31A-8-211 - Deposit.
31A-8-211. Deposit.
(1) Except as provided in Subsection (2), each health maintenance organizationauthorized in this state shall maintain a deposit with the commissioner under Section 31A-2-206in 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 financialstatement filed with the commissioner; or
(iii) an amount equal to the sum of three months uncovered health care expenditures asreported on the most recent financial statement filed with the commissioner.
(2) (a) After a hearing the commissioner may exempt a health maintenance organizationfrom 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 businessin this state for at least five years; and
(iii) the health maintenance organization has $5,000,000 surplus in excess of the healthmaintenance organization's company action level RBC as defined in Subsection31A-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 thecommissioner under Section 31A-2-206 in an amount equal to the minimum capital or permanentsurplus 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 projecteduncovered expenditures for the first year of operation;
(B) during the second year of operation, 12% of the limited health plan's projecteduncovered expenditures for the second year of operation;
(C) during the third year of operation, 14% of the limited health plan's projecteduncovered expenditures for the third year of operation;
(D) during the fourth year of operation, 18% of the limited health plan's projecteduncovered expenditures during the fourth year of operation; or
(E) during the fifth year of operation, and during all subsequent years, 20% of the limitedhealth plan's projected uncovered expenditures for the previous 12 months.
(b) Projections of future uncovered expenditures shall be established in a manner that isapproved by the commissioner.
(4) A deposit required by this section may be counted toward the minimum capital orminimum permanent surplus required under Section 31A-8-209.
Amended by Chapter 308, 2002 General Session