PARRIS N. GLENDENING, Governor

Ch. 35

REVISOR'S NOTE: This section is new language derived without substantive
change from the second and third sentences of former Art. 48A, § 355(a).

In item (3)(i) of this section, the reference to "articles" of incorporation is
substituted for the former reference to a "certificate" of incorporation for
accuracy.

As to the deletion of the former references to "license" in the introductory
language of this section, see the General Revisor's Note to this subtitle.

Defined terms: "Certificate of authority" § 1-101
"Commissioner" § 1-101
"Health care provider" § 14-101
"Health care services" § 14-101

14-110. ISSUANCE OF CERTIFICATE OF AUTHORITY.

THE COMMISSIONER SHALL ISSUE A CERTIFICATE OF AUTHORITY TO AN
APPLICANT IF:

(1) THE APPLICANT HAS PAID THE APPLICABLE FEE REQUIRED BY §
2-112 OF THIS ARTICLE; AND

(2) THE COMMISSIONER IS SATISFIED:

(I) THAT THE APPLICANT HAS BEEN ORGANIZED IN GOOD FAITH
FOR THE PURPOSE OF ESTABLISHING, MAINTAINING, AND OPERATING A
NONPROFIT HEALTH SERVICE PLAN;

(II) THAT:

1. EACH CONTRACT EXECUTED OR PROPOSED TO BE
EXECUTED BY THE APPLICANT AND A HEALTH CARE PROVIDER TO FURNISH
HEALTH CARE SERVICES TO SUBSCRIBERS TO THE NONPROFIT HEALTH SERVICE
PLAN, OBLIGATES OR, WHEN EXECUTED, WILL OBLIGATE EACH HEALTH CARE
PROVIDER PARTY TO THE CONTRACT TO RENDER THE HEALTH CARE SERVICES TO
WHICH EACH SUBSCRIBER IS ENTITLED UNDER THE TERMS AND CONDITIONS OF
THE VARIOUS CONTRACTS ISSUED OR PROPOSED TO BE ISSUED BY THE APPLICANT
TO SUBSCRIBERS TO THE PLAN; AND

2. EACH SUBSCRIBER IS ENTITLED TO REIMBURSEMENT
FOR PODIATRIC, CHIROPRACTIC, PSYCHOLOGICAL, OR OPTOMETRIC SERVICES,
REGARDLESS OF WHETHER THE SERVICE IS PERFORMED BY A LICENSED
PHYSICIAN, LICENSED PODIATRIST, LICENSED CHIROPRACTOR, LICENSED
PSYCHOLOGIST, OR LICENSED OPTOMETRIST;

(III) THAT:

1. EACH CONTRACT ISSUED OR PROPOSED TO BE ISSUED TO
SUBSCRIBERS TO THE PLAN IS IN A FORM APPROVED BY THE COMMISSIONER; AND

2. THE RATES CHARGED OR PROPOSED TO BE CHARGED
FOR EACH FORM OF EACH CONTRACT ARE FAIR AND REASONABLE; AND

- 877 -