ROBERT L. EHRLICH, JR., Governor Ch. 357
(i) that the applicant has been organized in good faith for the
purpose of establishing, maintaining, and operating a nonprofit health service plan
THAT:
1. IS COMMITTED TO A NONPROFIT CORPORATE
STRUCTURE;
2. IN ACCORDANCE WITH THE CHARTER OF THE NONPROFIT
HEALTH SERVICE PLAN, SEEKS TO PROVIDE AFFORDABLE AND ACCESSIBLE HEALTH
INSURANCE; AND
3. RECOGNIZES A RESPONSIBILITY TO CONTRIBUTE TO THE
IMPROVEMENT OF THE OVERALL HEALTH STATUS OF MARYLAND RESIDENTS;
(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;
(iv) that the applicant has a surplus, as defined in § 14-117 of this
subtitle, of the greater of:
1. $100,000; and
2. an amount equal to that required under § 14-117 of this
subtitle; and
(v) that, except for a nonprofit health service plan that insures
[fewer than] BETWEEN 1 AND 10,000 covered lives in the State, the nonprofit health
service plan's corporate headquarters is located in the State.
(B) IF THE COMMISSIONER DETERMINES THAT A NONPROFIT HEALTH
SERVICES PLAN DOES NOT CONTINUE TO SATISFY THE REQUIREMENTS OF THIS
SUBTITLE, THE COMMISSIONER MAY DISAPPROVE THE RENEWAL OF THE
CERTIFICATE OF AUTHORITY OF THE NONPROFIT HEALTH SERVICE PLAN.
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