reglab/housing_qa huggingface dataset:
GA Code § 33-20-9 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-9. Certificate of Authority Issuance

  The Commissioner shall be authorized to issue a certificate of authority in accordance with this chapter and other proper requirements of the Commissioner if the Commissioner is satisfied that:   All items required to be filed are in proper form and meet his approval;   The applicant is established as a bona fide health care corporation;   The services rendered by the corporation are not an unnecessary duplication of similar services in the community served and are desirable for the public necessity and convenience;   The applicant's proposed methods of solicitation of contracts and its proposed conditions or methods of operation appear to be fair and reasonable;   The method of establishing rates charged is fair, reasonable, and adequate and the benefits to be provided are fair and reasonable, provided that rates established in accordance with the applicable provisions of this chapter and Chapter 24 of this title may differ for separate services or classes or kinds of service, including service in different facilities, and between subscribers in different groups if based upon the experience of the group or locality and between subscribers in groups and individual subscribers not in groups; and   The amount provided as working capital is only provided by individuals or groups which have no financial interest in the activities of the health care corporation. Interest charged for working capital, if any, shall be reasonable, shall be subject to the general laws of this state governing permissible rates of interest, and shall be approved by the Commissioner; and payment of interest, if any, and repayment of such working capital shall be permitted only after provision has been adequately made for operating expenses, payments of benefits, and the establishment of required services.     On an application for an original certificate of authority, the Commissioner may, in his discretion, consider and rely upon recommendations of the medical societies, the hospitals, or any other persons in the areas in which the health care corporation proposes to operate.    (Code 1933, § 56-1719a, enacted by Ga. L. 1976, p. 1461, § 1.)
GA Code § 33-20-10 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-10. Expiration, Renewal, and Amendment of Certificate of Authority

  All certificates of authority shall expire at 12:00 Midnight on June 30 following the date of issuance or renewal. A health care corporation desiring renewal shall file on March 1 preceding expiration a copy of its annual statement as of December 31 of the preceding year in a form approved for current use by the Commissioner, provided that the Commissioner may for good cause grant an extension of time for filing such annual statement not to exceed 60 days. If the health care corporation qualifies therefor its certificate shall be renewed annually; provided, however, that any certificate of authority shall continue in full force and effect until the new certificate is issued or specifically refused.   The Commissioner may amend a certificate of authority at any time to accord with changes in the health care corporation's charter or powers.    (Code 1933, § 56-1722a, enacted by Ga. L. 1976, p. 1461, § 1.)
GA Code § 33-20-11 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-11. Refusal, Revocation, or Suspension of Certificate of Authority Generally

 The Commissioner may refuse to issue, or after a hearing refuse to renew, or revoke or suspend a health care corporation's certificate of authority in addition to other grounds provided for in this title if the corporation:    Violates any provision of this title other than the provisions of Code Section 33-20-12 as to which refusal, suspension, or revocation is mandatory;   Knowingly fails to comply with any lawful rule, regulation, or order of the Commissioner;   Is found by the Commissioner to be in unsound condition or in such condition as to render its further transaction of business in this state hazardous to its subscribers or to the public;   As a general scheme or plot, without just cause compels claimants to accept less than the amount due them or to bring action against it to secure full payment of claims;   Refuses to be examined or to produce its accounts, records, and files for examination by the Commissioner when required or refuses to furnish such other additional information as the Commissioner may deem advisable to consider the application for renewal of the corporation's certificate of authority;   Fails to pay any final judgment rendered against it in this state within 30 days after the judgment becomes final; or   Is affiliated with and under the same general management or interlocking directorate or ownership as another insurer or person which transacts direct insurance or other business in this state without having a certificate of authority or otherwise being authorized to do so, except as permitted under Chapter 5 of this title.    (Code 1933, § 56-1724a, enacted by Ga. L. 1976, p. 1461, § 1.)
GA Code § 33-20-12 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-12. Mandatory Refusal, Revocation, or Suspension

 The Commissioner shall refuse to issue or to renew or shall revoke or suspend a health care corporation's certificate of authority:    If such action is required by any provision of this title; or   If the health care corporation no longer meets the requirements for the authority originally granted on account of deficiency in assets or otherwise.    (Code 1933, § 56-1723a, enacted by Ga. L. 1976, p. 1461, § 1.)
GA Code § 33-20-13 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-13. Management of Corporations; General Powers; Requirements as to Reserves, Minimum Subscriber's Surpluses, and Charges

