reglab/housing_qa huggingface dataset:
KS Stat § 40-37a06 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 37a - Regulation Of Broker Controlled Insurers|40-37a06 Failure to comply with law, remedies for benefit of insurer; rights of policyholders, claimants, creditors and other third parties unaffected.

40-37a06. Failure to comply with law, remedies for benefit of insurer; rights of policyholders, claimants, creditors and other third parties unaffected. (a) (1) If the commissioner believes the controlling producer or any other person has not complied with this act, or any regulation or order promulgated hereunder, the commissioner may, after a hearing conducted under the provisions of the Kansas administrative procedures act, order the controlling producer to cease placing business with the controlled insurer; and(2) if it was found that because of such noncompliance, the controlled insurer or any policyholder thereof has suffered any loss or damage, the commissioner may maintain a civil action or intervene in an action brought by or on behalf of the insurer or policyholder for recovery of compensatory damages for the benefit of the insurer or policyholder or other appropriate relief.(b) If an order for liquidation or rehabilitation of the controlled insurer has been entered pursuant to K.S.A. 40-3605 et seq., and amendments thereto, and the receiver appointed under that order believes that the controlling producer or any other person has not materially complied with this act, or any regulation or order promulgated hereunder, and the insurer suffered any loss or damage therefrom, the receiver may maintain a civil action for recovery of damages or other appropriate sanctions for the benefit of the insurer.(c) Nothing contained in this section shall affect the right of the commissioner to impose any other penalties provided for in chapter 40 of the Kansas Statutes Annotated.(d) Nothing contained in this section is intended to or shall in any manner alter or affect the rights of policyholders, claimants, creditors or other third parties.History: L. 1992, ch. 14, § 6; L. 2005, ch. 163, § 7; July 1.
KS Stat § 40-3802 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3802 Same; written agreements required; contents.

40-3802. Same; written agreements required; contents. (a) No administrator shall act as such without a written agreement between the administrator and the insurer, and such written agreement shall be retained as part of the official records of both the insurer and the administrator for the duration of the agreement and five years thereafter. Such written agreement shall contain provisions which include the requirements of K.S.A. 40-3805 through 40-3809, and amendments thereto, except insofar as those requirements do not apply to the functions performed by the administrator.(b) The written agreement shall include a statement of duties that the administrator is expected to perform on behalf of the insurer and the lines, classes or types of insurance for which the administrator is to be authorized to administer. The agreement shall make provision with respect to underwriting or other standards pertaining to the business underwritten by the insurer.(c) The insurer or administrator may, with written notice to the other party and the commissioner, terminate the written agreement as provided in the agreement. The insurer may suspend the underwriting authority of the administrator during the pendency of any dispute regarding the termination of the written agreement. The insurer shall fulfill any lawful obligations with respect to policies affected by the written agreement regardless of any dispute between the insurer and the administrator.History: L. 1978, ch. 174, § 2; L. 2017, ch. 2, § 8; Mar. 9.
KS Stat § 40-3804 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3804 Same; payment to administrator of premiums or charges; effect.

40-3804. Same; payment to administrator of premiums or charges; effect. If an insurer utilizes the services of an administrator, the payment to the administrator of any premiums or charges for insurance by or on behalf of the insured shall be deemed to have been received by the insurer and the payment of return premiums or claims forwarded by the insurer to the administrator shall not be deemed payment to the insured or claimant until such payments are received by the insured or claimant. Nothing shall limit any right of the insurer against the administrator resulting from its failure to make payments to the insurer, insureds or claimants.History: L. 1978, ch. 174, § 3; L. 2017, ch. 2, § 9; Mar. 9.
KS Stat § 40-3806 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3806 Same; advertising; prior approval required.

40-3806. Same; advertising; prior approval required. An administrator may use only such advertising pertaining to the business underwritten by an insurer as has been approved by such insurer in advance of its use. An administrator that mentions any current or former client in its advertising must obtain the client's prior written consent.History: L. 1978, ch. 174, § 5; L. 2017, ch. 2, § 11; Mar. 9.
KS Stat § 40-3808 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3808 Same; compensation to administrator.

40-3808. Same; compensation to administrator. (a) An administrator shall not enter into an agreement or understanding with a payor in which the effect is to make the amount of the administrator's commissions, fees or charges contingent upon savings effected by the adjustment, settlement and payment of losses covered by the payor's obligations. This provision shall not prohibit an administrator from receiving performance-based compensation for providing hospital or other auditing services, from providing managed care or related services, or from being compensated for subrogation expenses.(b) This section shall not prevent the compensation of an administrator from being based on premiums or charges collected or the number of claims paid or processed.History: L. 1978, ch. 174, § 8; L. 2017, ch. 2, § 13; Mar. 9.
KS Stat § 40-3809 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3809 Same; written notice; disclosures.

