Alaska Stat. § 21.61.110 — AK Code / Title 21 / Chapter 21.61 / Section 21.61.110
Definitions.
Status: in_force

In AS 21.61.100  21.61.110, (1) air ambulance means a publicly or privately owned aircraft intended to be used and maintained or operated to provide critical care ambulance services, air medevacs, and medevac services for the transportation of individuals who are sick, injured, wounded, or otherwise helpless;

(2) air ambulance membership agreement means an agreement in exchange for consideration, to pay for, indemnify, or provide an amount or benefit to a person for the cost of air ambulance services;

(3) air ambulance service provider means a person that owns or operates an air ambulance;

(4) consideration means a membership fee, receipt of insurance proceeds, performance of a service, waiver of a right, or anything of value.
Alaska Stat. § 21.27.910 — AK Code / Title 21 / Chapter 21.27 / Section 21.27.910
Pharmacy audit procedural requirements.
Status: in_force

(a) When a pharmacy benefits manager conducts an audit of the records of a pharmacy, the period covered by the audit of a claim may not exceed two years from the date that the claim was submitted to or adjudicated by the pharmacy benefits manager, whichever is earlier. Except as required under AS 21.36.495 , a claim submitted to or adjudicated by a pharmacy benefits manager does not accrue interest during the audit period.

(b) A pharmacy benefits manager conducting an on-site audit shall give the pharmacy written notice of at least 10 business days before conducting an initial audit.

(c) A pharmacy benefits manager may not conduct (1) an audit during the first seven calendar days of any month unless agreed to by the pharmacy;

(2) more than one on-site audit of a pharmacy within a 12-month period; or

(3) on-site audits of more than 250 separate prescriptions at one pharmacy within a 12-month period unless fraud by the pharmacy or an employee of the pharmacy is alleged.

(d) If an audit involves clinical or professional judgment, the individual conducting the audit must (1) be a pharmacist who is licensed and in good standing under AS 08.80 ; or

(2) conduct the audit in consultation with a pharmacist who is licensed and in good standing under AS 08.80 .

(e) A pharmacy, in responding to an audit, may use (1) verifiable statements or records, including medication administration records of a nursing home, assisted living facility, hospital, physician, or other authorized practitioner, to validate the pharmacy record;

(2) a legal prescription to validate claims in connection with prescriptions, refills, or changes in prescriptions, including medication administration records, prescriptions transmitted by facsimile, electronic prescriptions, or documented telephone calls from the prescriber or the prescriber's agent.

(f) A pharmacy benefits manager shall audit each pharmacy under the same standards and parameters as other similarly situated pharmacies in a network pharmacy contract in this state.
Alaska Stat. § 21.75.320 — AK Code / Title 21 / Chapter 21.75 / Section 21.75.320
Applicable provisions of law.
Status: in_force

Except as otherwise specifically provided, the provisions of AS 21.75.010  21.75.270 and 21.75.900(2) and (3) are applicable to cooperative insurers.
Alaska Stat. § 21.06.060 — AK Code / Title 21 / Chapter 21.06 / Section 21.06.060
Records.
Status: in_force

(a) The director shall enter in permanent form records of official transactions, examinations, investigations, and proceedings and keep those records in the office of the director. The records and insurance filings in the office of the director are open to public inspection, except as otherwise provided in (b)  (g) of this section or other provisions of this title with respect to particular records or filings.

(b) Information and records, including written documents and electronic data, designated as confidential or not available for public inspection under this section or other provisions of this title (1) are not subject to inspection and copying under AS 40.25.110  40.25.220;

(2) may not be obtained from the director by subpoena, except for a subpoena issued by a state or federal law enforcement agency or grand jury;

(3) may be used by the director in a regulatory or legal proceeding; and

(4) may be released for public inspection if the person who provided the information or records to the director consents or releases incomplete or misleading information on the same topic to the public.