  Health care corporations shall be governed and conducted as corporations and the necessary expenses of administering the affairs of the corporations may be paid from the payments collected from subscribers.   A health care corporation may in its discretion limit the benefits that it will furnish, may divide such benefits as it elects to furnish into classes or kinds, and may furnish different benefits with different kinds or classes of contracts. A health care corporation may also select the hospitals and other participating facilities with which it shall contract and may establish its own standards for approval of such facilities or classes of facilities as it shall determine appropriate, as well as levels of payment which may differ between participating and nonparticipating facilities and different classes of facilities, provided that the contracts shall be fair and reasonable and the standards and levels of payment shall be fair and reasonable and shall not be unfairly discriminatory against any persons or facilities or classes of persons or facilities.   A health care corporation shall establish and maintain at all times proper reserves subject to the approval of the Commissioner in accordance with such standards and requirements as the Commissioner may establish by rule or regulation after any notice and hearing required for unearned subscription fees, for unpaid claims, for unreported claims, and for other known liabilities.   A health care corporation shall at all times maintain a minimum subscriber's surplus of not less than $1 million or such higher amount as the Commissioner may require by rule or regulation after any required notice and hearing for the protection of the subscribers.   A health care corporation shall be required to charge a minimum of one-half of 1 percent of income at risk on all accounts as a contribution towards subscriber's surplus and such funds derived therefrom shall be contributed to such health care corporation's subscriber's surplus under such terms and conditions as the Commissioner may reasonably require by order or regulation after any required notice and hearing, provided that, if the Commissioner determines after notice and hearing that the level of accumulated subscriber's surplus for a health care corporation is in excess of that reasonably required for the protection of the corporation's subscribers, the Commissioner shall have the authority to suspend the operation of this subsection until such time as the corporation's accumulated subscriber's surplus has returned to a level which is adequate for the protection of policyholders but not excessive.    (Code 1933, § 56-1706a, enacted by Ga. L. 1976, p. 1461, § 1; Ga. L. 1982, p. 3, § 33; Ga. L. 1995, p. 745, § 1.6.)
GA Code § 33-20-14 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-14. Acceptance of Applications

 When organized, health care corporations shall be authorized to accept applicants individually or in groups who may become subscribers of the corporation furnishing health care services under a contract which shall entitle each subscriber, beneficiary, and covered dependent to the health care services for such period of time as is provided in the contract.   (Code 1933, § 56-1709a, enacted by Ga. L. 1976, p. 1461, § 1.)
GA Code § 33-20-15 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-15. Issuance and Contents of Membership Certificates

  Every health care corporation shall issue to its subscribers a membership certificate which shall describe the health care plan under which the subscriber is enrolled and shall specify how the holder of such contract may obtain the name or names and addresses of participating providers of health care services upon whom the subscriber shall have the right to call for health care services and the nature of such services. The description in the membership certificate shall be consistent with this chapter and the purposes thereof.   The form, size of type, general arrangement, and contents of the membership certificate shall be subject to the approval of the Commissioner and shall be filed with and approved by him in accordance with Chapter 24 of this title and such rules, regulations, and procedures as the Commissioner may from time to time prescribe.    (Code 1933, § 56-1710a, enacted by Ga. L. 1976, p. 1461, § 1.)   Cross references.   - Provisions of accident and sickness insurance policies generally, § 33-24-20 et seq.
GA Code § 33-20-16 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-16. Right to Become Participating Physician or Approved Health Care Provider

