2009 Iowa Code
Title 13 - Commerce
Subtitle 1 - Insurance and Related Regulation
CHAPTER 514B - HEALTH MAINTENANCE ORGANIZATIONS
514B.3 - APPLICATION FOR A CERTIFICATE OF AUTHORITY.

        514B.3  APPLICATION FOR A CERTIFICATE OF AUTHORITY.
         An application for a certificate of authority shall be verified by
      an officer or authorized representative of the health maintenance
      organization, shall be in a form prescribed by the commissioner, and
      shall set forth or be accompanied by the following:
         1.  A copy of the basic organizational document, if any, of the
      applicant such as the articles of incorporation, articles of
      association, partnership agreement, trust agreement, or other
      applicable documents, and all of its amendments.
         2.  A copy of the bylaws, rules or similar document, if any,
      regulating the conduct of the internal affairs of the applicant.
         3.  A list of the names, addresses and official positions of the
      persons who are to be responsible for the conduct of the affairs of
      the applicant, including all members of the board of directors, board
      of trustees, executive committee, or other governing board or
      committee, the principal officers if a corporation and the partners
      or members if a partnership or association.
         4.  A copy of any contract made or to be made between any
      providers or persons listed in subsection 3 and the applicant.
         5.  A statement generally describing the health maintenance
      organization including, but not limited to, a description of its
      facilities and personnel.
         6.  A copy of the form of evidence of coverage.
         7.  A copy of the form of the group contract, if any, which is to
      be issued to employers, unions, trustees or other organizations.
         8.  Financial statements showing the applicant's assets,
      liabilities and sources of financial support.  If the applicant's
      financial affairs are audited by an independent certified public
      accountant, a copy of the applicant's most recent regular certified
      financial statement shall satisfy this requirement unless the
      commissioner directs that additional financial information is
      required for the proper administration of this chapter.
         9.  A description of the proposed method of marketing the plan, a
      financial plan which includes a three-year projection of operating
      results anticipated, and a statement as to the sources of funding.
         10.  A power of attorney executed by any applicant appointing the
      commissioner, the commissioner's successors in office, and deputies
      to receive process in any legal action or proceeding against the
      health maintenance organization on a cause of action arising in this
      state.
         11.  A statement reasonably describing the geographic area to be
      served.
         12.  A description of the complaint procedures to be utilized as
      required under section 514B.14.
         13.  A description of the procedures and programs to be
      implemented to meet the requirements for quality of health care as
      determined by the director of public health under section 514B.4.
         14.  A description of the mechanism by which enrollees shall be
      allowed to participate in matters of policy and operation as required
      by section 514B.7.
         15.  Other information the commissioner finds reasonably necessary
      to make the determinations required in section 514B.5.
         A health maintenance organization shall, unless otherwise provided
      for in this chapter, file notice with the commissioner and receive
      approval from the commissioner before modifying the operations
      described in the information required by this section.
         Upon receipt of an application for a certificate of authority, the
      commissioner shall immediately transmit copies of the application and
      accompanying documents to the director of public health and the
      affected regional health planning council, as authorized by Pub. L.
      No. 89-749, 42 U.S.C. § 246(b)2b, for their nonbinding consultation
      and advice.  

         Section History: Early Form

         [C75, 77, 79, 81, § 514B.3] 

         Section History: Recent Form

         2003 Acts, ch 91, §28; 2006 Acts, ch 1010, §140
         Referred to in § 514B.5, 514B.12