reglab/housing_qa huggingface dataset:
AK Stat § 21.86.900 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 86. Health Maintenance Organizations|Sec. 21.86.900. Definitions.

In this chapter, (1) “affiliation period” means a period of time under a contract with a health maintenance organization (A) that must expire before coverage becomes effective; (B) during which the health maintenance organization is not required to provide health care services or benefits; and (C) for which no premium is charged to the participant or beneficiary for coverage during the period; (2) “agent” means a person who is appointed by a health maintenance organization and who engages in solicitation of membership in the organization; “agent” does not include a person enrolling health maintenance organization members on behalf of an employer, a union, or other organization to whom a master subscriber contract has been issued, or an employee, who is not an independent contractor, of the health maintenance organization; (3) “basic health care services” means emergency care, inpatient hospital and physician care, and outpatient medical services, but does not include mental health services or services for alcohol or drug abuse; (4) “beneficiary” has the meaning given in AS 21.54.500; (5) “enrollee” means an individual who is enrolled in a health maintenance organization; (6) “enrollment date” has the meaning given in AS 21.54.500; (7) “evidence of coverage” means a certificate, agreement, or contract issued to an enrollee, setting out the coverage to which the enrollee is entitled; (8) “group market” has the meaning given in AS 21.54.500; (9) “health care services” means services for medical or dental care, or hospitalization, or services incident to the furnishing of that care or hospitalization, and includes services for the purpose of preventing, alleviating, curing, or healing human illness, injury, or physical disability; (10) “health maintenance organization” means a person that undertakes to provide or arrange for basic health care services to enrollees on a prepaid basis; (11) “health status factor” has the meaning given in AS 21.54.500; (12) “participant” has the meaning given in AS 21.54.500; (13) “person” has the meaning given in AS 01.10.060 and includes a joint venture; (14) “preexisting condition exclusion” has the meaning given in AS 21.54.500; (15) “provider” means a physician, hospital, or other person licensed or otherwise authorized in this state to furnish health care services; (16) “uncovered expenditures” means the costs of health care services that are covered by a health maintenance organization, but for which an enrollee would also be liable if the organization became insolvent; (17) “waiting period” has the meaning given in AS 21.54.500.
AK Stat § 21.87.010 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.010. Applicability.

(a) This chapter applies to every individual, person, firm, corporation, association, or organization of any kind hereafter engaging or purporting to engage in the provision of all or part of a health care service as defined in AS 21.87.330, for its subscribers in exchange for periodic prepayments in identifiable amount by or as to the subscribers. (b) This chapter does not apply to (1) insurers or fraternal benefit societies authorized to transact the kind of insurance involved under other chapters of this title; (2) fraternal and other organizations exempted from AS 21.24; (3) health care services provided by an employer to employees and their dependents, with or without contribution to the costs thereof by the employees, through health care service facilities owned, employed, or controlled by the employers; (4) infrequent instances of prepayment by or for the patient direct to the physician or hospital for specific services thereafter rendered to the patient by the physician or hospital; (5) [Repealed, § 3 ch 13 SLA 2014.]
AK Stat § 21.87.020 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.020. Purpose and interpretation.

(a) It is the purpose of this chapter to regulate in the public interest the formation and operation of prepaid health care service organizations, in order that the services may be made available upon a basis of fair and equitable contracts through state-licensed nonprofit organizations meeting reasonable standards as to administration, reserves, and financial soundness. (b) This chapter shall be liberally interpreted to effectuate the purpose declared in (a) of this section.
AK Stat § 21.87.030 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.030. Provisions exclusive.

A provision of this title does not apply to a health care service corporation unless contained or referred to in this chapter.
AK Stat § 21.87.040 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.040. Incorporation and certificate of authority required.

A person otherwise subject to this chapter may not engage or purport to engage in the provision of any part or all of a health care service for its subscribers in exchange for periodic prepayments in identifiable amount unless it is a service corporation incorporated under the laws of this state, and currently authorized as such a service corporation under a certificate of authority issued by the director under this chapter.
AK Stat § 21.87.050 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.050. Incorporation, approval of articles and amendments.

