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

(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.

Legislative History

As added by P.L.26-1994, SEC.25.