reglab/housing_qa huggingface dataset:
NC Gen Stat § 58-56-52 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56 - Third Party Administrators.|§ 58-56-52 - Prohibitions.

 58-56-52. Prohibitions.(a) No insurance company shall act as a third party administrator with respect to residents of this State, or residents of another state from offices in this State, in connection with life or health insurance or annuities unless that insurance company is authorized to do the business of insurance in this State and otherwise complies with the applicable laws of this State.(b) No insurance company shall enter into an agreement with an unauthorized insurance company to provide administrative services for residents of this State, or residents of another state from offices in this State, in connection with life or health insurance or annuities that would subject the unauthorized insurer to this section. (2005-209, s. 1.)
NC Gen Stat § 58-56-56 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56 - Third Party Administrators.|§ 58-56-56 - Waiver of application for license.

 58-56-56. Waiver of application for license.Upon request from a TPA, the Commissioner may waive the application requirements of G.S. 58-56-51(b) if the TPA has a valid license as a TPA issued in a state that has standards for TPAs that are at least as stringent as those contained in this Article. (1991, c. 627, s. 1.)
NC Gen Stat § 58-56-65 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56 - Third Party Administrators.|§ 58-56-65 - Committee on Third Party Administrators.

 58-56-65. Committee on Third Party Administrators.The Commissioner is authorized to appoint a Committee on Third Party Administrators in conformance with the provisions of G.S. 58-2-30. (1987, c. 676.)
NC Gen Stat § 58-56-66 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56 - Third Party Administrators.|§ 58-56-66 - Grounds for suspension or revocation of license.

 58-56-66. Grounds for suspension or revocation of license.(a) The Commissioner shall, after notice and opportunity for hearing, suspend or revoke the license of a TPA if the Commissioner finds that either of the following apply to the TPA:(1) The TPA is using methods or practices in the conduct of its business that render its further transaction of business in this State hazardous or injurious to insured persons or the public.(2) The TPA has failed to pay any judgment rendered against it in this State within 60 days after the judgment has become final.(b) The Commissioner may, after notice and opportunity for hearing, suspend or revoke the license of a TPA if the Commissioner finds that any of the following apply to the TPA:(1) The TPA has violated a rule or an order of the Commissioner or any provision of this Chapter.(2) The TPA has refused to be examined or to produce its accounts, records, and files for examination, or any of its officers has refused to give information with respect to its affairs or has refused to perform any other legal obligation as to that examination, when required by the Commissioner.(3) The TPA has, without just cause, refused to pay proper claims or perform services arising under its contracts or has, without just cause, caused covered individuals to accept less than the amount due them or caused covered individuals to employ attorneys or bring suit against the TPA to secure full payment or settlement of the claims.(4) The TPA is an affiliate of or under the same general management, interlocking directorate, or ownership as another TPA or insurer that unlawfully transacts business in this State without having a license.(5) The TPA at any time fails to meet any qualification for which issuance of the license could have been refused had the failure then existed and been known to the Commissioner at the time of the application.(6) The TPA has been convicted of, or has entered a plea of guilty or nolo contendere to, a felony without regard to whether judgment was withheld.(7) The TPA is under suspension or revocation in another state.(c) The Commissioner may without advance notice or hearing immediately suspend the license of any TPA if the Commissioner finds that any of the following apply to the TPA:(1) The TPA is insolvent or financially impaired. "Financially impaired" means that the TPA is unable or potentially unable to fulfill its contractual obligations.(2) A proceeding for receivership, conservatorship, rehabilitation, or other delinquency proceeding regarding the TPA has been commenced in any state.(3) The financial condition or business practices of the TPA otherwise pose an imminent threat to the public health, safety, or welfare of the residents of this State. (1991, c. 627, s. 1.)
NC Gen Stat § 58-56A-2 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56A - Pharmacy Benefits Management.|§ 58-56A-2 - Licensure.

