reglab/housing_qa huggingface dataset:
HI Rev Stat § 432D-16 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-16 Summary orders and supervision.

  §432D-16 Summary orders and supervision.  (a) Whenever the commissioner determines that the financial condition of any health maintenance organization is such that its continued operation might be hazardous to its enrollees, creditors, or the general public, or that it has violated any provision of this chapter, the commissioner, after notice and hearing, may order the health maintenance organization to take such action as may be reasonably necessary to rectify such condition or violation, including but not limited to one or more of the following:  (1) Reducing the total amount of present and potential liability for benefits by reinsurance or other method acceptable to the commissioner;  (2) Reducing the volume of new business being accepted;  (3) Reducing expenses by specified methods;  (4) Suspending or limiting the writing of new business for a period of time;  (5) Increasing the health maintenance organization's capital and surplus by contribution; or  (6) Taking such other steps as the commissioner may deem appropriate under the circumstances.  (b) For purposes of this section, the violation by a health maintenance organization of any law of this State to which such health maintenance organization is subject shall be deemed a violation of this chapter.  (c) The commissioner is authorized, by rule, to set uniform standards and criteria for early warning that the continued operation of any health maintenance organization might be hazardous to its enrollees, creditors, or the general public and to set standards for evaluating the financial condition of any health maintenance organization, which standards shall be consistent with the purposes expressed in subsection (a).  (d) The remedies and measures available to the commissioner under this section shall be in addition to, and not in lieu of, the remedies and measures available to the commissioner under the provisions of article 15 of chapter 431. [L 1995, c 179, pt of §1]
HI Rev Stat § 432D-17 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-17 Fees

  §432D-17 Fees. (a) The commissioner shall collect, in advance, the following fees:  (1) Certificate of authority:  (A) Application for a certificate of authority: $900; and  (B) Issuance of certificate of authority: $600; and  (2) For all services subsequent to the issuance of certificate of authority, including extension of the certificate of authority: $600 per year. The commissioner may, upon showing of good cause, waive or modify, in whole or part, all fees in this subsection by order.  (b) No certificate of authority shall contain an expiration date, but all certificates of authority shall be extended by the commissioner from time to time in order to continue to be valid. When the commissioner issues or extends a certificate of authority, the commissioner shall determine the date prior to which the certificate of authority shall be extended and shall so notify the insurer in writing. This date is called the extension date. The extension date shall be any date not less than one year and not more than three years after date of issue or extension of the certificate of authority. If the insurer qualifies, its certificate of authority shall be extended. The commissioner shall provide each holder of a certificate of authority at least thirty days' advance written notice of the applicable extension date. If the fee for the extension of the certificate of authority is not paid before or on the extension date, a penalty shall be imposed in the amount of fifty per cent of the fee. The commissioner shall provide notice in writing of the delinquency of extension and the imposition of the authorized penalty. If the fee and the penalty are not paid within thirty days immediately following the date of the notice of delinquency, the commissioner may revoke the certificate of authority and may not reinstate the certificate of authority until the fee and penalty have been paid.  (c) All fees and penalties collected pursuant to this section and penalties collected pursuant to section 432D-14 shall be deposited to the credit of the compliance resolution fund. [L 1995, c 179, pt of §1; am L 1999, c 247, §2; am L 2012, c 251, §13; am L 2015, c 63, §18; am L 2021, c 110, §21]
HI Rev Stat § 432D-18 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-18 Penalties and enforcement.

