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Session Laws, 1999
Volume 796, Page 288   View pdf image
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2. Its enrollment process;

3. Its quality assurance mechanism; and

4. Its internal grievance procedures;

(ii) The methods the health maintenance organization proposes to
use to offer its members and public representatives an opportunity to participate in
matters of policy and operation;

(iii) The location of the facilities where health care services will be
available regularly to members;

(iv) The type and specialty of physicians and health care personnel
who are engaged to provide health care services;

(v) The number of physicians and personnel in each category; and

(vi) The health and medical records system to provide
documentation of use by members;

(8) The form of each contract that the health maintenance organization
proposes to offer to subscribers showing the benefits to which they are entitled and a
table of the rates charged or proposed to be charged for each form of contract;

(9) A statement that describes with reasonable certainty each geographic
area to be served by the health maintenance organization;

(10) A statement of the financial condition of the health maintenance
organization, including:

(i) Sources of financial support;

(ii) A balance sheet showing assets, liabilities, and minimum
tangible net worth; and

(iii) Any other financial information the Commissioner requires for
adequate financial evaluation;

(11) Copies of any proposed advertising and proposed techniques and
methods of selling the services of the health maintenance organization;

(12) A power of attorney that is executed by the health maintenance
organization appointing the Commissioner as agent of the organization in this State
to accept service of process in any action, proceeding, or cause of action arising in this
State against the health maintenance organization; and

(13) Copies of the agreements proposed to be made between the health
maintenance organizations and providers of health care services.

DRAFTER'S NOTE:

Error: Function paragraph of bill being cured incorrectly indicated that §

 

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Session Laws, 1999
Volume 796, Page 288   View pdf image
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