the interests of the people of this state but not less frequently than one (1) time every three (3) years.
(b) The commissioner may make an examination concerning the quality of healthcare services of any health maintenance organization as often as he or she deems it necessary for the protection of the interests of the people of this state but not less frequently than one (1) time every three (3) years.
(c)(1) Every health maintenance organization shall submit its books and records relating to the healthcare plan to the examinations and in every way facilitate them.
(2) For the purpose of examinations, the commissioner may administer oaths to and examine the officers and agents of the health maintenance organization.
(3) Medical records of individuals and records of physicians and hospitals providing services under a contract to the health maintenance organization shall be subject to the examination.
(d) The expenses of examinations under this section shall be assessed against the health maintenance organization being examined and remitted to the commissioner.
(e) In lieu of the examination, the commissioner may accept the report of an examination made by the insurance commissioner of another state or director of the department of health of another state.
(f)(1) Any examination under this section that is to commence within one (1) year prior to the date a health maintenance organization shall cease to provide healthcare services in this state, may be reduced in scope or waived in its entirety, upon application of the health maintenance organization and approval of the commissioner.
(2) The commissioner shall consider the following in determining whether a full or partial waiver may be granted:
(A) Claims payment history;
(B) Consumer complaint history;
(C) Financial condition; and
(D) Compliance with § 23-76-118.
(3) Any health maintenance organization requesting a waiver of an examination shall continue to comply with § 23-76-118 until such time as it is no longer providing healthcare services in this state.
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Arkansas Code — all titles (historical 2020) · legal_authorities
23-76-118. Protection against insolvency.
(a)Deposit Requirements.
(1)(A) All health maintenance organizations authorized to transact business in this state shall deposit through the Insurance Commissioner securities eligible for deposit under § 23-63-903 that at all times shall have a par or market value of not less than three hundred thousand dollars ($300,000), with the exception of limited benefit health maintenance organizations whose security deposit shall not be less than one hundred thousand dollars ($100,000).
(B) The commissioner shall also be authorized to require a special surplus deposit for the benefit of enrollees from each health maintenance organization.
(2) All deposits made through the commissioner and held in this state shall be subject to the applicable provisions of §§ 23-63-903 — 23-63-907, 23-63-910, and 23-63-911, which refer to administration of deposits.
(3)(A)(i) A health maintenance organization, excluding limited benefit health maintenance organizations, that is in operation on August 1, 1997, shall make a deposit equal to one hundred fifty thousand dollars ($150,000).
(ii) In the second year, the amount of the additional deposit for a health maintenance organization that is in operation August 1, 1997, shall be equal to one hundred fifty thousand dollars ($150,000), for a total of three hundred thousand dollars ($300,000).
(B)(i) A limited benefit health maintenance organization that is in operation on August 1, 1997, shall make a deposit equal to seventy-five thousand dollars ($75,000).
(ii) In the second year, the amount of the additional deposit for a limited benefit health maintenance organization that is in operation on August 1, 1997, shall be equal to twenty-five thousand dollars ($25,000) for a total of one hundred t
Source: Arkansas Code — historical release 78 (November 6, 2020) · 23-76-118
Stored review status: Historical 2020-11-06 source release; later amendments not reconciled; machine-extracted, not independently legally reviewed; source heading status: text_in_historical_source. The source passage cites 23-76-118. This identifies an authority to review, not proof of applicability.