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31.12.06.00.htm 31.12.06.00. Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 12 HEALTH MAINTENANCE ORGANIZATIONS; ENTITIES THAT ACT AS HEALTH INSURERS Chapter 06 Managed Care Organizations ― Financial Compliance Requirements Authority: Health-General Article, §15-102.3, 15-102.4(d) and 15-102.6; Insurance Article, §2-109 and 4-311(b)2) Annotated Code of Maryland Ch. 331, §3, Acts of 2000
31.12.06.01.htm 31.12.06.01. 01 Definitions.. A. All terms defined in Health-General Article, Title 15, Subtitle 1, Annotated Code of Maryland, which are used in this chapter have the same meaning as in that statute unless the terms are defined differently in this chapter. In this chapter, the following terms have the meanings indicated.B. Terms Defined.. 1) "Administration" means the Maryland Insurance Administration.. 2) "Applicant" means an organization applying to become a managed care organization..
31.12.06.02.htm 31.12.06.02. 02 Financial Requirements.. A. An applicant or MCO may not engage in business as an MCO unless determined by the Insurance Commissioner to be in compliance with the financial requirements of Health-General Article, §15-102.4, Annotated Code of Maryland.B. Upon request, the MCO shall submit to the Administration the following documents:. 1) A copy of the articles of incorporation of the applicant or MCO and any amendments to it, certified by the Maryland Depart
31.12.06.02-1.htm 31.12.06.02-1. 02-1 Risk-Based Capital Requirements.. A. Health Insurer. In this regulation, the term "health insurer" has the meaning stated in Insurance Article, §4-301(g) Annotated Code of Maryland.B. Requirements Applicable to MCOs. Unless exempted by the Insurance Commissioner, beginning with the Annual Statement filed for the year ending December 31, 2001, an MCO shall comply with the risk-based capital requirements of Insurance Article, Title 4, Subtitle 3, Annotat
31.12.06.03.htm 31.12.06.03. 03 Application of Maryland Insurance Acquisitions Disclosure and Control Act.. A. Exemption. If the Commissioner determines that this regulation or a part of this regulation is not intended to apply to a managed care organization or affiliate, the Commissioner may exempt the managed care organization or affiliate from this regulation or the part of this regulation.B. In this regulation, the following terms have the meanings indicated:. 1) "Holding company" mean
31.12.06.04.htm 31.12.06.04. 04 Annual and Interim Financial Reports.. A. On or before March 1 of each year, each MCO operating under a contract with the Department shall file, in duplicate, a report that includes a consolidated financial statement.B. The Commissioner may require interim statements of the MCOs, on such points as the Commissioner deems necessary and proper at any time during the period between the filing of annual statements.C. The report shall:.
31.12.06.05.htm 31.12.06.05. 05 Financial Examination.. A. The Commissioner may make an examination of the operation of a managed care organization as often as the Commissioner deems necessary for the protection of the interest of the people of Maryland, but the examinations may not be less frequent than once every 5 years.B. The expense of examinations shall be assessed against the MCO being examined in accordance with Health-General Article, §19-718, Annotated Code of Maryland.
31.12.06.06.htm 31.12.06.06. 06 Rehabilitation or Liquidation of an MCO.. Any rehabilitation or liquidation of an MCO shall be:. A. Deemed to be the rehabilitation or liquidation of a health maintenance organization; and. B. Subject to the requirements of Health-General Article, §19-706.1, Annotated Code of Maryland..
31.12.06.9999.htm 31.12.06.9999. Administrative History Effective date:. Regulations .01―06 adopted as an emergency provision effective November 8, 1996 (23:25 Md. R. 1730) adopted permanently effective February 10, 1997 (24:3 Md. R. 186) ―Chapter recodified from COMAR 09.31.24 to COMAR 31.12.06 effective September 7, 1998 (25:18 Md. R. 1439)Regulation .02-1 adopted effective August 20, 2001 (28:16 Md. R. 1484). Regulation .03 amended effective May 24, 2004 (31:10 Md. R. 796).
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