Indiana § 27-17-2-2 Application; requirements

Indiana Statutes

§ 27-17-2-2 — Application; requirements

Indiana·Title 27 INSURANCE·Art. 17 DISCOUNT MEDICAL CARD PROGRAM·Ch. 2 Registration of Discount Medical Card Program

(a)An application for registration to operate as a discount medical card program organization must be filed with the department on a form prescribed by the department.

(b)An application filed under subsection (a) must be:

(1)sworn to by an officer or authorized representative of the applicant; and

(2)accompanied by the following:

(A)A copy of the applicant's organizational documents, such as articles of incorporation, including all amendments.

(B)A copy of the applicant's bylaws or other enabling documents that establish the organizational structure and governance of the applicant.

(C)A list of the names, addresses, official positions, and biographical information of each individual responsible for conducting the applicant's affairs, including each:

(i)member of the board of direct

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(a) An application for registration to operate as
a discount medical card program organization must be filed with the
department on a form prescribed by the department.
(b) An application filed under subsection (a) must be:
(1) sworn to by an officer or authorized representative of the
applicant; and
(2) accompanied by the following:
(A) A copy of the applicant's organizational documents, such as
articles of incorporation, including all amendments.
(B) A copy of the applicant's bylaws or other enabling
documents that establish the organizational structure and
governance of the applicant.
(C) A list of the names, addresses, official positions, and
biographical information of each individual responsible for
conducting the applicant's affairs, including each:
(i) member of the board of directors, board of trustees,
executive committee, or other governing board or committee;
and
(ii) officer.
(D) A statement generally describing the applicant, the
applicant's facilities and personnel, and the medical services for
which discounts will be available.
(E) A complete list of all program providers in Indiana
available to Indiana cardholders.
(F) A copy of the form of any contract or arrangement between
the applicant and a person listed in clause (C).
(G) A copy of the form of any contract between the applicant
and a person for the performance on the applicant's behalf of
any function, including marketing, administration, enrollment,
investment management, and contracting for the provision of
medical services to cardholders.
(H) A description of the proposed method of marketing.
(I) A toll free telephone number that program providers and
cardholders can use at least forty (40) hours per week during
normal business hours to contact the applicant.
(J) A copy of the applicant's cancellation and refund policy.
(K) A description of program provider and cardholder
complaint procedures.
(L) The name and address of the applicant's agent for service of
process, notice or demand, or an executed power of attorney
appointing the commissioner as the attorney of the applicant in
Indiana for service of process for a cause of action arising in
Indiana.
(M) Other information the commissioner reasonably requires to
make the determinations required under this chapter.