2016 Kentucky Revised Statutes CHAPTER 304 - INSURANCE CODE Subtitle 38A - Limited Health Service Organizations 304.38A-040 Issuance of certificate of authority -- Notification of deficiencies in application and of reasons for denial.
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304.38A-040 Issuance of certificate of authority -- Notification of deficiencies in
application and of reasons for denial.
(1)
(2)
(3)
Following receipt of an application filed pursuant to KRS 304.38A-030, the
commissioner shall review the application and notify the applicant of any
deficiencies. The commissioner shall issue a certificate of authority to an applicant
if the following conditions are met:
(a) The applicant has verified to the commissioner that it has an initial minimum
worth of at least two hundred fifty thousand dollars ($250,000);
(b) The requirements of KRS 304.38A-030 have been fulfilled;
(c) The individuals responsible for conducting the applicant's affairs are
competent, trustworthy, and possess good reputations, and have had
appropriate experience, training, or education;
(d) The applicant is financially responsible and may reasonably be expected to
meet its obligations to enrollees and to prospective enrollees. In making his or
her determination, the commissioner may consider:
1.
The financial soundness;
2.
The adequacy of surplus, working capital, other sources of funding, and
provisions for contingencies;
3.
Any agreement for paying the cost of the limited health services or for
alternative coverage in the event of insolvency of the limited health
service organization; and
4.
The manner in which the requirements of KRS 304.38A-030 have been
fulfilled; and
(e) Any deficiencies identified by the commissioner have been corrected.
If the certificate of authority is denied, the commissioner shall notify the applicant
and shall specify the reasons for denial in the notice. The limited health service
organization shall have sixty (60) days from the date of receipt of the notice to
request a hearing before the commissioner pursuant to KRS 304.2-310.
Each certificate of authority issued to a limited health service organization shall
designate the type of services the limited health service organization is authorized to
provide.
Effective: July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1518, effective July 15, 2010. -- Created
2002 Ky. Acts ch. 105, sec. 13, effective July 15, 2002.
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