§36-6904. Certification by Insurance Commissioner - Issuance of
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certificate.
A. Upon receipt of an application for issuance of a certificate of authority, the Insurance Commissioner shall within forty-five
(45)days determine whether the applicant, with respect to health care services to be furnished, has complied with the provisions of Section 6907 of this title.
B. The Insurance Commissioner shall, within forty-five
(45)days of determining compliance or deficiency, issue a certificate of authority to a person filing a completed application upon receipt of the prescribed fees and upon the Insurance Commissioner's being satisfied that:
1. The persons responsible for the conduct of the affairs of the applicant are competent and trustworthy, and possess good reputations;
2. Any deficiency identified has been corrected and the Insurance Commissioner has determined that the health maintenance organization's proposed plan of operation meets the requirements of Section 6907 of this title;
3. The health maintenance organization will effectively provide or arrange for the provision of basic health care services on a prepaid basis, through insurance or otherwise, except to the extent of reasonable requirements for copayments or deductibles, or both; and
4. The health maintenance organization is in compliance with the provisions of Sections 6913 and 6915 of this title.
C. A certificate of authority shall be denied only after the Insurance Commissioner complies with the requirements of Section 6920 of this act title. No other criteria may be used to deny a certificate of authority. Added by Laws 2003, c. 197, § 4, eff. Nov. 1, 2003. Amended by Laws 2021, c. 478, § 36, emerg. eff. May 12, 2021.