reglab/housing_qa huggingface dataset:
HI Rev Stat § 432E-38 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432E. Patients' Bill of Rights and Responsibilities Act|432E-38 Approval of independent review organizations.

  §432E-38 Approval of independent review organizations. (a) An independent review organization shall be approved by the commissioner in order to be eligible to be assigned to conduct external reviews under this part.  (b) To be eligible for approval by the commissioner to conduct external reviews under this part an independent review organization shall:  (1) Submit an application on a form required by the commissioner and include all documentation and information necessary for the commissioner to determine if the independent review organization satisfies the minimum qualifications established under this part; and  (2) Except as otherwise provided in subsection (c), shall be accredited by a nationally-recognized private accrediting entity that the commissioner has determined has independent review organization accreditation standards that are equivalent to or exceed the minimum standards established by this section and section 432E-39.  (c) The commissioner may approve independent review organizations that are not accredited by a nationally-recognized private accrediting entity if there are no acceptable nationally-recognized private accrediting entities providing independent review organization accreditation.  (d) The commissioner may charge an application fee that the independent review organizations shall submit to the commissioner with an application for approval and re-approval.  (e) Approval pursuant to this section is effective for two years, unless the commissioner determines before its expiration that the independent review organization does not meet the minimum qualifications established under this part. If the commissioner determines that an independent review organization has lost its accreditation or no longer satisfies the minimum requirements of this part, the commissioner shall terminate the approval of the independent review organization and remove the independent review organization from the list of independent review organizations approved to conduct external reviews maintained by the commissioner.  (f) The commissioner shall maintain and periodically update a list of approved independent review organizations. [L 2011, c 230, pt of §2]
HI Rev Stat § 432E-40 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432E. Patients' Bill of Rights and Responsibilities Act|432E-40 Hold harmless for independent review organizations.

  §432E-40 Hold harmless for independent review organizations. No independent review organization or clinical reviewer working on behalf of an independent review organization or an employee, agent, or contractor of an independent review organization shall be liable in damages to any person for any opinions rendered or acts or omissions performed within the scope of the organization's or person's duties under the law during or upon completion of an external review conducted pursuant to this part, unless the opinion was rendered or the act or omission was performed in bad faith or involved gross negligence. [L 2011, c 230, pt of §2]
HI Rev Stat § 432E-41 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432E. Patients' Bill of Rights and Responsibilities Act|432E-41 External review reporting requirements.

  §432E-41 External review reporting requirements. (a) An independent review organization assigned pursuant to this part to conduct an external review shall maintain written records in the aggregate by state and by health carrier on all requests for external review for which it conducted an external review during a calendar year and upon request shall submit a report to the commissioner, as required under subsection (b).  (b) Each independent review organization required to maintain written records on all requests for external review pursuant to subsection (a) for which it was assigned to conduct an external review shall submit to the commissioner, upon request, a report in the format specified by the commissioner. The report shall include in the aggregate by state, and for each health carrier:  (1) The total number of requests for external review;  (2) The number of requests for external review resolved and, of those resolved, the number resolved upholding the adverse action and the number resolved reversing the adverse action;  (3) The average length of time for resolution;  (4) The summary of the types of coverages or cases for which an external review was sought, as provided in the format required by the commissioner;  (5) The number of external reviews that were terminated as the result of a reconsideration by the health carrier of its adverse action after the receipt of additional information from the enrollee or the enrollee's appointed representative; and  (6) Any other information the commissioner may request or require.  The independent review organization shall retain the written records required pursuant to this subsection for at least three years.  (c) Each health carrier shall maintain written records in the aggregate, by state and for each type of health benefit plan offered by the health carrier on all requests for external review that the health carrier receives notice of from the commissioner pursuant to this part.  Each health carrier required to maintain written records on all requests for external review shall submit to the commissioner, upon request, a report in the format specified by the commissioner that includes in the aggregate, by state, and by type of health benefit plan:  (1) The total number of requests for external review;  (2) From the total number of requests for external review reported, the number of requests determined eligible for a full external review; and  (3) Any other information the commissioner may request or require.  The health carrier shall retain the written records required pursuant to this subsection for at least three years. [L 2011, c 230, pt of §2]
HI Rev Stat § 432E-42 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432E. Patients' Bill of Rights and Responsibilities Act|432E-42 Funding of external review.

