(a) An insurance company authorized to do business in the District may, either directly or through a subsidiary or affiliate, organize and operate a health maintenance organization under the provisions of this chapter. Notwithstanding any other provisions of law, any 2 or more such insurance companies, or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance organization. The business of insurance is deemed to include the providing of health care by a health maintenance organization owned or operated by an insurer or subsidiary thereof.
(b) Notwithstanding any other provision of insurance laws, an insurer may contract with a health maintenance organization to provide insurance or similar protection against the cost of care provided through health maintenance organizations and to provide coverage in the event of the failure of a health maintenance organization to meet its obligations.
(c) The enrollees of a health maintenance organization constitute a permissible group under such laws. Among other things, under such contracts the insurer may make benefit payments to health maintenance organizations for health care services rendered by providers.
(Apr. 9, 1997, D.C. Law 11-235, § 18, 44 DCR 818; Mar. 24, 1998, D.C. Law 12-81, § 46(d), 45 DCR 745.)
1981 Ed., § 35-4517.
Structure District of Columbia Code
Title 31 - Insurance and Securities
Chapter 34 - Health Maintenance Organizations
§ 31–3402. Establishment of health maintenance organizations
§ 31–3403. Issuance of certificate of authority
§ 31–3404. Powers of health maintenance organizations
§ 31–3405. Fiduciary responsibilities
§ 31–3406. Quality assurance program
§ 31–3407. Requirements for group contract, individual contract, and evidence of coverage
§ 31–3408. Annual report. [Repealed]
§ 31–3408.01. Compliance with other laws
§ 31–3409. Information to enrollees
§ 31–3410. Grievance procedures [Repealed]
§ 31–3412. Protection against insolvency
§ 31–3413. Uncovered expenditures insolvency deposit
§ 31–3414. Enrollment period; replacement coverage in the event of insolvency
§ 31–3415. Filing requirements for rating information
§ 31–3416. Regulation of health maintenance organization producers
§ 31–3417. Powers of insurance corporations
§ 31–3418. Examinations. [Repealed]
§ 31–3419. Suspension or revocation of certificate of authority
§ 31–3420. Rehabilitation, liquidation, or conservation of health maintenance organizations
§ 31–3421. Summary orders and supervision
§ 31–3423. Penalties and enforcement
§ 31–3424. Statutory construction and relationship to other laws
§ 31–3425. Filings and reports as public documents
§ 31–3426. Confidentiality of medical information and limitation of liability
§ 31–3427. Acquisition of control of or merger of a health maintenance organization
§ 31–3428. Coordination of benefits. [Repealed]
§ 31–3429. Point of service plan