  §432D-18 Penalties and enforcement. (a) The commissioner, in lieu of suspension or revocation of a certificate of authority, may impose an administrative fine pursuant to section 432D-14(b).  (b) If the commissioner, for any reason, has cause to believe that any violation of this chapter has occurred or is threatened, the commissioner may give notice to the health maintenance organization and to the representatives, or other persons who appear to be involved in such suspected violation, to arrange a conference with the alleged violators or their authorized representatives for the purpose of attempting to ascertain the facts relating to such suspected violation and, in the event it appears that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing such violation. Proceedings under this subsection shall not be governed by any formal procedural requirements, and may be conducted in such manner as the commissioner may deem appropriate under the circumstances. However, unless consented to by the health maintenance organization, no order may result from a conference until the requirements of this section are satisfied.  (c) The commissioner may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any act or practice in violation of the provisions of this chapter. Any person aggrieved by an order of the commissioner under this section may obtain judicial review of the order in the manner provided for by chapter 91.  (d) In the case of any violation of the provisions of this chapter, if the commissioner elects not to issue a cease and desist order, or in the event of noncompliance with a cease and desist order issued pursuant to subsection (c), the commissioner may institute a proceeding to obtain injunctive or other appropriate relief in any court of competent jurisdiction.  (e) Notwithstanding any other provisions of this chapter, if a health maintenance organization fails to comply with the net worth requirement of this chapter, the commissioner may take appropriate action to assure that the continued operation of the health maintenance organization will not be hazardous to its enrollees. [L 1995, c 179, pt of §1]
HI Rev Stat § 432D-18.5 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-18.5 REPEALED.

 §432D-18.5 REPEALED. L 2009, c 149, §13. Cross References  Insurance fraud, see § §431:2-401 to 431:2-410.
HI Rev Stat § 432D-19 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-19 Statutory construction and relationship to other laws.

  §432D-19 Statutory construction and relationship to other laws. (a) Except as provided in subsection (d) and otherwise provided in this chapter, the insurance laws and hospital or medical service corporation laws shall not apply to the activities authorized and regulated under this chapter of any health maintenance organization granted a certificate of authority under this chapter. This chapter shall not apply to an insurer or hospital or medical service corporation licensed and regulated pursuant to the insurance laws or the hospital or medical service corporation laws of this State except with respect to its health maintenance organization activities authorized and regulated pursuant to this chapter.  (b) Solicitation of enrollees by a health maintenance organization granted a certificate of authority, or its representatives, shall not be construed to violate any provision of law relating to solicitation or advertising by health professionals.  (c) Any health maintenance organization granted a certificate of authority under this chapter shall not be deemed to be practicing medicine or osteopathic medicine and shall be exempt from the provision of chapter 453 relating to the practice of medicine or osteopathic medicine.  (d) Article 2, article 2D, part IV of article 3, article 6, part III of article 7, article 9A, article 13, article 14G, and article 15 of chapter 431, and sections 431:3-301, 431:3-302, 431:3-303, 431:3-304, 431:3-305, 431:10-225, and 431:10-226.5, and the powers granted by those provisions to the commissioner shall apply to health maintenance organizations, so long as the application in any particular case is in compliance with and is not preempted by applicable federal statutes and regulations. [L 1995, c 179, pt of §1; am L 1998, c 178, §4; am L 2002, c 74, § §4, 6; am L 2003, c 3, §22; am L 2007, c 175, §4; am L 2009, c 11, §54; am L 2011, c 80, §9; am L 2012, c 251, §14; am L 2013, c 56, §2; am L 2014, c 186, §16; am L 2016, c 141, §20]
HI Rev Stat § 432D-20 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-20 Filings and reports as public documents.

  §432D-20 Filings and reports as public documents. Notwithstanding chapter 92F and any other laws to the contrary, all applications and filings required under this chapter shall be treated as public, except for trade secrets or privileged or confidential quality assurance, commercial, or financial information; provided that any annual financial statement that may be required under section 432D-5 shall be public. [L 1995, c 179, pt of §1]
HI Rev Stat § 432D-21 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-21 Confidentiality of medical information.

  §432D-21 Confidentiality of medical information. Any data or information pertaining to the diagnosis, treatment, or health of any enrollee or applicant obtained from such person or from any provider by any health maintenance organization shall be held in confidence and shall not be disclosed to any person except to the extent that it may be necessary to carry out the purposes of this chapter, upon the express consent of the enrollee or applicant, pursuant to statute or court order for the production of evidence or the discovery thereof, or in the event of a claim or litigation between such person and the health maintenance organization wherein such data or information is pertinent. A health maintenance organization shall be entitled to claim any statutory privileges against disclosure which the provider who furnished the information to the health maintenance organization is entitled to claim. [L 1995, c 179, pt of §1] Law Journals and Reviews  Driving into the Sunset: A Proposal for Mandatory Reporting to the DMV by Physicians Treating Unsafe Elderly Drivers. 25 UH L. Rev. 59 (2002).
HI Rev Stat § 432D-22 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-22 Acquisition of control of or merger of a health maintenance organization.

