WILLIAM DONALD SCHAEFER, Governor                        H.B. 1563

(C) EACH REGIONAL HEALTH COOPERATIVE SHALL;

(1) UNDERTAKE ACTIVITIES NECESSARY TO ADMINISTER THE
PROGRAM, INCLUDING MARKETING AND PUBLICIZING THE PROGRAM, AND TO
ENSURE COMPLIANCE WITH THE PROGRAM BY PARTICIPATING CARRIERS,
EMPLOYERS, AND ENROLLEES.

(2) ENSURE FAIR AND AFFIRMATIVE MARKETING OF THE PROGRAM
WHICH MAY INCLUDE PROVISIONS FOR PAYMENT OF SERVICING FEES OR
COMMISSIONS TO LICENSED AGENTS AND BROKERS;

(3)      DEVELOP GRIEVANCE PROCEDURES FOR RESOLVING DISPUTES
BETWEEN THE REGIONAL HEALTH COOPERATIVES AND;

(I) MEMBER EMPLOYERS;

(II) ELIGIBLE EMPLOYEES; OR

(III) INDIVIDUAL ENROLLEES;

(4)      DEVELOP GRIEVANCE PROCEDURES WHICH ENROLLEES WHO MAY
HAVE A DISPUTE WITH A PARTICIPATING CARRIER MAY USE:

(I) UPON EXHAUSTION OF THE GRIEVANCE PROCEDURE
MECHANISM OR OTHER ADMINISTRATIVE REMEDIES AS MAY BE ESTABLISHED
UNDER THE ENROLLEES' HEALTH BENEFIT PLAN; AND

(II) PRIOR TO RESORTING TO ANY GRIEVANCE PROCEDURE OF
THE INSURANCE ADMINISTRATION;

(5)      ADOPT OTHER RULES AS NECESSARY TO ADMINISTER THE
PROGRAM;

(6)      APPOINT COMMITTEES AS NECESSARY TO PROVIDE TECHNICAL
ASSISTANCE IN THE OPERATION OF THE PROGRAM; AND

(7)      EXERCISE ANY OTHER POWER REASONABLY NECESSARY TO CARRY
OUT THIS SUBTITLE.

710. REGIONAL HEALTH COOPERATIVES - REPORTING; CONFIDENTIALITY.

(A) (1) EACH REGIONAL HEALTH COOPERATIVE SHALL SET DEADLINES
FOR PARTICIPATING CARRIERS FOR THE FILING OF REPORTS REQUIRED UNDER
THIS SUBTITLE.

(2)      EACH PARTICIPATING CARRIER SHALL SUBMIT THE INFORMATION
REQUIRED BY THE REGIONAL HEALTH COOPERATIVE WITHIN THE DEADLINES
PRESCRIBED, FOR THE PURPOSE OF ALLOWING THE REGIONAL HEALTH
COOPERATIVE TO DETERMINE THE CARRIER'S COMPLIANCE WITH THIS SUBTITLE.

(3)      THE INSURANCE COMMISSIONER MAY ADOPT REGULATIONS THAT
IMPOSE PENALTIES ON PARTICIPATING CARRIERS FOR FAILURE TO FILE A REPORT
IN ACCORDANCE WITH THE RULES ADOPTED BY A REGIONAL HEALTH
COOPERATIVE.

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