 Every doctor of medicine, every doctor of dental surgery, every podiatrist, and every health care provider within a class approved by the health care corporation who is appropriately licensed to practice and who is reputable and in good standing shall have the right to become a participating physician or approved health care provider for medical or surgical care, or both, as the case may be, under such terms or conditions as are imposed on other participating physicians or approved health care providers within such approved class under similar circumstances in accordance with this chapter.   (Code 1933, § 56-1712a, enacted by Ga. L. 1976, p. 1461, § 1.)   Law reviews.   - For annual survey on administrative law, see 61 Mercer L. Rev. 1 (2009).   JUDICIAL DECISIONS    "Any Willing Provider" (AWP) statute did not apply to a health maintenance organization (HMO) because: (1) the statute did not apply to for-profit corporations not statutorily defined as "surviving corporations," and (2) the HMO had never been an O.C.G.A. T. 33, Ch. 20 health care corporation, nor was the HMO an insurer's subsidiary any longer, so the HMO was not a surviving corporation, and O.C.G.A. § 33-21-28(a) barred applying the AWP statute to the HMO. Northeast Ga. Cancer Care, LLC v. Blue Cross & Blue Shield of Ga., Inc., 315 Ga. App. 521, 726 S.E.2d 714 (2012), cert. denied, No. S12C1322, 2012 Ga. LEXIS 1018 (Ga. 2012), cert. denied, No. S12C1413, 2012 Ga. LEXIS 1033 (Ga. 2012).   Exhaustion of remedies required.    - Medical group's suit for a declaratory judgment as to the group's rights to participate in a health maintenance organization under Georgia's Any Willing Provider Statute, O.C.G.A. § 33-20-16, was procedurally barred by the failure to exhaust administrative remedies by first submitting the group's dispute to the Georgia Insurance Commissioner pursuant to O.C.G.A. § 33-20-30. Northeast Ga. Cancer Care, LLC v. Blue Cross & Blue Shield of Ga., Inc., 297 Ga. App. 28, 676 S.E.2d 428 (2009), cert. denied, No. S09C1241, 2009 Ga. LEXIS 805 (Ga. 2009).    "Any Willing Provider" (AWP) statute applied to a health insurer's preferred provider (PPO) network because: (1) the insurer was an O.C.G.A. T. 33, Ch. 20 health care corporation; (2) the AWP statute expressly applied to health care corporations; and (3) the AWP statute applied to the PPO network since the insurer, under the Preferred Provider Arrangements Act, O.C.G.A. § 33-30-20 et seq., could administer a preferred provider arrangement which was a health benefit plan. Northeast Ga. Cancer Care, LLC v. Blue Cross & Blue Shield of Ga., Inc., 315 Ga. App. 521, 726 S.E.2d 714 (2012), cert. denied, No. S12C1322, 2012 Ga. LEXIS 1018 (Ga. 2012), cert. denied, No. S12C1413, 2012 Ga. LEXIS 1033 (Ga. 2012).
GA Code § 33-20-17 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-17. Powers of Corporations to Contract for Provision of Health Care Services; Receipt of Payments

  Any health care corporation organized or operated under this chapter and engaged in the operation of a health care plan may contract with any agency, instrumentality, or political subdivision of the United States of America or of this state for the furnishing of health care services and in aid or furtherance of said contract, may accept, receive, and administer in trust funds directly or indirectly made available by the agency, instrumentality, or political subdivision and, further, any health care corporation may subcontract with any organization which has contracted with any agency, instrumentality, or political subdivision of the United States of America or of this state for the furnishing of medical, hospital, and other health care services, by which subcontract the health care corporation undertakes to furnish the services required by the basic contract.   A health care corporation may enter into contracts with a corporation or association in this state or elsewhere so that reciprocity of benefits may be provided to subscribers; transfer of subscribers from one corporation to another may be effected to conform to the subscriber's place of residence; uniform benefits may be provided for all or for separate categories of employees and the dependents of such employees of corporations and other organizations transacting business in this state or elsewhere and a composite rate, that is, a rate representing the composite experience of the areas involved, may be charged for such employees and their dependents; or hospital or other health care services may be provided for subscribers of the corporation or other corporations or associations by means of risk sharing and other joint undertakings, including reinsurance, which the directors of the corporation may from time to time approve in accordance with the laws of this state. Group master contracts and the contracts issued to subscribers by a corporation subject to this chapter may specify the circumstances under which payments will be made and the rates of such payment to hospitals or other health care providers, wherever located, with which the corporation has no contract for hospital service or other health care service furnished the subscribers and other beneficiaries under the contract.   Each health care corporation may in its discretion receive and accept from governmental agencies payment covering all or part of the cost to provide health care services for needy or other persons. Each health care corporation may in its discretion receive and accept payments from private agencies, corporations, associations, groups of individuals, or others covering all or part of the cost of subscriptions to provide health care service for needy and other persons.    (Code 1933, § 56-1707a, enacted by Ga. L. 1976, p. 1461, § 1; Ga. L. 1982, p. 3, § 33.)
GA Code § 33-20-18 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-18. Sale of Contracts Providing for Payment of Specified Charges Made by Participating Physicians; Right of Subscribers to Select Physicians; Liability of Corporations for Negligence of Physicians