 58-56A-2. Licensure.(a) A person or organization may not establish or operate as a pharmacy benefits manager for health benefit plans in this State without obtaining a license from the Commissioner of the Department of Insurance.(b) The Commissioner shall develop an application for licensure to operate in this State as a pharmacy benefits manager and may charge an initial application fee of two thousand dollars ($2,000) and an annual renewal fee of one thousand five hundred dollars ($1,500). The pharmacy benefits manager application form must collect only the following information:(1) The name, address, and telephone contact number of the pharmacy benefits manager.(2) The name and address of the pharmacy benefits manager's agent for service of process in this State.(3) The name and address of each person with management or control over the pharmacy benefits manager.(4) The name and address of each person with a beneficial ownership interest in the pharmacy benefits manager.(5) Either (i) a signed statement that, to the best of the applicant's knowledge, no officer with management or control of the pharmacy benefits manager has been convicted of a felony or has violated any requirement of State or federal law applicable to pharmacy benefits management or (ii) a description of any felony or any violation of any requirement of State or federal law applicable to pharmacy benefits management committed by any officer with management or control of the pharmacy benefits manager.(c) Unless otherwise provided for in this Article, an applicant or a pharmacy benefits manager that is licensed to conduct business in the State shall file a notice describing any material modification of the information required under this section.(d) The Commissioner shall adopt rules establishing the licensing and reporting requirements of pharmacy benefits managers consistent with the provisions of this Article.  (2021-161, s. 1(b).)
NC Gen Stat § 58-56A-4 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56A - Pharmacy Benefits Management.|§ 58-56A-4 - Pharmacy and pharmacist protections.

 58-56A-4. Pharmacy and pharmacist protections.(a) A pharmacy benefits manager may only charge fees or otherwise hold a pharmacy responsible for a fee relating to the adjudication of a claim if the fee is reported on the remittance advice of the adjudicated claim or is set out in contract between the pharmacy benefits manager and the pharmacy. No fee or adjustment for the receipt and processing of a claim, or otherwise related to the adjudication of a claim, shall be charged without a justification on the remittance advice or as set out in contract and agreed upon by the pharmacy or pharmacist for each adjustment or fee. This section shall not apply with respect to claims under an employee benefit plan under the Employee Retirement Income Security Act of 1974 or Medicare Part D.(b) Nothing in this Article shall abridge the right of a pharmacist to refuse to fill or refill a prescription if the pharmacist believes it would be harmful to the patient or is not in the patient's best interest, or if there is a question to the validity of the prescription.(c) A pharmacy or pharmacist shall not be prohibited by a pharmacy benefits manager from dispensing any prescription drug, including specialty drugs dispensed by a credentialed and accredited pharmacy, allowed to be dispensed under a license to practice pharmacy under Article 4A of Chapter 90 of the General Statutes.(d) A pharmacy benefits manager shall not penalize or retaliate against a pharmacist or pharmacy for exercising rights provided under this Article. This subsection does not apply to breach of contract between a pharmacy and a pharmacy benefits manager.(e) A claim for pharmacist services may not be retroactively denied or reduced after adjudication of the claim unless any of the following apply:(1) The original claim was submitted fraudulently.(2) The original claim payment was incorrect because the pharmacy or pharmacist had already been paid for the pharmacist services.(3) The pharmacist services were not rendered by the pharmacy or pharmacist.(4) The adjustments were agreed to by the pharmacy or pharmacist.(5) The adjustments were part of an attempt to limit overpayment recovery efforts by a pharmacy benefits manager.(f) Nothing in this section shall be construed to limit overpayment recovery efforts by a pharmacy benefits manager.  (2017-116, s. 2; 2021-161, s. 1(b).)
NC Gen Stat § 58-56A-10 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56A - Pharmacy Benefits Management.|§ 58-56A-10 - Recodified as G.S. 58-56A-30.

 58-56A-10: Recodified as G.S. 58-56A-30.  (2015-273, s. 2; 2016-78, s. 6.3.)
NC Gen Stat § 58-56A-15 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56A - Pharmacy Benefits Management.|§ 58-56A-15 - Pharmacy benefits manager networks.