(a) A service corporation shall be formed as a nonprofit, nonstock medical service corporation, or hospital service corporation, or a combination medical and hospital service corporation, consistent with the applicable requirements of this chapter under the statutes of this state governing the formation of nonprofit, nonstock corporations in general. (b) Before the articles of incorporation of the proposed corporation formed after July 1, 1966, are filed with the commissioner of commerce, community, and economic development, they shall be submitted to the director, and the commissioner may not file the articles unless the director's approval is endorsed thereon. The director shall approve the articles unless the director finds that they do not comply with law. If not approved, the director shall return the proposed articles of incorporation to the incorporators together with a written statement of particulars of the reasons for nonapproval. (c) An amendment of the articles of incorporation of a service corporation may not be filed with the commissioner unless it is first submitted to and approved by the director, and bears the director's approval endorsed on it. The director shall approve the amendment unless the director finds that it was not lawfully adopted or that the articles of incorporation as amended would be unlawful. If not approved, the director shall return the proposed amendment to the corporation together with a written statement of the particulars of the reasons for nonapproval.
AK Stat § 21.87.060 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.060. Name of corporation.

A service corporation may not have or use a corporate or business name that includes the words “insurance,” “casualty,” “surety,” “health and accident,” “mutual,” or other terms descriptive of an insurer or insurance business. A service corporation may not have or use a name so similar to that of another corporation transacting business in this state when the service corporation was formed that it would tend to confuse or mislead the public.
AK Stat § 21.87.070 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.070. Qualifications for certificate of authority.

The director may not issue or permit to exist a certificate of authority to be or act as a service corporation to a corporation that does not fulfill the following qualifications: (1) it must be incorporated as provided in AS 21.87.050, as either a medical service corporation, or as a hospital service corporation, or as a combined medical and hospital service corporation; (2) it must intend to and actually conduct its business in good faith as a nonprofit corporation; (3) if a hospital service corporation, it must have in force at all times while so authorized, service agreements with participant hospitals located in the areas of the subscribers' residences, convenient as to location and sufficient as to capacity and facilities reasonably to furnish the hospital services provided or proposed to be provided by the corporation to its subscribers; (4) if a medical service corporation, it must have in force service agreements with participant providers located in the areas of the subscribers' residences convenient as to location and sufficient in numbers and facilities reasonably to furnish the medical and surgical services provided or proposed to be provided by the corporation to its subscribers; (5) if a newly formed corporation, it must possess sufficient available working funds to pay all reasonably anticipated cost of acquisition of new business and operating expenses, other than payment for hospital or medical services, for a period of not less than the six months following the date of issuance of the certificate of authority, if issued, or $100,000, whichever amount is greater; (6) it must fulfill all other applicable requirements of this chapter.
AK Stat § 21.87.080 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.080. Application for certificate of authority.

(a) Application for a certificate of authority to transact business as a service corporation shall be made to the director, on forms as prepared and furnished by the director and requiring the information relative to the applicant, its directors, officers, and affairs as the director may reasonably require consistent with this chapter. (b) The application shall be accompanied by the following documents that are not already on file with the director: (1) one copy of the applicant's articles of incorporation and of all amendments, certified by the commissioner; (2) one copy of the applicant's bylaws, certified by its corporate secretary; (3) if a medical service corporation, a copy of each form of service agreement entered into or proposed to be entered into with participant providers, together with a list showing the name, residence and office addresses, and date of execution of the service agreement by each participant provider; (4) if a hospital service corporation, a copy of each service agreement entered into with participant hospitals certified by the applicant's corporate secretary; (5) a copy of each form of subscribers' contract proposed to be offered; (6) a schedule of the rates proposed to be charged subscribers; (7) a financial statement of the applicant as of a date not more than 30 days before the filing of the application, showing among other things the amount of working funds available to the applicant, the source of the funds, and accompanied by a copy of the agreement under which the funds were contributed to or provided for the applicant; (8) a copy of any other relevant document reasonably requested by the director. (c) At the time of filing the application the applicant shall pay to the director an application fee and a fee for issuance of the certificate of authority set under AS 21.06.250.
AK Stat § 21.87.090 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.090. Issuance or refusal of certificate of authority.