40-3809. Same; written notice; disclosures. (a) Where the services of an administrator are utilized, the administrator shall provide a written notice, approved by the payor, to covered individuals advising them of the identity of and relationship among the administrator, the policyholder and the payor.(b) When an administrator collects funds, the reason for collection of each item shall be identified to the insured party and each item shall be shown separately from any premium. Additional charges may not be made for services to the extent the services have already been paid for by the payor.(c) The administrator shall disclose to the payor all charges, fees and commissions that the administrator receives arising from services it provides for the payor, including any fees or commissions paid by payors providing reinsurance or stop-loss insurance.History: L. 1978, ch. 174, § 9; L. 2017, ch. 2, § 14; Mar. 9.
KS Stat § 40-3810 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3810 Same; registration requirement.

40-3810. Same; registration requirement. A person who is not required to be licensed as an administrator under this act and who directly or indirectly underwrites, collects charges or premiums from or adjusts or settles claims on residents of this state only in connection with life, annuity or health coverage provided by a self-funded plan other than a governmental or church plan, shall register with the commissioner annually, verifying its status as herein described. This section shall not apply to an insurer or to an individual performing these actions as an employee of an insurer. This section shall also not apply to a person performing these actions under contract to or as an employee of an administrator.History: L. 1978, ch. 174, § 10; L. 1988, ch. 356, § 126; L. 2017, ch. 2, § 15; Mar. 9.
KS Stat § 40-3813 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3813 Same; nonresident license; fees.

40-3813. Same; nonresident license; fees. (a) Unless an administrator has obtained a home state license in this state, any administrator who performs duties as an administrator in this state shall obtain a nonresident administrator license in accordance with the provisions of this section by filing with the commissioner the uniform application, accompanied by a letter of certification. In lieu of requiring an administrator to file a letter of certification with the uniform application, the commissioner may verify the nonresident administrator's home state certificate of authority or license status through an electronic database maintained by the NAIC, its affiliates or subsidiaries.(b) An administrator shall not be eligible for a nonresident administrator license under the provisions of this section if it does not hold a license in a home state that has adopted a substantially similar law governing administrators.(c) Except as provided in subsections (b) and (h) the commissioner shall issue to the administrator a nonresident administrator license promptly upon receipt of a complete application.(d) Each nonresident administrator shall file biennially, as a part of its application for renewal of its license, a statement that its home state administrator license remains in force and has not been revoked or suspended by its home state during the preceding years. Each nonresident administrator renewal application shall be accompanied by a renewal application fee in the amount of $200.(e) At the time of filing the application for licensing required under the provisions of this section, the nonresident administrator shall pay a license application fee in the amount of $400.(f) An administrator licensed or applying for licensure under the provisions of this section shall produce its accounts, records and files for examination, and make its officers available to give information with respect to its affairs, as often as reasonably required by the commissioner.(g) A nonresident administrator is not required to hold a nonresident administrator license in this state if the administrator is licensed in its home state and the administrator's duties in this state are limited to:(1) The administration of a group policy or plan and no more than a total of 20% of covered persons, for all plans the administrator services, reside in this state; and(2) the total number of covered persons residing in this state is less than 100.(h) The commissioner may refuse to issue a nonresident administrator license, or delay the issuance of a nonresident administrator license, if the commissioner determines that, due to events or information obtained subsequent to the home state's licensure of the administrator, the nonresident administrator cannot satisfy the requirements of this act or that grounds exist for the home state's revocation or suspension of the administrator's home state certificate of authority or license.History: L. 2017, ch. 2, § 3; L. 2019, ch. 54, § 6; July 1.
KS Stat § 40-3814 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3814 Same; annual report; fees.