  §432D-22 Acquisition of control of or merger of a health maintenance organization. No person may make a tender for or a request or invitation for tenders of, enter into an agreement to exchange securities for, or acquire in the open market or otherwise, any voting security of a health maintenance organization or enter into any other agreement if, after the consummation thereof, that person, directly or indirectly, or by conversion or by exercise of any right to acquire, would be in control of the health maintenance organization, and no person may enter into an agreement to merge or consolidate with or otherwise to acquire control of a health maintenance organization, unless, at the time any offer, request, or invitation is made or any agreement is entered into, or prior to the acquisition of the securities if no offer or agreement is involved, the person has filed with the commissioner and has sent to the health maintenance organization information required by section 431:11-104 and the offer, request, invitation, agreement, or acquisition has been approved by the commissioner. Approval by the commissioner shall be governed by section 431:11-104(d); provided that if no action is taken by the commissioner within thirty days, the offer, request, invitation, agreement, or acquisition shall be deemed approved. [L 1995, c 179, pt of §1; am L 2000, c 74, §6]
HI Rev Stat § 432D-23 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-23 Required provisions and benefits.

  §432D-23 Required provisions and benefits.  Notwithstanding any provision of law to the contrary, each policy, contract, plan, or agreement issued in the State after January 1, 1995, by health maintenance organizations pursuant to this chapter, shall include benefits provided in sections 431:10-212, 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.2, 431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126, 431:10A-132, 431:10A-133, 431:10A-140, and 431:10A-134, and chapter 431M. [L 1995, c 179, pt of §1; am L 1999, c 77, §8 and c 86, §4; am L 2000, c 243, §4; am L 2009, c 168, §3 and c 169, §8; am L 2010, c 157, §3; am L 2012, c 92, §4; am L 2015, c 197, §3, c 213, §5, and c 235, §5; am L 2016, c 204, §4] Note  Applicability of 2016 amendment. L 2016, c 204, § §6, 8. Attorney General Opinions  No reference was made to new section added to article 10A of chapter 431 [ §431:10A-601], by §4 of reciprocal beneficiaries act [L 1997, c 383]; thus, §431:10A-601 did not apply to health maintenance organizations. Att. Gen. Op. 97-5.
HI Rev Stat § 432D-23.6 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-23.6 Federally funded programs; exemption.

  §432D-23.6 Federally funded programs; exemption. Requirements relating to mandated coverages shall not be applicable to any health maintenance organization offering health insurance under a federally funded program under the Social Security Act, as amended; provided that this exemption shall apply only to that part of the health maintenance organization's business under the federally funded program. [L 1999, c 159, §3]
HI Rev Stat § 432D-24 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-24 Coordination of benefits.

  §432D-24 Coordination of benefits. (a) Health maintenance organizations are permitted, but not required to adopt provisions for coordination of benefits to avoid overinsurance and to provide for the orderly payment of claims when a person is covered by two or more group health insurance or health care plans.  (b) If health maintenance organizations adopt provisions for coordination of benefits, the provisions must be consistent with the coordination of benefits provisions that are in general use in the State for coordinating coverage between two or more group health insurance or health care plans. [L 1995, c 179, pt of §1]
HI Rev Stat § 432D-25 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-25 Disclosure of health care coverage and benefits.

  §432D-25 Disclosure of health care coverage and benefits. In order to ensure that all individuals understand their health care options and are able to make informed decisions, all health maintenance organizations shall provide current and prospective enrollees with written disclosure of coverages and benefits, including information on coverage principles and any exclusions or restrictions on coverage.  The information provided shall be current, understandable, and available prior to enrollment, and upon request after enrollment. A policy or contract provided to an enrollee which describes coverages and benefits shall be in conformance with part I of article 10 of chapter 431. L 1996, c 274, §3; am L 1999, c 246, §5 Cross References  Patients' bill of rights and responsibilities act, see chapter 432E.
HI Rev Stat § 432D-26 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-26 Genetic information nondiscrimination in health insurance coverage.

