Indiana Code
Chapter 34. Limited Service Health Maintenance Organizations
27-13-34-9. Issuance of Certificate of Authority; Application Deficiencies; Denial of Application

Sec. 9. (a) After receiving an application filed under section 8 of this chapter, the commissioner shall review the application and notify the applicant of any deficiencies in the application.
(b) The commissioner shall issue a certificate of authority to an applicant if the following conditions are met:
(1) The requirements of section 8 of this chapter have been fulfilled.
(2) The individuals responsible for conducting the affairs of the applicant are competent, trustworthy, possess good reputations, and have had appropriate experience, training, or education.
(3) The applicant is financially responsible and may reasonably be expected to meet its obligations to enrollees and to prospective enrollees. In making this determination, the commissioner may consider:
(A) the financial soundness of the arrangements of the applicant for limited health services;
(B) the adequacy of the applicant's working capital, other sources of funding, and provisions for contingencies;
(C) any agreement for paying the cost of the limited health services or for alternative coverage in the event of insolvency of the limited service health maintenance organization; and
(D) the manner in which the requirements of sections 16 and 17 of this chapter have been fulfilled.
(4) The agreements with providers for the provision of limited health services contain the provisions required by section 15 of this chapter.
(5) Any deficiencies identified by the commissioner have been corrected.
(c) If an application for a certificate of authority is denied, the commissioner shall notify the applicant and shall specify in the notice the reasons for the denial of the application. Within thirty (30) days after receiving the notice, the applicant may request a hearing before the commissioner under IC 4-21.5.
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