40-3814. Same; annual report; fees. (a) Each administrator licensed under the provisions of this act shall file an annual report for the preceding calendar year with the commissioner on or before July 1 of each year, or within such extension of time as the commissioner may grant for good cause, accompanied by an annual report fee in the amount of $100. The annual report shall include:(1) An audited financial statement attested to by an independent certified public accountant. An audited annual financial report prepared on a consolidated basis shall include a columnar consolidating or combining worksheet that shall be filed with the report and include the following:(A) Amounts shown on the consolidated audited financial report shown on the worksheet;(B) amounts for each entity stated separately; and(C) explanations of consolidating and eliminating entries included.(2) In lieu of submitting an audited financial statement, and upon written application by an administrator and good cause shown, the commissioner may grant a hardship exemption from filing audited financial statements and allow the submission of unaudited financial statements. Acceptable formats for unaudited financial statements, that shall include notes, are:(A) Reports compiled or reviewed by a certified public accountant; or(B) internal financial reports prepared in accordance with GAAP, certified by at least two officers, owners or directors of the administrator.If unaudited financial statements are submitted, the administrator must secure and maintain a surety bond in a form prescribed by the commissioner for the use and benefit of the commissioner to be held in trust for the benefit and protection of covered persons and any payor or self-funded plan against loss by reason of acts of fraud or dishonesty, for the greater of 10% of funds handled for the benefit of Kansas residents or $20,000.(b) The annual report shall be in the form and contain such matters as the commissioner prescribes and shall be verified by at least two officers, owners or directors of the administrator.(c) The annual report shall include the complete names and addresses of all payors and for self-funded plans, all employers and trusts, with which the administrator had agreements during the preceding fiscal year. The report shall also include the number of Kansas residents covered by each of the plans.History: L. 2017, ch. 2, § 4; L. 2019, ch. 54, § 7; July 1.
KS Stat § 40-3816 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3816 Same; delivery of materials.

40-3816. Same; delivery of materials. Any policies, certificates, booklets, termination notices or other written communications delivered by the payor to the administrator for delivery to insured parties or covered individuals shall be delivered by the administrator promptly after receipt of instructions from the payor to deliver them.History: L. 2017, ch. 2, § 6; Mar. 9.
KS Stat § 40-3817 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3817 Same; citation of act.

40-3817. Same; citation of act. K.S.A. 40-3801, 40-3802, 40-3804 through 40-3810 and K.S.A. 40-3812 through 40-3817, and amendments thereto, shall be known and may be cited as the third party administrators act.History: L. 2017, ch. 2, § 1; Mar. 9.
KS Stat § 40-3821 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3821 Pharmacy benefits manager registration act; citation of act; applicability.

40-3821. Pharmacy benefits manager registration act; citation of act; applicability. (a) K.S.A. 40-3821 through 40-3828, and amendments thereto, shall be known and may be cited as the pharmacy benefits manager registration act.(b) This act shall apply to any pharmacy benefits manager that provides claims processing services, other prescription drug or device services, or both, to covered persons who are residents of this state.(c) This act shall not apply to any pharmacy benefits manager that holds a certificate of registration as an administrator pursuant to K.S.A. 40-3810, and amendments thereto.History: L. 2006, ch. 154, § 1; Apr. 27.
KS Stat § 40-3822 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3822 Same; definitions.

40-3822. Same; definitions. For purposes of this act: (a) "Commissioner" means the commissioner of insurance as defined by K.S.A. 40-102, and amendments thereto.(b) (1) "Covered entity" means:(A) A nonprofit hospital or medical service corporation, health insurer, health benefit plan or health maintenance organization;(B) a health program administered by a department or the state in the capacity of provider of health coverage; or(C) an employer, labor union or other group of persons organized in the state that provides health coverage to covered individuals who are employed or reside in the state.(2) Covered entity shall not include any:(A) Self-funded plan that is exempt from state regulation pursuant to ERISA;(B) plan issued for coverage for federal employees; or(C) health plan that provides coverage only for accidental injury, specified disease, hospital indemnity, medicare supplement, disability income, long-term care or other limited benefit health insurance policies and contracts.(c) "Covered person" means a member, policyholder, subscriber, enrollee, beneficiary, dependent or other individual participating in a health benefit plan.(d) "Pharmacy benefits management" means:(1) Any of the following services provided with regard to the administration of the following pharmacy benefits:(A) Mail service pharmacy;(B) claims processing, retail network management and payment of claims to pharmacies for prescription drugs dispensed to covered individuals;(C) clinical formulary development and management services;(D) rebate contracting and administration;(E) certain patient compliance, therapeutic intervention and generic substitution programs; or(F) disease management programs involving prescription drug utilization; and(2) (A) the procurement of prescription drugs by a prescription benefits manager at a negotiated rate for dispensation to covered individuals within this state; or(B) the administration or management of prescription drug benefits provided by a covered insurance entity for the benefit of covered individuals.(e) "Pharmacy benefits manager" means a person, business or other entity that performs pharmacy benefits management. Pharmacy benefits manager includes any person or entity acting in a contractual or employment relationship for a pharmacy benefits manager in the performance of pharmacy benefits management for a covered entity.The term "pharmacy benefits manager" shall not include a covered insurance entity.(f) "Person" means an individual, partnership, corporation, organization or other business entity.History: L. 2006, ch. 154, § 2; Apr. 27.
KS Stat § 40-3823 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3823 Same; registration.