  Health care corporations shall have the right to sell contracts providing for the payment of specified charges made by participating physicians furnishing medical or surgical care, or both, to the holders of such contracts, their beneficiaries, and covered dependents as provided for in this Code section.   The contracts shall not in any manner restrict the right of the holder to obtain the services of any physician nor shall such contracts attempt to control the relationship existing between any holder or beneficiary of any such contract and his physician.   The private physician-patient relationship shall be maintained, and a subscriber shall at all times have free choice of any physician or of any health care provider or facility within a class approved by the corporation in accordance with this chapter; provided, however, that nothing contained in this Code section shall be deemed to prohibit the use of either a group of participating physicians or approved health care providers and representatives of approved facilities which have been approved by the medical societies in the county or counties in which corporations operate to review charges made by physicians or other providers of health care services participating in the plan so as to ensure that the charges do not exceed the usual, customary, and reasonable charges made by other physicians or other providers of health care services for similar services and that such services are necessary and do not involve unnecessary utilization of services or facilities.   No provision of this chapter shall be construed as authorizing the corporate practice of medicine; and health care corporations shall not practice medicine. No physician rendering service or called on to render service to a member, beneficiary, or covered dependent and no other provider of health care services shall be construed to be an agent or employee of such corporation; and such corporation shall not be liable for the negligence, misfeasance, malfeasance, or nonfeasance of any provider of health care services or of any physician rendering medical or surgical services to any member, beneficiary, or covered dependent.    (Code 1933, § 56-1711a, enacted by Ga. L. 1976, p. 1461, § 1; Ga. L. 2000, p. 136, § 33.)   RESEARCH REFERENCES   ALR.    - Health service plan as violation of medical practice acts, 119 A.L.R. 1290.
GA Code § 33-20-19 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-19. Regulation and Supervision of Corporations by Commissioner Generally; Payment of Fees and Taxes by Corporations Generally

 Health care corporations shall be subject to regulation and supervision by the Commissioner and shall be required to pay any fees and taxes, including premium taxes, as are now or may hereafter be required of life insurers under this title in accordance with Chapters 2, 3, 8, and 12 of this title and the other applicable provisions of this title.   (Code 1933, § 56-1715a, enacted by Ga. L. 1976, p. 1461, § 1.)
GA Code § 33-20-20 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-20. Submission to Commissioner of Operating Plan, Schedule of Rates, and Amount of Service; Approval by Commissioner

 Except for corporations subject to this chapter which are surviving corporations, health care corporations shall before accepting applications from subscribers in a nonprofit health care plan submit to the Commissioner a plan of operating and overhead expenses, operation cost, and salaries paid or to be paid during any current year together with a schedule of its rates to be charged and the amount of health care service contracted to be rendered, which plan, rates, and amount of service shall be first approved by the Commissioner as fair and reasonable before the corporation shall engage in business.   (Code 1933, § 56-1716a, enacted by Ga. L. 1976, p. 1461, § 1; Ga. L. 1995, p. 745, § 1.7.)
GA Code § 33-20-21 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-21. Approval of Commissioner of Rates to Be Paid to Providers of Services

 Except for corporations subject to this chapter which are surviving corporations, the Commissioner shall first approve the rates of payment to be made by health care corporations to providers of health care services on behalf of said corporation, its subscribers, beneficiaries, and covered dependents as being fair and reasonable before said corporation shall engage in business.   (Code 1933, § 56-1717a, enacted by Ga. L. 1976, p. 1461, § 1; Ga. L. 1995, p. 745, § 1.8.)
GA Code § 33-20-22 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-22. Investment of Funds of Corporations

 Health care corporations shall invest in or lend their funds on security of and shall hold as invested assets only such assets as are authorized by Articles 1 and 3 of Chapter 11 of this title for the investments of assets of domestic insurance companies and such investments shall be subject to the same requirements, conditions, restrictions, and limitations as are applicable to the investments by such insurers.   (Code 1933, § 56-1714a, enacted by Ga. L. 1976, p. 1461, § 1; Ga. L. 1999, p. 592, § 16.)
GA Code § 33-20-23 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-23. Maintenance of Books and Records Showing Funds Collected and Disbursed; Examination of Books and Records by Commissioner

 Every health care corporation shall keep complete books and records in accordance with the requirements of the Commissioner showing all funds collected and disbursed. All books and records shall be subject to examination by the Commissioner in accordance with Chapter 2 of this title applicable to life insurers and the expenses of the examination borne by said corporation.   (Code 1933, § 56-1720a, enacted by Ga. L. 1976, p. 1461, § 1.)
GA Code § 33-20-24 (2021)
2021 Georgia Code|Title 33 - Insurance|Chapter 20 - Health Care Plans|§ 33-20-24. Filing of Reports With Commissioner

 Every health care corporation shall on or before March 1 in each year after it shall have commenced to do business pursuant to a certificate of authority make and file with the Commissioner a report of its affairs and operations during the year ending December 31 of the preceding year. The annual report shall be made in such form and contain such information as the Commissioner may by regulation from time to time prescribe and require in protecting the public interest and the interest of the subscribers of any health care corporation. The Commissioner may by regulation require such additional periodic reports as he may from time to time prescribe as necessary or appropriate to protect the policyholders and the public and to ensure the solvency of any health care corporation. The Commissioner may require that the reports be verified under oath by such appropriate officers or agents as he may designate by regulation and may require the reports to be published. Compliance with this Code section shall be a condition to the renewal of a certificate of authority under Code Section 33-20-10.   (Code 1933, § 56-1721a, enacted by Ga. L. 1976, p. 1461, § 1.)