 58-56A-15. Pharmacy benefits manager networks.(a) A pharmacy benefits manager shall not deny the right to any properly licensed pharmacist or pharmacy to participate in a retail pharmacy network on the same terms and conditions of other similarly situated participants in the network.(b) A pharmacist or pharmacy that is a member of a pharmacy service administrative organization that enters into a contract with a health benefit plan issuer or a pharmacy benefits manager on the pharmacy's behalf is entitled to receive from the pharmacy service administrative organization a copy of the contract provisions applicable to the pharmacy, including each provision relating to the pharmacy's rights and obligations under the contract.(c) Termination of a pharmacy or pharmacist from a pharmacy benefits manager network does not release the pharmacy benefits manager from the obligation to make any payment due to the pharmacy or pharmacist for pharmacist services properly rendered according to the contract. This subsection does not apply in cases of fraud, waste, and abuse.  (2021-161, s. 1(b).)
NC Gen Stat § 58-56A-20 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56A - Pharmacy Benefits Management.|§ 58-56A-20 - Pharmacy benefits manager affiliate disclosure; sharing of data.

 58-56A-20. Pharmacy benefits manager affiliate disclosure; sharing of data.A pharmacy benefits manager shall not, in any way that is prohibited by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), transfer or share records relative to prescription information containing patient-identifiable and prescriber-identifiable data to a pharmacy benefits manager affiliate.  (2021-161, s. 1(b).)
NC Gen Stat § 58-56A-21 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56A - Pharmacy Benefits Management.|§ 58-56A-21 - Claims data provided to health benefit plan.

 58-56A-21. Claims data provided to health benefit plan.Upon the request of an insurer offering a health benefit plan that contracts with a pharmacy benefits manager, the pharmacy benefits manager shall provide the insurer with claims data that reflects the total amount the insurer paid to the pharmacy benefits manager under the health benefit plan for a specified outpatient prescription drug, including the ingredient cost and the dispensing fee. The pharmacy benefits manager shall also provide the cost that it paid for the specified outpatient prescription drug, including the ingredient cost and the dispensing fee.  (2021-161, s. 1(b).)
NC Gen Stat § 58-56A-25 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56A - Pharmacy Benefits Management.|§ 58-56A-25 - Enforcement.

 58-56A-25. Enforcement.(a) The Commissioner may make an examination of the affairs of any pharmacy benefits manager pursuant to the services that it provides for an insurer or a health benefit plan that are relevant to determining if the pharmacy benefits manager is in compliance with this Article. When making an examination, the Commissioner may retain attorneys, independent actuaries, independent certified public accountants, or other professionals and specialists as examiners. The pharmacy benefits manager shall bear the cost of retaining those persons.(b) Pending, during, and after the examination of any pharmacy benefits manager, the Commissioner shall not make public the information or data acquired, and the information or data acquired during an examination is considered proprietary and confidential and is not a public record under Chapter 132 of the General Statutes.(c) Violations of this Article are subject to the penalties under G.S. 58-56A-30. After notice and hearing, a pharmacy benefits manager may also be subject to revocation of, or a refusal to renew, a license to operate in this State as a result of violations of this Article.  (2021-161, s. 1(b).)
NC Gen Stat § 58-56A-45 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56A - Pharmacy Benefits Management.|§ 58-56A-45 - Rules.

 58-56A-45. Rules.The Commissioner shall adopt rules to implement the provisions of this Article.  (2021-161, s. 1(b).)
NC Gen Stat § 58-56A-50 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 56A - Pharmacy Benefits Management.|§ 58-56A-50 - Contracts with 340B covered entities.

 58-56A-50. Contracts with 340B covered entities.(a) A contract entered into between a pharmacy benefits manager and a 340B covered entity's pharmacy or between a pharmacy benefits manager and a 340B contract pharmacy shall not do any of the following:(1) Restrict access to a pharmacy network or adjust 340B drug reimbursement rates based on whether a pharmacy dispenses drugs under the 340B drug discount program.(2) Assess any additional, or vary the amount of any, fees, chargebacks, or other adjustments on the basis of a drug being dispensed under the 340B drug discount program or a pharmacy's status as a 340B covered entity or a 340B contract pharmacy. This section does not prevent adjustments to correct errors or overpayments resulting from an adjudicated claim.(b) No pharmacy benefits manager making payments pursuant to a health benefit plan shall discriminate against a 340B covered entity or a 340B contract pharmacy in a manner that prevents or interferes with an enrollee's choice to receive a prescription drug from an in-network 340B covered entity or an in-network 340B contract pharmacy.(c) The provisions of G.S. 58-51-37 shall apply to pharmacy benefits managers with respect to 340B covered entities and 340B contract pharmacies.(d) Any provision of a contract entered into between a pharmacy benefits manager and a 340B covered entity or 340B contract pharmacy that is contrary to this section is unenforceable.  (2021-161, s. 1(b).)
NC Gen Stat § 58-57-1 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 57 - Regulation of Credit Insurance.|§ 58-57-1 - Application of Article.

