Indiana § 27-13-13-8 Additional financial requirements

Indiana Statutes

§ 27-13-13-8 — Additional financial requirements

Indiana § 27-13-13-8

Title 27INSURANCE

Art. 13HEALTH MAINTENANCE ORGANIZATIONS

Ch. 13Protection Against Insolvency; Deposit Requirements

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Bluebook

Ind. Code § 27-13-13-8 (2026).

Text

(a)In addition to meeting all other financial requirements imposed by IC 27-13-12 and this chapter, a health maintenance organization that offers a point of service product shall maintain either of the following:

(1)A reinsurance agreement, which must be satisfactory to the commissioner, that cedes one hundred percent (100%) of the liability for out-of-plan services.

(2)A ratio of the revenues of the health maintenance organization from the point of service product to the net worth of the organization of not more than three (3) to one (1).

(b)The reinsurance to which subsection (a)(1) refers may be used to:

(1)directly make payments for out-of-plan services; or

(2)reinsure coverage for out-of-plan services.

(c)To achieve the ratio referred to in subsection (a)(2), a health maintenan

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(a) In addition to meeting all other financial
requirements imposed by IC 27-13-12 and this chapter, a health
maintenance organization that offers a point of service product shall
maintain either of the following:
(1) A reinsurance agreement, which must be satisfactory to the
commissioner, that cedes one hundred percent (100%) of the
liability for out-of-plan services.
(2) A ratio of the revenues of the health maintenance organization
from the point of service product to the net worth of the
organization of not more than three (3) to one (1).
(b) The reinsurance to which subsection (a)(1) refers may be used
to:
(1) directly make payments for out-of-plan services; or
(2) reinsure coverage for out-of-plan services.
(c) To achieve the ratio referred to in subsection (a)(2), a health
maintenance organization may use reinsurance to cede part or all of the
liability for out-of-plan services.