(1) Except as provided in Subsection (2), each health maintenance organization authorized in this state shall maintain a deposit with the commissioner under Section 31A-2-206 in an amount equal to the sum of: (a) $100,000; and (b) 50% of the greater of: (i) $900,000; (ii) 2% of the annual premium revenues as reported on the most recent annual financial statement filed with the commissioner; or (iii) an amount equal to the sum of three months uncovered health care expenditures as reported on the most recent financial statement filed with the commissioner.
(a) $100,000; and
(b) 50% of the greater of: (i) $900,000; (ii) 2% of the annual premium revenues as reported on the most recent annual financial statement filed with the commissioner; or (iii) an amount equal to the sum of three months uncovered health care expenditures as reported on the most recent financial statement filed with the commissioner.
(i) $900,000;
(ii) 2% of the annual premium revenues as reported on the most recent annual financial statement filed with the commissioner; or
(iii) an amount equal to the sum of three months uncovered health care expenditures as reported on the most recent financial statement filed with the commissioner.
(2) (a) After a hearing the commissioner may exempt a health maintenance organization from the deposit requirement of Subsection (1) if: (i) the commissioner determines that the enrollees' interests are adequately protected; (ii) the health maintenance organization has been continuously authorized to do business in this state for at least five years; and (iii) the health maintenance organization has $5,000,000 surplus in excess of the health maintenance organization's company action level RBC as defined in Subsection 31A-17-601(8)(b). (b) The commissioner may rescind an exemption given under Subsection (2)(a).
(a) After a hearing the commissioner may exempt a health maintenance organization from the deposit requirement of Subsection (1) if: (i) the commissioner determines that the enrollees' interests are adequately protected; (ii) the health maintenance organization has been continuously authorized to do business in this state for at least five years; and (iii) the health maintenance organization has $5,000,000 surplus in excess of the health maintenance organization's company action level RBC as defined in Subsection 31A-17-601(8)(b).
(i) the commissioner determines that the enrollees' interests are adequately protected;
(ii) the health maintenance organization has been continuously authorized to do business in this state for at least five years; and
(iii) the health maintenance organization has $5,000,000 surplus in excess of the health maintenance organization's company action level RBC as defined in Subsection 31A-17-601(8)(b).
(b) The commissioner may rescind an exemption given under Subsection (2)(a).
(3) (a) Each limited health plan authorized in this state shall maintain a deposit with the commissioner under Section 31A-2-206 in an amount equal to the minimum capital or permanent surplus plus 50% of the greater of: (i) .5 times minimum required capital or minimum permanent surplus; or (ii) (A) during the first year of operation, 10% of the limited health plan's projected uncovered expenditures for the first year of operation; (B) during the second year of operation, 12% of the limited health plan's projected uncovered expenditures for the second year of operation; (C) during the third year of operation, 14% of the limited health plan's projected uncovered expenditures for the third year of operation; (D) during the fourth year of operation, 18% of the limited health plan's projected uncovered expenditures during the fourth year of operation; or (E) during the fifth year of operation, and during all subsequent years, 20% of the limited health plan's projected uncovered expenditures for the previous 12 months. (b) Projections of future uncovered expenditures shall be established in a manner that is approved by the commissioner.
(a) Each limited health plan authorized in this state shall maintain a deposit with the commissioner under Section 31A-2-206 in an amount equal to the minimum capital or permanent surplus plus 50% of the greater of: (i) .5 times minimum required capital or minimum permanent surplus; or (ii) (A) during the first year of operation, 10% of the limited health plan's projected uncovered expenditures for the first year of operation; (B) during the second year of operation, 12% of the limited health plan's projected uncovered expenditures for the second year of operation; (C) during the third year of operation, 14% of the limited health plan's projected uncovered expenditures for the third year of operation; (D) during the fourth year of operation, 18% of the limited health plan's projected uncovered expenditures during the fourth year of operation; or (E) during the fifth year of operation, and during all subsequent years, 20% of the limited health plan's projected uncovered expenditures for the previous 12 months.
(i) .5 times minimum required capital or minimum permanent surplus; or
(ii) (A) during the first year of operation, 10% of the limited health plan's projected uncovered expenditures for the first year of operation; (B) during the second year of operation, 12% of the limited health plan's projected uncovered expenditures for the second year of operation; (C) during the third year of operation, 14% of the limited health plan's projected uncovered expenditures for the third year of operation; (D) during the fourth year of operation, 18% of the limited health plan's projected uncovered expenditures during the fourth year of operation; or (E) during the fifth year of operation, and during all subsequent years, 20% of the limited health plan's projected uncovered expenditures for the previous 12 months.
(A) during the first year of operation, 10% of the limited health plan's projected uncovered expenditures for the first year of operation;
(B) during the second year of operation, 12% of the limited health plan's projected uncovered expenditures for the second year of operation;
(C) during the third year of operation, 14% of the limited health plan's projected uncovered expenditures for the third year of operation;
(D) during the fourth year of operation, 18% of the limited health plan's projected uncovered expenditures during the fourth year of operation; or
(E) during the fifth year of operation, and during all subsequent years, 20% of the limited health plan's projected uncovered expenditures for the previous 12 months.
(b) Projections of future uncovered expenditures shall be established in a manner that is approved by the commissioner.
(4) A deposit required by this section may be counted toward the minimum capital or minimum permanent surplus required under Section 31A-8-209.
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