2019 US Virgin Islands Code
Title 22 - Insurance
Chapter 60 - Third Party Administrators
§ 1537. Annual report and filing fee
(a) Each TPA licensed under section 1533 shall file an annual report in duplicate originals for the preceding calendar year with the Commissioner on or before March 31 of each year, or within such extension of time as the Commissioner for good cause may grant. The report must be in the form prescribed by the Commissioner and must contain such additional information and attachments as the Commissioner determines necessary including, but not limited to, a disaggregation of all health insurance premiums received and claim payments made by the TPA from all other premiums and payments. The annual reports must include an audited financial statement audited by an independent certified public accountant. An audited financial or annual report prepared on a consolidated basis must include a columnar consolidating or combining worksheet that must be filed with the report and include the following:
(1) Amounts shown on the consolidated audited financial report must be shown on the worksheet;
(2) Amounts for each entity must be stated separately, and
(3) Explanations of consolidating and eliminating entries must be included. The report must be verified by at least two officers of the TPA.
(b) The annual report must include the complete names and addresses of all payors with whom the TPA had agreements during the preceding fiscal year.
(c) At the time of filing its annual report, the TPA shall pay a filing fee as required by the Commissioner.
(d) The Commissioner shall review the most recently filed annual report of each TPA on or before September 1 of each year. Upon completion of its review, the Commissioner shall either:
(1) issue a certification to the TPA that the annual report shows that the TPA has a positive net worth as evidenced by audited financial statements and is currently licensed and in good standing, or noting any deficiencies found in that annual report and financial statements; or
(2) update any electronic database maintained by the NAIC, its affiliates or subsidiaries, indicating that the annual report shows that the TPA has a positive net worth as evidenced by audited financial statements and complies with existing law, or noting any deficiencies found in the annual report.
