§ 26.1-17.1-20 — Suspension or revocation of certificate of authority

North Dakota § 26.1-17.1-20

• Jurisdiction: North Dakota
• Title 26.1: Insurance
• Ch. 26.1-17.1: Prepaid Limited Health Service Organizations

Text

1. The commissioner may suspend or revoke the certificate of authority issued to a
prepaid limited health service organization pursuant to this chapter upon determining
that any of the following conditions exist:
a. The prepaid limited health service organization is operating significantly in
contravention of its basic organizational document or in a manner contrary to that
described in and reasonably inferred from any other information submitted
pursuant to section 26.1-17.1-03, unless amendments to such submissions have
been filed and authorized pursuant to section 26.1-17.1-07.
b. The prepaid limited health service organization issues an evidence of coverage or
uses rates or charges which do not comply with the requirements of sections
26.1-17.1-08 and 26.1-17.1-09.
c. The prepaid limited health service organization is unable to fulfill its obligations to
furnish limited health services.
d. The prepaid limited health service organization is not financially responsible and
may reasonably be expected to be unable to meet its obligations to enrollees or
prospective enrollees.
e. The tangible net equity of the prepaid limited health service organization is less
than that required by section 26.1-17.1-17 or the prepaid limited health service
organization has failed to correct any deficiency in its tangible net equity as
required by the commissioner.
f. The prepaid limited health service organization has failed to implement in a
reasonable manner the complaint system required by section 26.1-17.1-12.
g. The continued operation of the prepaid limited health service organization would
be hazardous to its enrollees.
h. The prepaid limited health service organization has otherwise failed to comply
with this chapter.

2. If the commissioner has cause to believe that grounds for the suspension or
revocation of a certificate of authority exist, the commissioner shall notify the prepaid
limited health service organization in writing specifically stating the grounds for
suspension or revocation and fixing a time not more than sixty days thereafter for a
hearing on the matter in accordance with chapter 28-32.
3. When the certificate of authority of a prepaid limited health service organization is
revoked, such organization shall proceed, immediately following the effective date of
the order of revocation, to wind up its affairs, and shall conduct no further business
except as may be essential to the orderly conclusion of the affairs of such
organization. It shall engage in no further advertising or solicitation whatsoever. The
commissioner may, by written order, permit such further operation of the organization
as the commissioner may find to be in the best interest of the enrollees, to the end that
the enrollees will be afforded the greatest practical opportunity to obtain continuing
limited health services.