(a) If, after the application for certificate of authority is completed, the director finds that the applicant is fully qualified for a certificate of authority in accordance with this chapter, and that the service agreements, subscribers contracts, schedule of rates are in compliance with the applicable provisions of this chapter, the director shall issue to the applicant a certificate of authority as a medical service corporation or as a hospital service corporation, or as a combined medical and hospital service corporation, as the case may be. (b) If the director does not so find, the director shall refuse to issue a certificate of authority and shall give the applicant written notice setting out the particulars of the reasons for the refusal, accompanied by return of the fee tendered for issuance of the certificate of authority. (c) The director shall either issue or refuse to issue the certificate of authority within a reasonable time after the filing and completion of application.
AK Stat § 21.87.100 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.100. Continuance or expiration of certificate of authority.

(a) A certificate of authority issued to a service corporation shall continue in force as long as the corporation is entitled to it under this chapter, and until suspended or revoked by the director or terminated at the request of the corporation; subject, however, to continuance of the certificate by the corporation each year by (1) payment, before June 30, of the continuation fee set under AS 21.06.250; (2) filing by the insurer of its annual statement for the preceding calendar year as required under AS 21.87.240. (b) If not continued by the service corporation, its certificate of authority shall expire at midnight on the June 30 following the failure of the insurer to continue it in force. The director shall promptly notify the insurer of the occurrence of a failure resulting in impending expiration of its certificate of authority.
AK Stat § 21.87.110 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.110. Suspension or revocation of certificate of authority.

(a) The director shall suspend or revoke the certificate of authority of a service corporation that the director finds, after a hearing, is no longer qualified under this chapter. (b) The director may after a hearing, suspend or revoke the certificate of authority for a violation by the service corporation of a provision of this chapter for which mandatory suspension or revocation is not required under (a) of this section, or on an applicable ground set out in AS 21.09.140 and 21.09.150. (c) A service corporation may not, while its certificate of authority is suspended or revoked, transact business as a service corporation other than that necessary and incidental to the discharge of its contracts and agreements outstanding on the day the suspension or revocation became effective. The corporation may not, after the revocation of its certificate of authority, solicit or issue new subscriber's contracts.
AK Stat § 21.87.120 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.120. Services and benefits that may be provided by medical service corporations.

(a) A medical service corporation shall have the right to provide to its subscribers part or all of the following services and benefits only: (1) medical and surgical services furnished to the subscriber by participant providers; (2) indemnity in reasonable amount with respect to medical and surgical services furnished to the subscriber by nonparticipant providers, but subject to AS 21.87.070(4); (3) indemnity in reasonable amount with respect to hospital services furnished the subscriber while under the care and treatment of a participant provider or under the care and treatment of another provider upon referral by a participant provider; (4) indemnity in reasonable amount with respect to appliances, prosthetics, and similar devices and replacements, and ambulance, x-ray, physiotherapy, and similar services. (b) This section does not prohibit the corporation from acting as compensated servicing agent as to health care services to be provided by a public agency, or under agreements between other parties not solicited by the corporation.
AK Stat § 21.87.130 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.130. Services and benefits that may be provided by hospital service corporations.

(a) A hospital service corporation shall have the right to provide to its subscribers part or all of the following services and benefits only: (1) hospital services furnished to the subscriber by participant hospitals; (2) indemnity in a reasonable amount with respect to hospital services furnished to the subscriber by nonparticipant hospitals, but subject to AS 21.87.070(3); (3) indemnity in a reasonable amount for other health care services, as defined in AS 21.87.330. (b) This section does not prohibit the corporation from acting as compensated servicing agent as to health care services to be provided by a public agency, or under agreements between other parties not solicited by the corporation.
AK Stat § 21.87.140 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.140. Medical service agreements.

(a) A medical service corporation shall enter into service agreements with providers licensed by the state only. (b) Each service agreement shall require the participant providers to furnish to subscribers of the service corporation the medical or surgical services, or both, that are, under the subscriber's contract, to be furnished by participant providers. This obligation to furnish the service, as provided for in the subscriber's contract, shall be a direct obligation of the participant providers to the subscribers as well as to the service corporation. (c) Each service agreement shall further effectively provide in substance that (1) the participant provider shall be compensated for services rendered to a subscriber in accordance with terms contained in the agreement or attached to and made a part of the agreement and that the participant provider may not request or receive from the service corporation compensation for the services that is not in accord with the terms; (2) compensation for services may be prorated and settled under the circumstances and in the manner referred to in AS 21.87.300; (3) if the participant provider withdraws from the agreement, the withdrawal may not be effective as to a subscriber's contract in force on the date of the withdrawal until the termination of the subscriber's contract or the next anniversary of the subscriber's contract, whichever date is the earlier. (d) The proposed form of the service agreement shall be filed with the director and is subject to the approval of the director under AS 21.87.180.
AK Stat § 21.87.150 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.150. Hospital service agreements.