  §432D-26 Genetic information nondiscrimination in health insurance coverage. (a) No health maintenance organization may:  (1) Use an individual's or a family member's genetic information, or request for genetic services, to deny or limit any coverage or establish eligibility, continuation, enrollment, or premium payments;  (2) Request or require collection or disclosure of an individual's or a family member's genetic information; or  (3) Disclose an individual's or a family member's genetic information without the written consent of the person affected, the person's legal guardian, or a person with power of attorney for health care for the person affected. This consent shall be required for each disclosure and shall include the name of each person or organization to whom the disclosure will be made.  (b) As used in this section:  "Family member" means, with respect to the individual, another individual related by blood to that individual.  "Genetic information" means information about genes, gene products, hereditary susceptibility to disease, or inherited characteristics that may derive from the individual or family member.  "Genetic services" means health services to obtain, assess, or interpret genetic information for diagnosis, therapy, and genetic counseling. [L 1997, c 91, §3] Law Journals and Reviews  Privacy and Genetics: Protecting Genetic Test Results in Hawai`i. 25 UH L. Rev. 449 (2003).
HI Rev Stat § 432D-27 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-27 Policies relating to domestic abuse cases.

  §432D-27 Policies relating to domestic abuse cases. (a) No health maintenance organization shall deny or refuse to accept an application for insurance, refuse to insure, refuse to renew, cancel, restrict, or otherwise terminate a policy of insurance, or charge a different rate for the same coverage, on the basis that the applicant or enrollee is, has been, or may be a victim of domestic abuse.  (b) Nothing in this section shall prevent a health maintenance organization from taking any of the actions set forth in subsection (a) on the basis of loss history or medical condition, or for any other reason not otherwise prohibited by this section or any other law, regulation, or rule.  (c) Any form filed or filed after July 15, 1998 or subject to a rule adopted under chapter 91 may exclude coverage for losses caused by intentional or fraudulent acts of any enrollee.  (d) Nothing in this section prohibits a health maintenance organization from investigating a claim and complying with chapter 432D.  (e) As used in this section, "domestic abuse" means:  (1) Physical harm, bodily injury, assault, or the infliction of fear of imminent physical harm, bodily injury, or assault between family or household members;  (2) Sexual assault of one family or household member by another;  (3) Stalking of one family or household member by another family or household member;  (4) Intentionally, knowingly, or recklessly causing damage to property so as to intimidate or attempt to control the behavior of another household member; or  (5) Coercive control, as defined in section 586-1, between family or household members. [L 1998, c 171, §5; am L 2004, c 122, §92; am L 2020, c 20, §4] Revision Note  "July 15, 1998" substituted for "the effective date of this section" pursuant to §23G-15.
HI Rev Stat § 432D-28 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-28 Federal law compliance.

  §432D-28 Federal law compliance. A health maintenance organization shall comply with applicable federal law. The commissioner shall enforce the consumer protections and market reforms relating to insurance as set forth in the federal Patient Protection and Affordable Care Act, Public Law 111-148. [L 2011, c 15, §4]
HI Rev Stat § 432D-29 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432D. Health Maintenance Organization Act|432D-29 Prohibition on rescissions of coverage.

  §432D-29 Prohibition on rescissions of coverage. (a) Notwithstanding sections 431:10-226.5 and 431:10A-106 to the contrary, a health maintenance organization shall not rescind coverage under a health benefit plan with respect to an individual, including a group to which the individual belongs or family coverage in which the individual is included, after the individual is covered under the plan, unless:  (1) The individual or a person seeking coverage on behalf of the individual performs an act, practice, or omission that constitutes fraud;  (2) The individual makes an intentional misrepresentation of material fact as prohibited by the terms of the plan or coverage; or  (3) The individual fails to timely pay required premiums or contributions toward the cost of coverage; provided that the rescission is in compliance with federal regulations.  As used in this subsection, "a person seeking coverage on behalf of the individual" shall not include an insurance producer or employee or authorized representative of the health carrier.  (b) A health maintenance organization shall provide at least thirty days advance written notice to each plan enrollee or, for individual health insurance coverage, to each primary subscriber, who would be affected by the proposed rescission of coverage before coverage under the plan may be rescinded in accordance with subsection (a) regardless of whether, in the case of group health insurance coverage, the rescission applies to the entire group or only to an individual within the group.  (c) This section applies regardless of any applicable contestability period. [L 2014, c 186, §3]