58-93-75. Continuation of health care services.
The Commissioner shall require that each PHP have a plan for handling insolvency. The plan must allow for health care services to be provided to enrollees until the PHP's enrollees whose enrollment in a PHP is not voluntary are enrolled in another PHP. In considering the plan, the Commissioner may require any of the following:
(1) Insurance to cover the expenses to be paid for enrollee health care services after an insolvency.
(2) Provisions in provider contracts that obligate the provider to provide services for the duration of the period after the PHP's insolvency until the PHP's enrollees whose enrollment in a PHP is not voluntary are enrolled in another PHP.
(3) Insolvency reserves.
(4) Letters of credit acceptable to the Commissioner.
(5) Any other arrangements to assure that health care services are provided to enrollees as specified in this section. (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.