  §432E-42 Funding of external review. The health carrier against which a request for a standard external review or an expedited external review is filed shall pay the cost of the independent review organization for conducting the external review. There shall be no recourse against the commissioner for the cost of conducting the external review and the selection of an independent review organization shall not be subject to chapter 103D; provided that the commissioner may initially approve up to three independent review organizations to serve beginning on the effective date of this part until the initial procurement process is completed; provided further that in any year in which procurement subject to chapter 103D does not produce at least three independent review organizations eligible for selection under section 432E-39, the commissioner may approve up to three independent review organizations notwithstanding the requirements of chapter 103D. [L 2011, c 230, pt of §2] Note  For "effective date of this part", referred to in second sentence, see L 2011, c 230, §17.
HI Rev Stat § 432E-44 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432E. Patients' Bill of Rights and Responsibilities Act|432E-44 Rules.

  §432E-44 Rules. The insurance commissioner shall adopt rules pursuant to chapter 91 to effectuate the purpose of this part including requirements for forms to request external review and expedited external review, to request approval by independent review organizations, and for disclosure of conflicts of interest by enrollees and health carriers. [L 2011, c 230, pt of §2]
HI Rev Stat § 432G-3 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432G. Dental Insurers|432G-3 Fiduciary responsibilities.

 §432G-3 Fiduciary responsibilities. (a) Any director, officer, employee, or partner of a dental insurer who receives, collects, disburses, or invests funds in connection with the activities of an organization shall be responsible for the funds in a fiduciary relationship to the organization.  (b) A dental insurer shall maintain in force a fidelity bond or fidelity insurance on employees, officers, directors, and partners subject to subsection (a) in an amount not less than $250,000 for each dental insurer or a maximum of $5,000,000 in aggregate maintained on behalf of dental insurers owned by a common parent corporation, or a sum as may be prescribed by the commissioner. [L 2013, c 191, pt of §1]
HI Rev Stat § 432G-4 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432G. Dental Insurers|432G-4 Annual reports.

 §432G-4 Annual reports. (a) Each dental insurer shall file with the commissioner:  (1) An audit, by an independent certified public accountant or an accounting firm designated by the dental insurer of the financial statements, reporting the financial condition and results of operations of the dental insurer, annually on or before June 1, or a later date as the commissioner upon request or for cause may specify. The dental insurer, on an annual basis and prior to the commencement of the audit, shall notify the commissioner in writing of the name and address of the person or firm retained to conduct the annual audit. The commissioner may disapprove the dental insurer's designation within fifteen days of receipt of the dental insurer's notice, and the dental insurer shall be required to designate another independent certified public accountant or accounting firm;  (2) A list of the providers who have executed a contract that complies with section 432G-6(d), annually on or before March 1; and  (3) A description of the available grievance procedures, the total number of grievances handled through those procedures, a compilation of the causes underlying those grievances, and a summary of the final disposition of those grievances, annually on or before March 1.  (b) The commissioner may require additional reports as are deemed necessary and appropriate to enable the commissioner to carry out the commissioner's duties under this chapter.  (c) Any dental insurer failing or refusing to submit any of the documents required under this section shall be liable for a penalty in an amount not less than $100 and not more than $500 for each day of delinquency. Penalties collected pursuant to this section shall be deposited into the compliance resolution fund. [L 2013, c 191, pt of §1]
HI Rev Stat § 432G-5 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432G. Dental Insurers|432G-5 Information to subscribers.

