2006 Kentucky Revised Statutes - .060   Issuance of certificate of authority.

304.38-060 Issuance of certificate of authority. Upon receipt of an application for issuance of a certificate of authority, the executive director shall issue or deny the same. Issuance of a certificate of authority shall be granted only if the executive director finds that the applicant has complied with KRS 304.38-040 and has paid the application fee, and the executive director is satisfied that the following conditions are met: (1)  The persons responsible for the conduct of the affairs of the application are competent, trustworthy, and possess good reputations; (2)  The health maintenance organization is financially responsible and may reasonably be expected to meet its obligations to enrollees and prospective enrollees. In making this determination, the executive director may consider: (a)  The  financial  soundness  of  the  health  maintenance  organization's arrangements for health care services and the schedule of charges used in connection therewith; (b)  The adequacy of working capital; (c)  Any agreement with an insurer, a government, or any other organization for insuring the payment of the cost of health care services or the provision for automatic applicability of an alternative coverage in the event of discontinuance of the health maintenance organization or its inability to meet its financial obligations; (d)  Examples of any agreements with providers for the provision of health care services by provider type; and (e)  Compliance with KRS 304.38-070 if the applicant is applying for a health maintenance organization certificate of authority as a guarantee that the obligations will be duly performed. Effective: July 15, 2002 History:Amended 2002 Ky. Acts ch. 105, sec. 24, effective July 15, 2002. -- Amended 2000 Ky. Acts ch. 427, sec. 4, effective July 14, 2000. -- Amended 1986 Ky. Acts ch. 437, sec. 27, effective July 15, 1986. -- Created 1974 Ky. Acts ch. 357, subtit. 38, sec. 6, effective June 21, 1974. Legislative Research Commission Note (6/20/2005). 2005 Ky. Acts chs. 11, 85, 95, 97, 98, 99, 123, and 181 instruct the Reviser of Statutes to correct statutory references to agencies and officers whose names have been changed in 2005 legislation confirming the reorganization of the executive branch. Such a correction has been made in this section.