(a) Each prepaid limited health service organization shall have and maintain fully paid-in capital stock, if a for-profit stock corporation, or statutory surplus funds, if a nonprofit corporation, totaling at least:
(1) The greater of $250,000 or ten percent of its expenses for the previous twelve-month period as reported in its most recent financial statement filed pursuant to subsection (a), section twelve of this article, with respect to each limited health service for which the organization will not offer inpatient services up to a maximum total for all limited health services of the required capital and surplus for an insurer under article three, section five-b of this chapter; and
(2) The greater of $1 million or ten percent of its expenses for the previous twelve-month period as reported in its most recent financial statement filed pursuant to subsection (a), section twelve of this article, with respect to each limited health service for which the organization will offer inpatient services up to a maximum total for all limited health services of the required capital and surplus for an insurer under article three, section five-b of this chapter.
(b) For purposes of this section, "expenses" means those costs set forth by the national association of Insurance Commissioners (NAIC) in the statement of revenues, expenses and net worth contained in the annual statement instruction--limited health service organization and the official NAIC annual statement blanks--limited health service organization.
Structure West Virginia Code
Article 25D. Prepaid Limited Health Service Organization Act
§33-25D-3. Application for Certificate of Authority; Addition of Services
§33-25D-5. Issuance of Certificate of Authority
§33-25D-7. Powers of Organization
§33-25D-8. Governing Body; Enrollee Participation
§33-25D-9. Fiduciary Responsibilities of Managers; Fidelity Bond
§33-25D-10. Provider Contracts
§33-25D-12. Annual and Quarterly Reports
§33-25D-13. Annual Report to Enrollees
§33-25D-14. Grievance Procedure
§33-25D-15. Prohibited Practices
§33-25D-16. Agent Licensing and Appointment Required; Regulation of Marketing
§33-25D-20. Suspension or Revocation of Certificate of Authority
§33-25D-23. Administrative Procedures
§33-25D-25. Penalties and Enforcement
§33-25D-26. Scope of Provisions; Applicability of Other Laws
§33-25D-27. Filings and Reports as Public Documents
§33-25D-28. Confidentiality of Medical Information
§33-25D-29. Authority to Contract With Prepaid Limited Health Service Organizations Under Medicaid