2005 Idaho Code - 41-3904 — CERTIFICATE OF AUTHORITY REQUIRED -- EXCEPTIONS -- APPLICATION OF CERTAIN PROVISIONS

                                  TITLE  41
                                  INSURANCE
                                  CHAPTER 39
                             MANAGED CARE REFORM
    41-3904.  CERTIFICATE OF AUTHORITY REQUIRED -- EXCEPTIONS -- APPLICATION
OF CERTAIN PROVISIONS. (1) No person shall in this state offer a managed care
plan on a predetermined and prepaid basis, unless authorized under a
certificate of authority issued by the director. A person offering a managed
care plan on a predetermined and prepaid basis is deemed to be transacting the
business of insurance.
    (2)  An organization proposing to offer a managed care plan on a
predetermined and prepaid basis, after it has filed its application for a
certificate of authority as provided in section 41-3906, Idaho Code, and while
its application is pending, if permitted by and in accordance with rules
promulgated by the director, may inform the public concerning its proposed
health care services.
    (3)  Entities not offering a managed care plan shall not be subject to the
provisions of this chapter.
    (4)  An entity not required to obtain a certificate of authority which
holds itself out to the public or markets itself as an organization rendering
basic health care services to a specified population through a managed care
plan shall be subject to and must comply with the following sections of this
chapter but shall not be subject to regulation by the department: 41-3902;
41-3903; 41-3904; 41-3909(1) and (2); 41-3914(1) and (2); 41-3915(1), (2),
(3), (4), (5), (6) and (8); 41-3916; 41-3917; 41-3918(1), (2) and (4);
41-3919(1) and (2); 41-3920; 41-3921(2), (3) and (4); 41-3922(2); 41-3926;
41-3927; 41-3928; 41-3930 and 41-3932, Idaho Code.