 §432G-5 Information to subscribers. (a) The dental insurer shall provide to its subscribers a list of providers and participating providers, upon enrollment and reenrollment.  (b) Every dental insurer shall provide to its subscribers notice of any material change in the operation of the organization that will affect them directly within thirty days of the material change.  (c) The dental insurer shall provide to subscribers information on how dental care services may be obtained, where additional information on access to dental care services may be obtained, a description of the internal grievance procedures, and a telephone number for a subscriber to contact the dental insurer at no cost to the subscriber.  (d) For the purpose of this section, "material change" means any major change in provider or participating provider agreements. [L 2013, c 191, pt of §1]
HI Rev Stat § 432G-7 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432G. Dental Insurers|432G-7 Uncovered expenditures insolvency deposit.

 §432G-7 Uncovered expenditures insolvency deposit. (a) If, at any time, uncovered expenditures exceed ten per cent of total dental care expenditures, a dental insurer shall place with the commissioner or with any organization or trustee acceptable to the commissioner through which a custodial or controlled account is maintained, an uncovered expenditures insolvency deposit consisting of cash or securities that are acceptable to the commissioner. Such deposit shall have, at all times, a fair market value in an amount of one-hundred-twenty per cent of the dental insurer's outstanding liability for uncovered expenditures for enrollees in this State, including incurred but not reported claims, and shall be calculated as of the first day of the month and maintained for the remainder of the month. If a dental insurer is not otherwise required to file a quarterly report, it shall file a report within forty-five days of the end of the calendar quarter with information sufficient to demonstrate compliance with this section.  (b) The deposit required under this section is in addition to the deposit required under section 432G-6 and is an asset of the dental insurer in the determination of net worth. All income from the deposits or trust accounts subject to this section shall be an asset of the dental insurer and may be withdrawn from the deposit or trust account quarterly with the approval of the commissioner.  (c) A dental insurer that has made a deposit may withdraw that deposit or any part of the deposit if:  (1) A substitute deposit of cash or securities of equal amount and value is made;  (2) The fair market value exceeds the amount of the required deposit; or  (3) The required deposit under subsection (a) is reduced or eliminated. Deposits, substitutions, or withdrawals may be made only with the prior written approval of the commissioner.  (d) The deposit required under this section shall be held in trust and shall be used only as provided in this section. The commissioner may use the deposit of an insolvent dental insurer for administrative costs associated with administering the deposit and payment of claims of enrollees of this State for uncovered expenditures in this State. Claims for uncovered expenditures shall be paid on a pro rata basis based on assets available to pay such ultimate liability for incurred expenditures. Partial distribution may be made pending final distribution. Any amount of the deposit remaining shall be paid into the liquidation or receivership of the dental insurer.  (e) The commissioner may prescribe the time, manner, and form for filing claims under subsection (d).  (f) The commissioner may require dental insurers to file annual, quarterly, or more frequent reports as the commissioner deems necessary to demonstrate compliance with this section. The commissioner may require that the reports include liability for uncovered expenditures as well as an audit opinion. [L 2013, c 191, pt of §1]
HI Rev Stat § 432G-8 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432G. Dental Insurers|432G-8 Reserve credit for reinsurance.

 §432G-8 Reserve credit for reinsurance. Any dental insurer that takes credit for reserves on risks ceded to a reinsurer shall be subject to provisions of article 4A of chapter 431. [L 2013, c 191, pt of §1]
HI Rev Stat § 432G-9 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432G. Dental Insurers|432G-9 Replacement coverage.