(a) A hospital service corporation shall enter into service agreements with hospitals approved or licensed by the state only. (b) Each service agreement must require the participant hospital to furnish to subscribers of the service corporation the hospital services that are, under the subscriber's contract, to be furnished by participant hospitals; and this obligation to furnish the service, as provided for in the subscriber's contract, shall be a direct obligation of the participant hospitals to the subscribers as well as to the service corporation. (c) Each service agreement must further effectively in substance provide that (1) the participant hospitals shall be compensated for services rendered to a subscriber in accordance with terms contained in the agreement or attached to and made a part of the agreement and that the hospital may not request or receive from the service corporation compensation for the services that is not in accord with the terms; (2) compensation for services may be prorated and settled under the circumstances and in the manner referred to in AS 21.87.300; (3) if the participant hospital withdraws from the agreement, the withdrawal may not be effective as to a subscriber's contract in force on the date of the withdrawal until the termination of the subscriber's contract or the next anniversary of the subscriber's contract, whichever date is the earlier. (d) The service corporation shall terminate the service agreement of a particular participant hospital, in addition to other bases of termination provided for in the agreement, if it is determined that the hospital has knowingly charged or attempted to charge the service corporation for a service not actually rendered, or has knowingly violated a material provision of the service agreement. (e) The proposed form of a service agreement and of the standard riders and endorsements to it shall be filed with the director and are subject to the approval of the director under AS 21.87.180.
AK Stat § 21.87.160 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.160. Subscriber's contracts.

(a) Each subscriber's contract issued after July 1, 1966, by a service corporation constitutes a direct obligation of the participant providers or participant hospitals of the service corporation to render the medical or hospital services, as the case may be, as agreed to be rendered by the participants in the subscriber's contract. (b) Each subscriber's contract or certificate must in adequate detail set out provisions from which can be readily determined (1) the services to which the subscriber is entitled from participant providers or participant hospitals, as the case may be; (2) the benefits, if any, to which the subscriber is entitled on an indemnity basis, consistent with AS 21.87.120, 21.87.130 and the other provisions of this chapter; (3) the periodic subscription charge, rate, or fee payable by or to the subscriber; or, if not so expressed and the charge, rate, or fee is subject to change, the subscriber's contract must require that not less than 30 days' written notice of the new charge, rate, or fee shall be given to the subscriber or the remitting agent of the subscriber before the change is effective; (4) the date when the respective services and benefits become available to the subscriber, date of expiration of the contract, and the terms, if any, under which the contract may be continued or renewed; (5) all other terms and conditions of the agreement between the parties consistent with this chapter; (6) that the subscriber's contract and riders and endorsements thereon or thereto, together with application therefor, if any, signed by the subscriber, and identification issued to the subscriber, constitutes the entire contract between the parties. (c) A contract may not restrict the subscriber's right to free choice of provider or hospital, but must restrict benefits to be provided on a service basis to services rendered by participant providers and participant hospitals. (d) All exceptions and exclusions in the contract shall be printed and otherwise set out as prominently as the services or benefits to which they apply. (e) This title may not be construed to prohibit a service corporation from issuing contracts to groups of persons under a master contract. In this event, however, each subscriber covered under the master contract shall be issued an individual certificate that shall set out in adequate detail the provisions itemized in (b) of this section. (f) All proposed forms of subscriber's contracts shall be filed with the director and are subject to the approval of the director under AS 21.87.180.
AK Stat § 21.87.170 (2021)
2021 Alaska Statutes|Title 21. Insurance|Chapter 87. Hospital and Medical Service Corporations|Sec. 21.87.170. Minimum service benefits.

(a) Each service agreement and subscriber's contract entered into or issued by a service corporation must provide for health care services of a substantial and broad character to be rendered to subscribers on a service basis by participant providers or participant hospitals. (b) The director may, after a hearing, by regulation establish certain minimums of service benefits to be provided consistent with (a) of this section.