40-3823. Same; registration. Registration requirement to act as a pharmacy benefits manager.(a) No person shall act or operate as a pharmacy benefits manager without first obtaining a valid certificate of registration issued by the commissioner.(b) Each person seeking a certificate of registration to act as a pharmacy benefits manager shall file with the commissioner an application for a certificate of registration upon a form to be furnished by the commissioner. The application form shall include:(1) The name, address, official position and professional qualifications of each individual who is responsible for the conduct of the affairs of the pharmacy benefits manager, including all members of the board of directors, board of trustees, executive committee, other governing board or committee, the principal officers in the case of a corporation, the partners or members in the case of a partnership or association and any other person who exercises control or influence over the affairs of the pharmacy benefits manager.(2) The name and address of the applicant's agent for service of process in the state.(3) A nonrefundable application fee of $140.History: L. 2006, ch. 154, § 3; Apr. 27.
KS Stat § 40-3824 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3824 Same; fees.

40-3824. Same; fees. (a) Each pharmacy benefits manager registration shall expire on March 31 each year and may be renewed annually on the request of the registrant. The application for renewal shall be submitted on a form furnished by the commissioner and accompanied by a renewal fee of $140. The application for renewal shall be in such form and contain such matters as the commissioner prescribes.(b) If a registration renewal fee is not paid by the prescribed date, the amount of the fee, plus a penalty fee of $140 shall be paid. The pharmacy benefits manager registration may be revoked or suspended by the commissioner until the renewal fee and any penalty assessed has been paid.(c) Any person who performs or is performing any pharmacy benefits management service on the effective date of this act must obtain a certificate of registration as a pharmacy benefits manager from the commissioner within 90 days after the effective date of this act in order to continue to do business in Kansas.History: L. 2006, ch. 154, § 4; Apr. 27.
KS Stat § 40-3825 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3825 Same; rules and regulations.

40-3825. Same; rules and regulations. In accordance with the provisions of the rules and regulations filing act, K.S.A. 77-415 et seq., and amendments thereto, the commissioner may adopt, amend and revoke rules and regulations governing the administration and enforcement of this act, including, but not limited to:(a) The content of the application form;(b) the content of any other form or report required to implement this act; and(c) such other rules and regulations as the commissioner may deem necessary to carry out the provisions of this act.History: L. 2006, ch. 154, § 5; Apr. 27.
KS Stat § 40-3826 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3826 Same; violation; penalty.

40-3826. Same; violation; penalty. Any person who acts as a pharmacy benefits manager without being registered as required by this act shall be subject to a fine of $500 for each violation.History: L. 2006, ch. 154, § 6; Apr. 27.
KS Stat § 40-3827 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3827 Same; pharmacy benefits manager registration fee fund.

40-3827. Same; pharmacy benefits manager registration fee fund. The commissioner shall remit all moneys received by or for the commissioner under the provisions of this act to the state treasurer at least monthly. Upon receipt of each such remittance, the state treasurer shall deposit the entire amount thereof in the state treasury and such amount shall be credited to the pharmacy benefits manager registration fund.History: L. 2006, ch. 154, § 7; Apr. 27.
KS Stat § 40-3828 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3828 Same; severability.

40-3828. Same; severability. If any provision of this act or the application thereof to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of the act which can be given effect without the invalid provision or application, and to this end the provisions of this act are severable.History: L. 2006, ch. 154, § 8; Apr. 27.
KS Stat § 40-3829 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 38 - Regulation And Registration Of Administrators|40-3829 Pharmacy benefits managers; maximum allowable cost pricing; definitions.

40-3829. Pharmacy benefits managers; maximum allowable cost pricing; definitions. As used in this act*:(a) "List" means the list of drugs for which maximum allowable costs have been established;(b) "maximum allowable cost" or "MAC" means the maximum amount that a pharmacy benefits manager will reimburse a pharmacy for the cost of a generic drug;(c) "network pharmacy" means a pharmacy that contracts with a pharmacy benefits manager; and(d) "pharmacy benefits manager" or "PBM" shall have the same meaning as K.S.A. 40-3822(e), and amendments thereto.History: L. 2016, ch. 13, § 1; July 1.