Indiana Code
Chapter 34. Limited Service Health Maintenance Organizations
27-13-34-10. Powers of Limited Service Health Maintenance Organization

Sec. 10. (a) Subject to subsection (b), the powers of a limited service health maintenance organization include the following:
(1) The purchase, lease, construction, renovation, operation, or maintenance of:
(A) medical facilities that will provide limited health services;
(B) equipment for medical facilities providing limited health services; and
(C) other property reasonably required for the principal office of the limited service health maintenance organization or for purposes necessary in the transaction of the business of the organization.
(2) Engaging in transactions between affiliated entities, including loans and the transfer of responsibility under any or all contracts:
(A) between affiliates; or
(B) between the limited service health maintenance organization and the parent organization of the limited service health maintenance organization.
(3) The furnishing of limited health services through the following:
(A) Providers.
(B) Provider associations.
(C) Agents for providers who are under contract with or are employed by the limited service health maintenance organization. The contracts with providers, provider associations, or agents for providers may include fee for service, cost plus, capitation, or other payment or risk-sharing agreements.
(4) Contracting with any person for the performance on behalf of the limited service health maintenance organization of certain functions, including:
(A) marketing;
(B) enrollment; and
(C) administration.
(5) Contracting with:
(A) an insurance company licensed in Indiana; or
(B) an authorized reinsurer for the provision of insurance, indemnity, or reimbursement against the cost of health care services provided by the limited service health maintenance organization.
(6) The offering of point-of-service products for the limited health services for which the limited service health maintenance organization is licensed so long as the limited service health maintenance organization complies with the reinsurance or ratio requirements of IC 27-13-13-8.
(7) The joint marketing of products with:
(A) an insurance company that is licensed in Indiana; or
(B) a health maintenance organization that is authorized to conduct business in Indiana;
if the company that is offering each product is clearly identified.
(8) Providing limited health services at the expense of a self-funded plan.
(b) Nothing in this section qualifies an asset of a prepaid limited health service organization as an admitted asset.
As added by P.L.26-1994, SEC.25.

Structure Indiana Code

Indiana Code

Title 27. Insurance

Article 13. Health Maintenance Organizations

Chapter 34. Limited Service Health Maintenance Organizations

27-13-34-0.1. Application of Certain Amendments to Chapter

27-13-34-1. "Enrollee" Defined

27-13-34-2. "Evidence of Coverage" Defined

27-13-34-3. "Limited Health Services" Defined

27-13-34-4. "Limited Service Health Maintenance Organization" Defined

27-13-34-5. "Provider" Defined

27-13-34-6. "Subscriber" Defined

27-13-34-7. Certificate of Authority Required; Foreign Entities

27-13-34-8. Application for Certificate of Authority; Requirements

27-13-34-9. Issuance of Certificate of Authority; Application Deficiencies; Denial of Application

27-13-34-10. Powers of Limited Service Health Maintenance Organization

27-13-34-11. Modification of Documents; Filing; Disapproval

27-13-34-12. Applicable Statutes

27-13-34-13. Evidence of Coverage; Required Information

27-13-34-14. Examinations by Commissioner

27-13-34-15. Required Contract Terms and Conditions; Exemptions

27-13-34-16. "Net Worth" and "Uncovered Expense" Defined; Computation of Net Worth; Minimum Net Worth

27-13-34-17. Required Deposit

27-13-34-18. Fidelity Bonds; Deposit in Place of Bond

27-13-34-19. Annual Reports; Additional Reports

27-13-34-20. Suspension or Revocation of Certificate of Authority

27-13-34-21. Chapter Violations; Fines and Penalties

27-13-34-22. Supervision, Rehabilitation, or Liquidation; Remedies and Measures

27-13-34-23. Fees

27-13-34-24. Dental Care Services and Director; Review of Adverse Decisions; Complaints

27-13-34-26. Complaints; Records