58-93-40. Management and exclusive agreements; custodial agreements.
(a) No PHP shall enter into an exclusive management or custodial agreement unless the agreement is first filed with the Commissioner and approved under this section within (i) 45 days after filing or (ii) a reasonable extended period as specified by notice from the Commissioner given within a 45-day period after filing.
(b) The Commissioner shall disapprove an agreement submitted under subsection (a) of this section if the Commissioner determines that the agreement does any of the following:
(1) Subjects the PHP to excessive charges.
(2) Extends for an unreasonable period of time.
(3) Does not contain fair and adequate standards of performance.
(4) Enables persons under the contract to manage the PHP who are not sufficiently trustworthy, competent, experienced, and free from conflict of interest to manage the PHP with due regard for the interests of its enrollees, creditors, or the public.
(5) Contains provisions that impair the interests of the PHP's enrollees, creditors, or the public. (2018-49, s. 1(a).)
Structure North Carolina General Statutes
North Carolina General Statutes
Article 93 - Prepaid Health Plan Licensing Act.
§ 58-93-5 - (Effective until contingency met see note) Definitions.
§ 58-93-10 - Maximize federal reimbursement.
§ 58-93-15 - Commissioner use of consultants and other professionals.
§ 58-93-25 - Issuance and continuation of license.
§ 58-93-40 - Management and exclusive agreements; custodial agreements.
§ 58-93-45 - Fiduciary responsibilities.
§ 58-93-50 - Statements filed with Commissioner.
§ 58-93-65 - Hazardous financial condition.
§ 58-93-70 - Protection against insolvency.
§ 58-93-75 - Continuation of health care services.
§ 58-93-80 - Incurred but not reported claims.
§ 58-93-85 - Suspension or revocation of license.
§ 58-93-90 - Rehabilitation or liquidation of PHP.
§ 58-93-95 - Administrative procedures.
§ 58-93-100 - Penalties and enforcement.