A. In addition to the annual statement, the Commission may require a licensed health maintenance organization to file additional reports, exhibits or statements considered necessary to secure complete information concerning the condition, solvency, experience, transactions or affairs of the health maintenance organization. The Commission shall establish reasonable deadlines for filing these additional reports, exhibits, or statements and may require verification by any officers of the health maintenance organization designated by the Commission.
B. The Commission may require a licensed health maintenance organization to file with the National Association of Insurance Commissioners (NAIC) a copy of its financial statement required to be filed pursuant to § 38.2-4307, on a quarterly basis. Unless otherwise prescribed by the Commission, all such financial statements, whether filed with the Commission or the NAIC, shall be prepared in accordance with applicable provisions of the annual statement instructions and the accounting practices and procedures manual adopted by the NAIC, or any successor publications. The Commission may prescribe that additional copies of financial statements and other reports be filed in machine-readable format.
C. Each annual and quarterly statement shall be accompanied by a statement of covered and uncovered expenses. The statement shall be prepared in accordance with instructions prescribed by the Commission for reporting the expenses of the health maintenance organization during the three months comprising the most recently ended calendar-year quarter. The statement of covered and uncovered expenses shall not be required for any health maintenance organization that reports a capital and surplus amount of at least $4,500,000 on its most recent annual or quarterly financial statement filed with the Commission.
1990, c. 224; 1999, c. 482; 2000, c. 503; 2006, c. 448.
Structure Code of Virginia
Chapter 43 - Health Maintenance Organizations
§ 38.2-4301. Establishment of health maintenance organizations
§ 38.2-4302. Issuance of license; fee; minimum net worth; impairment
§ 38.2-4305. Fiduciary responsibilities
§ 38.2-4306. Evidence of coverage and charges for health care services
§ 38.2-4306.1. Interest on claim proceeds
§ 38.2-4307.1. Additional reports
§ 38.2-4310. Protection against insolvency
§ 38.2-4312. Prohibited practices
§ 38.2-4312.1. Pharmacies; freedom of choice
§ 38.2-4312.3. Patient access to emergency services
§ 38.2-4313. Licensing of agents
§ 38.2-4314. Powers of insurers and health services plans
§ 38.2-4316. Suspension or revocation of license
§ 38.2-4320. Authority of Commonwealth to contract with health maintenance organizations
§ 38.2-4321. Health maintenance organization affected by chapter