(c) The director or a person acting under the authority of the director who receives information or records designated in this title as confidential or not available for public inspection may not be permitted or required to testify about the information or records in a civil action not involving the state or a state agency, officer, or employee.

(d) A person required or requested to provide information or records to the director under this title does not waive a claim of privilege that the person may have by providing the information or records to the director.

(e) In the performance of duties under this title, the director may (1) disclose confidential information or records to the legislature, state, federal, and international regulatory or law enforcement agencies, or the National Association of Insurance Commissioners if the recipient will maintain the confidentiality of the information or records;

(2) receive information or records from state, federal, and international regulatory or law enforcement authorities or the National Association of Insurance Commissioners and maintain the confidentiality of the information or records if requested to do so or given notice that the information or records are confidential under the law of the jurisdiction supplying them; and

(3) enter into agreements consistent with this section governing the sharing of information or records that are confidential under this title with other state, federal, and international regulatory or law enforcement agencies or the National Association of Insurance Commissioners for the purpose of furthering any regulatory or legal action that may be taken as part of the recipient's official duties.

(f) The following information or records submitted to or obtained by the director are confidential: (1) personally identifiable consumer information; however, the director may disclose the information or records for the purpose of attempting to resolve a consumer complaint;

(2) information or records established by a showing satisfactory to the director to be a trade secret or proprietary business information, including (A) detailed health insurance claim cost data; and

(B) justification for usual, customary, and reasonable charge determinations;

(3) information or records provided by a person not subject to this title at the request of the director if the information or records are identified as confidential by the director; and

(4) analysis ratios and examination synopses concerning insurance companies that are submitted to the director by the National Association of Insurance Commissioners.

(g) The director may withhold information or records from public inspection for as long as the director finds the withholding is (1) necessary to protect a person against unwarranted injury; or

(2) in the public interest.
Alaska Stat. § 21.56.190 — AK Code / Title 21 / Chapter 21.56 / Section 21.56.190
Mandatory reissue of coverage.
Status: in_force

The director may adopt regulations to require small employer insurers, as a condition of transacting business with small employers in this state after July 1, 1993, to reissue a health care insurance plan to a small employer who has had its health care insurance plan terminated or not renewed by the insurer after January 1, 1993. The director may prescribe the terms for the reissue of coverage that the director determines are reasonable and necessary to provide continuity of coverage to small employers.
Alaska Stat. § 21.39.160 — AK Code / Title 21 / Chapter 21.39 / Section 21.39.160
Penalties.
Status: in_force

(a) If the director finds, following an appropriate hearing, that a person or organization has violated a provision of this chapter, the director may impose a civil penalty not to exceed $200 or the actual amount of gain, whichever is greater, for each violation, but if the director finds the violation to be wilful the director may impose a penalty of $2,000 or three times the actual amount of gain, whichever is greater, for each violation. The penalties may be in addition to any other penalty provided by law. In this section, gain means the difference between the amount actually charged and the amount that should have been charged under applicable filings of the person or organization.

(b) The director may suspend the license of a rating organization or insurer that fails to comply with an order of the director within the time limited by the order or an extension of time granted by the director. The director may not suspend the license of a rating organization or insurer for failure to comply with an order until the time prescribed for an appeal has expired or, if an appeal has been taken, until the order has been affirmed. The director may determine when a suspension of license becomes effective. The suspension shall remain in effect for the period fixed by the director unless the director modifies or rescinds the suspension, or until the order upon which the suspension is based is modified, rescinded, or reversed.

(c) A penalty may not be imposed and a license may not be suspended or revoked except upon a written order of the director, stating findings, made after a hearing held upon not less than 10 days written notice to the person or organization specifying the alleged violation.
Alaska Stat. § 21.86.020 — AK Code / Title 21 / Chapter 21.86 / Section 21.86.020
Issuance of certificate of authority; approval of changes.
Status: in_force

(a) Within 10 days after receipt of an application for a certificate of authority, the director shall forward a copy of the application to the commissioner of health. Within 60 days after the commissioner of health receives the copy of the application, the commissioner shall make a recommendation regarding the granting of the certificate of authority.

