§ 26-34-105 — Powers of health maintenance organizations

Wyoming § 26-34-105

• Jurisdiction: Wyoming
• Title 26: Insurance Code
• Ch. 34: HEALTH MAINTENANCE ORGANIZATIONS

Text

(a) The powers of a health maintenance organization
include but are not limited to the:
(i) Purchase, lease, construction, renovation,
operation or maintenance of hospitals or medical facilities, or
both, and their ancillary equipment, and any property as may
reasonably be required for its principal office or for any
purposes as may be necessary in the transaction of the business
of the organization;
(ii) Making of loans to a medical group under
contract with it in furtherance of its program or the making of
loans to a corporation or corporations under its control for the
purpose of acquiring or constructing medical facilities and
hospitals or in furtherance of a program providing health care
services to enrollees;
(iii) Furnishing of health care services through
providers which are under contract with or employed by the
health maintenance organization;
(iv) Contracting with any person for the performance
on its behalf of certain functions such as marketing, enrollment
and administration;
(v) Contracting with an insurance company licensed in
this state, or with a hospital or health service corporation
authorized to do business in this state, for the provision of
insurance, indemnity or reimbursement against the cost of health
care services provided by the health maintenance organization;
(vi) Offering of other health care services, in
addition to basic health care services. Nonbasic health care
services may be offered by a health maintenance organization on
a prepaid basis without offering basic health care services to
any group or individual;
(vii) The joint marketing of products with an
insurance company licensed in this state or with a hospital or
medical service corporation authorized to do business in this
state as long as the company that is offering each product is
clearly identified.
(b) A health maintenance organization shall file notice,
with adequate supporting information, with the commissioner
prior to the exercise of any power granted in paragraph (a)(i),
(ii) or (iv) of this section. The commissioner shall disapprove
any exercise of power only if in his opinion it would
substantially and adversely affect the financial soundness of
the health maintenance organization and endanger its ability to
meet its obligations. If the commissioner does not disapprove
within forty-five (45) days from the date of the filing, it is
deemed approved.
(c) The commissioner may promulgate rules and regulations
exempting from the filing requirement of subsection (b) of this
section those activities having a de minimis effect.