 §432G-9 Replacement coverage. (a) Any carrier providing replacement coverage with respect to group dental benefits within a period of sixty days from the date of discontinuance of a prior dental insurer contract or policy providing such dental benefits shall immediately cover all enrollees who were validly covered under the previous dental insurer contract or policy at the date of discontinuance and who would otherwise be eligible for coverage under the succeeding carrier's contract, regardless of any provisions of the contract relating to active employment.  (b) Except to the extent benefits for the condition would have been reduced or excluded under the prior carrier's contract or policy, no provision in a succeeding carrier's contract of replacement coverage which would operate to reduce or exclude benefits on the basis that the condition giving rise to a claim for benefits preexisted the effective date of the succeeding carrier's contract shall be applied with respect to those enrollees validly covered under the prior carrier's contract or policy on the date of discontinuance. [L 2013, c 191, pt of §1]
HI Rev Stat § 432G-10 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432G. Dental Insurers|432G-10 Powers of insurers and hospital and medical service corporations.

 §432G-10 Powers of insurers and hospital and medical service corporations. (a) An insurance company licensed in this State, or a hospital or medical service corporation authorized to do business in this State, either directly or through a subsidiary or affiliate, may organize and operate a dental insurer under the provisions of this chapter. Notwithstanding any other law to the contrary, any two or more insurance companies, hospital or medical service corporations, dental insurers, or subsidiaries or affiliates thereof, may jointly organize and operate a dental insurer. The business of insurance is deemed to include the providing of dental care services by a dental insurer owned or operated by an insurer or a subsidiary thereof.  (b) Notwithstanding any contrary provision of laws pertaining to insurance or hospital or medical service corporations under chapter 431, 432, or 432D, an insurer or a hospital or medical service corporation may contract with a dental insurer to provide insurance or similar protection against the cost of dental care services provided through dental insurers and to provide coverage in the event of the failure of the dental insurer to meet its obligations. The enrollees of a dental insurer constitute a group permitted under chapter 431, 432, or 432D. Among other things, under such contracts, the insurer or hospital or medical service corporation may make benefit payments to dental insurers for dental care services rendered by providers. [L 2013, c 191, pt of §1]
HI Rev Stat § 432G-11 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432G. Dental Insurers|432G-11 Examinations.

 §432G-11 Examinations. (a) The commissioner may examine the affairs of any dental insurer or of any providers with whom a dental insurer has contracts, agreements, or other arrangements as often as is reasonably necessary for the protection of the interests of the people of this State.  (b) Every dental insurer and provider shall submit its books and records for examination and in every way facilitate the completion of an examination by the commissioner. In the event a dental insurer or a provider fails to comply with the directions of the commissioner, the commissioner may examine the affiliates of the dental insurer or provider to obtain the information. For the purpose of examinations, the commissioner may administer oaths to and examine the officers and agents of the dental insurer and the principals of providers concerning their business.  (c) The cost of examinations under this section shall be assessed against the dental insurer or provider being examined and shall be remitted to the commissioner for deposit into the compliance resolution fund.  (d) In lieu of the commissioner's own examination, the commissioner may accept the report of an examination made by the commissioner or the appropriate official of another state. [L 2013, c 191, pt of §1]
HI Rev Stat § 432G-12 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432G. Dental Insurers|432G-12 Fees.

 §432G-12 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 a 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 shall be deposited into the compliance resolution fund. [L 2013, c 191, pt of §1; am L 2015, c 63, § §20, 21; am L 2021, c 110, §22]
HI Rev Stat § 432G-14 (2021)
2021 Hawaii Revised Statutes|Title 24. Insurance|432G. Dental Insurers|432G-14 Summary orders and supervision.

 §432G-14 Summary orders and supervision.  (a) Whenever the commissioner determines that the financial condition of any dental insurer 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 dental insurer to take such action as may be reasonably necessary to rectify such condition or violation, including but not limited to:  (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 dental insurer's capital and surplus by contribution; or  (6) Taking any other steps as the commissioner may deem appropriate under the circumstances.  (b) For purposes of this section, the violation by a dental insurer of any law of this State to which the dental insurer is subject shall be deemed a violation of this chapter.  (c) The commissioner is authorized to set uniform standards and criteria for early warning that the continued operation of any dental insurer might be hazardous to its enrollees, creditors, or the general public, and to set standards for evaluating the financial condition of any dental insurer, 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 2013, c 191, pt of §1]