58-67-110. Protection against insolvency.
(a) The Commissioner shall require deposits in accordance with the provisions of G.S. 58-67-25.
(b) Each full service health maintenance organization shall maintain a minimum net worth equal to the greater of one million dollars ($1,000,000) or the amount required pursuant to the risk-based capital provisions of Article 12 of this Chapter. Each single service health maintenance organization shall maintain a minimum net worth equal to the greater of fifty thousand dollars ($50,000) or that amount required pursuant to the risk-based capital provisions of Article 12 of this Chapter.
(c), (d) Repealed by Session Laws 2003-212, s. 21, effective October 1, 2003.
(e) Every full service medical health maintenance organization shall have and maintain at all times an adequate plan for protection against insolvency acceptable to the Commissioner. In determining the adequacy of such a plan, the Commissioner may consider:
(1) A reinsurance agreement preapproved by the Commissioner covering excess loss, stop loss, or catastrophes. The agreement must provide that the Commissioner will be notified no less than 60 days prior to cancellation or reduction of coverage.
(2) A conversion policy or policies that will be offered by an insurer to the enrollees in the event of the health maintenance organization's insolvency.
(3) Any other arrangements offering protection against insolvency that the Commissioner may require. (1987, c. 631, s. 5; 1989, c. 776, ss. 11, 12; 2003-212, s. 21.)
Structure North Carolina General Statutes
North Carolina General Statutes
Article 67 - Health Maintenance Organization Act.
§ 58-67-10 - Establishment of health maintenance organizations.
§ 58-67-11 - Additional HMO application information.
§ 58-67-12 - Commissioner use of consultants and other professionals.
§ 58-67-20 - Issuance and continuation of license.
§ 58-67-30 - Management and exclusive agreements; custodial agreements.
§ 58-67-35 - Powers of health maintenance organizations.
§ 58-67-45 - Fiduciary responsibilities.
§ 58-67-50 - Evidence of coverage and premiums for health care services.
§ 58-67-55 - Statements filed with Commissioner.
§ 58-67-65 - Prohibited practices.
§ 58-67-66 - Collaboration with local health departments.
§ 58-67-70 - Coverage for chemical dependency treatment.
§ 58-67-74 - Coverage for certain treatment of diabetes.
§ 58-67-75 - No discrimination against mentally ill or chemically dependent individuals.
§ 58-67-76 - Coverage for mammograms and cervical cancer screening.
§ 58-67-77 - Coverage for prostate-specific antigen (PSA) tests.
§ 58-67-78 - Coverage of certain prescribed drugs for cancer treatment.
§ 58-67-79 - Coverage for reconstructive breast surgery following mastectomy.
§ 58-67-80 - Meaning of terms "accident", "accidental injury", and "accidental means".
§ 58-67-85 - Master group contracts, filing requirement; required and prohibited provisions.
§ 58-67-88 - Continuity of care.
§ 58-67-90 - Licensing and regulation of agents.
§ 58-67-95 - Powers of insurers, hospitals, prepaid health plans, and medical service corporations.
§ 58-67-105 - Hazardous financial condition.
§ 58-67-110 - Protection against insolvency.
§ 58-67-115 - Hold harmless agreements or special deposit.
§ 58-67-120 - Continuation of benefits.
§ 58-67-125 - Enrollment period.
§ 58-67-130 - Replacement coverage.
§ 58-67-135 - Incurred but not reported claims.
§ 58-67-140 - Suspension or revocation of license.
§ 58-67-145 - Rehabilitation, liquidation, or conservation of health maintenance organization.
§ 58-67-155 - Administrative procedures.
§ 58-67-165 - Penalties and enforcement.
§ 58-67-170 - Statutory construction and relationship to other laws.
§ 58-67-171 - Other laws applicable to HMOs.
§ 58-67-175 - Filings and reports as public documents.