(b) The director shall either issue or deny a certificate of authority within 30 days after receipt of the commissioner of health's recommendation. However, the director may extend the time for issuance or denial of a certificate of authority if additional information is needed in order to make a decision, and notice of the extension is provided to the applicant by the 90th day after the director received the application. A certificate of authority shall be issued if the director determines that the following conditions are met: (1) the persons responsible for the conduct of the affairs of the applicant are competent and trustworthy;

(2) the applicant 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;

(3) the applicant is financially responsible and may reasonably be expected to meet its obligations to enrollees and prospective enrollees; in determining if this condition is met, the director may consider (A) the financial soundness of the arrangements for health care services and the schedule of charges used in connection with those services;

(B) the adequacy of working capital;

(C) an agreement with an insurer, a hospital or medical service corporation, a government, or other organization for ensuring the payment of the cost of health care services or providing for automatic applicability of an alternative coverage if the health maintenance organization is discontinued;

(D) an agreement with providers for the provision of health care services; and

(E) a deposit of cash or securities submitted under AS 21.86.140 ;

(4) the enrollees will be afforded an opportunity to participate in matters of policy and operation as provided in AS 21.86.040 ;

(5) nothing in the proposed method of operation, as shown by the information submitted under AS 21.86.010 or by independent investigation, is contrary to the public interest;

(6) the information submitted under AS 21.86.010 (b)(12) indicates that the applicant will be able to comply with state and federal statutes and regulations regarding the quality of health care.

(c) If a certificate of authority is denied under this section, the applicant may request a hearing under AS 21.86.200 .
Alaska Stat. § 21.22.130 — AK Code / Title 21 / Chapter 21.22 / Section 21.22.130
Regulations.
Status: in_force

The director may adopt regulations to carry out the provisions of this chapter.
Alaska Stat. § 21.27.215 — AK Code / Title 21 / Chapter 21.27 / Section 21.27.215
Employment contracts.
Status: in_force

(a) A firm may enter into an employment contract with a licensed individual to conduct business under the supervision of and in the name of the firm. The employment contract must be in writing and must specify the lines and classes of authorities of the individual and the firm. The individual and the firm shall retain a copy of the contract and shall reply in writing within three working days to an inquiry of the director regarding any business transacted by the individual and the firm.

(b) The firm shall examine the credentials of the individual to determine that the individual is licensed to conduct the kinds of business described in the contract.

(c) A licensed individual may, if authorized by the firm and an insurer for which the firm is an agent, issue on the firm's behalf contracts of insurance in accordance with a written agency employment contract.

(d) A firm shall be responsible for the actions of an individual transacting insurance under the firm's employment contracts. In any disciplinary proceeding under this title, the existence of the employment contract shall be prima facie evidence that the firm knew of the activities of the individual.

(e) The individual and the firm shall maintain a current list of all of their respective contracts that identifies, for each contract, the parties to the contract, the parties' mailing addresses, electronic mailing addresses, and telephone numbers, and the parties' license numbers, and the effective and termination dates of employment.

(f) A licensee shall retain the records of an employment contract and make the records available for examination and inspection by the director, at any business time during the five years immediately following the date of the termination of the employment contract unless the director orders a longer period of retention. If the licensee assumes the business of another licensee or former licensee by merger, purchase, or otherwise, the requirements of AS 21.27.350 (c) apply.
Alaska Stat. § 21.51.140 — AK Code / Title 21 / Chapter 21.51 / Section 21.51.140
Legal actions.
Status: in_force

There shall be a provision as follows:

Legal Actions: No action at law or in equity shall be brought to recover on this policy before the expiration of 60 days after written proof of loss has been furnished in accordance with the requirements of this policy. No action shall be brought after the expiration of three years after the written proof of loss is required to be furnished.