§ 27-13-34-9 — Issuance of certificate of authority; application deficiencies; denial of application

(a) After receiving an application filed under
section 8 of this chapter, the commissioner shall review the application
and notify the applicant of any deficiencies in the application.
(b) The commissioner shall issue a certificate of authority to an
applicant if the following conditions are met:
(1) The requirements of section 8 of this chapter have been
fulfilled.
(2) The individuals responsible for conducting the affairs of the
applicant are competent, trustworthy, possess good reputations,
and have had appropriate experience, training, or education.
(3) The applicant is financially responsible and may reasonably
be expected to meet its obligations to enrollees and to prospective
enrollees. In making this determination, the commissioner may
consider:
(A) the financial soundness of the arrangements of the applicant
for limited health services;
(B) the adequacy of the applicant's working capital, other
sources of funding, and provisions for contingencies;
(C) any agreement for paying the cost of the limited health
services or for alternative coverage in the event of insolvency
of the limited service health maintenance organization; and
(D) the manner in which the requirements of sections 16 and 17
of this chapter have been fulfilled.
(4) The agreements with providers for the provision of limited
health services contain the provisions required by section 15 of
this chapter.
(5) Any deficiencies identified by the commissioner have been
corrected.
(c) If an application for a certificate of authority is denied, the
commissioner shall notify the applicant and shall specify in the notice
the reasons for the denial of the application. Within thirty (30) days
after receiving the notice, the applicant may request a hearing before
the commissioner under IC 4-21.5.

Legislative History

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