This text of Wyoming § 26-34-115 (Uncovered expenditures insolvency deposit) is published on Counsel Stack Legal Research, covering Wyoming primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
(a)If at any time uncovered expenditures exceed ten
percent (10%) of total health care expenditures, a health
maintenance organization shall place an uncovered expenditures
insolvency deposit with the commissioner, or with any
organization or trustee acceptable to the commissioner through
which a custodial or controlled account is maintained, cash or
securities that are acceptable to the commissioner. The deposit
shall at all times have a fair market value in an amount of one
hundred twenty percent (120%) of the organization's outstanding
liability for uncovered expenditures for enrollees in this
state, including incurred but not reported claims, and shall be
calculated as of the first day of the month and maintained for
the remainder of the month. If a health maintenance
organization is
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(a) If at any time uncovered expenditures exceed ten
percent (10%) of total health care expenditures, a health
maintenance organization shall place an uncovered expenditures
insolvency deposit with the commissioner, or with any
organization or trustee acceptable to the commissioner through
which a custodial or controlled account is maintained, cash or
securities that are acceptable to the commissioner. The deposit
shall at all times have a fair market value in an amount of one
hundred twenty percent (120%) of the organization's outstanding
liability for uncovered expenditures for enrollees in this
state, including incurred but not reported claims, and shall be
calculated as of the first day of the month and maintained for
the remainder of the month. If a health maintenance
organization is not otherwise required to file a quarterly
report, it shall file a report within forty-five (45) days of
the end of the calendar quarter with information sufficient to
demonstrate compliance with this section.
(b) The deposit required under this section is in addition
to the deposit required under W.S. 26-34-114(g) and (h) and is
an admitted asset of the health maintenance organization in the
determination of net worth. All income from such deposits or
trust account shall be assets of the health maintenance
organization and may be withdrawn quarterly with the approval of
the commissioner.
(c) A health maintenance organization that has made a
deposit may withdraw that deposit or any part of the deposit if:
(i) A substitute deposit of cash or securities of
equal amount and value is made;
(ii) The fair market value exceeds the amount of the
required deposit; or
(iii) The required deposit under subsection (a) of
this section is reduced or eliminated.
(d) Deposits, substitutions or withdrawals may be made
only with the prior written approval of the commissioner.
(e) The deposit required under this section is in trust
and may be used only as provided under this section. The
commissioner may use the deposit of an insolvent health
maintenance organization for administrative costs associated
with administering the deposit and payment of claims of
enrollees of this state for uncovered expenditures in this
state. Claims for uncovered expenditures shall be paid on a pro
rata basis based on assets available to pay the ultimate
liability for incurred expenditures. Partial distribution may
be made pending final distribution. Any amount of the deposit
remaining shall be paid into the liquidation or receivership of
the health maintenance organization.
(f) The commissioner may by regulation prescribe the time,
manner and form for filing claims under subsection (e) of this
section.
(g) The commissioner may by regulation or order require
health maintenance organizations to file annual, quarterly or
more frequent reports as he deems necessary to demonstrate
compliance with this section. The commissioner may require that
the reports include liability for uncovered expenditures as well
as an audit opinion.