 58-57-1. Application of Article.All credit life insurance, all credit accident and health insurance, all credit property insurance, all credit insurance on credit card balances, all family leave credit insurance, and all credit unemployment insurance written in connection with direct loans, consumer credit installment sale contracts of whatever term permitted by G.S. 25A-33, leases, or other credit transactions shall be subject to the provisions of this Article, except credit insurance written in connection with direct loans of more than 15 years' duration. The provisions of this Article shall be controlling as to such insurance and no other provisions of Articles 1 through 64 of this Chapter shall be applicable unless otherwise specifically provided; nor shall such insurance be subject to the provisions of this Article where the issuance of such insurance is an isolated transaction on the part of the insurer not related to an agreement or a plan for insuring debtors of the creditor. (1975, c. 660, s. 1; 1987, c. 826, ss. 1, 12; 1993, c. 226, s. 1; 1999-351, s. 5.2.)
NC Gen Stat § 58-57-10 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 57 - Regulation of Credit Insurance.|§ 58-57-10 - Forms of insurance which are authorized.

 58-57-10. Forms of insurance which are authorized.Credit life insurance and credit accident and health insurance shall be issued only in the following forms:(1) Individual policies of life insurance issued to debtors on the term plan;(2) Individual policies of accident and health insurance issued to debtors on a term plan or disability benefit provisions in individual policies of credit life insurance;(3) Group policies of life insurance issued to creditors providing insurance upon the lives of debtors on the term plan;(4) Group policies of accident and health insurance issued to creditors on a term plan insuring debtors or disability benefit provisions in group credit life insurance policies to provide such coverage. (1975, c. 660, s. 1.)
NC Gen Stat § 58-57-15 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 57 - Regulation of Credit Insurance.|§ 58-57-15 - Amount.

 58-57-15. Amount.(a) Credit Life Insurance. -(1) The amount of credit life insurance shall not exceed the amount of unpaid indebtedness as it exists from time to time, less any unearned interest or finance charges; provided, however, that if the amount of credit insurance is based on a predetermined schedule, the amount of credit insurance shall not exceed the scheduled amount of unpaid indebtedness, less any unearned interest or finance charges, plus an amount equal to three monthly installments or the equivalent thereof.(2) Notwithstanding the provisions of the above subdivision, insurance on seasonal credit line commitments (such as may be found in agricultural credit transactions) not exceeding one year in duration may be written up to the amount of the loan commitment on a nondecreasing or level term plan.(3) Notwithstanding this or any other section, insurance on education credit transaction commitments may be written for the amount of such commitment.(b) Credit Accident and Health and Credit Unemployment Insurance. - The total amount of indemnity payable by credit accident and health or credit unemployment insurance in the event of disability or unemployment, as defined in the policy, shall not exceed the indebtedness; and the amount of each monthly benefit shall not exceed the indebtedness divided by the number of months in the term of the loan. A daily benefit equal in amount to one thirtieth of the scheduled monthly payment is permissible. For open-end credit transactions, the total amount of indemnity payable shall not exceed the amount of unpaid indebtedness at the time disability or unemployment begins, including interest and insurance charges that would accrue on that indebtedness using the creditor's minimum payment schedule. The periodic indemnity may exceed the creditor's minimum payment amount. (1975, c. 660, s. 1; 1981, c. 759, s. 1; 1993, c. 226, s. 3; c. 553, s. 75.)
NC Gen Stat § 58-57-20 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 57 - Regulation of Credit Insurance.|§ 58-57-20 - Term; termination prior to scheduled maturity.

 58-57-20. Term; termination prior to scheduled maturity.Except as otherwise provided in this section, the term of any credit life insurance or credit accident and health insurance shall, subject to acceptance by the insurer, commence on the date when the debtor becomes obligated to the creditor, except that, where a group policy provides coverage with respect to existing obligations, the insurance on a debtor with respect to such indebtedness shall commence on the effective date of the policy. For credit insurance offered to the debtor subsequent to the date the debtor becomes obligated to the creditor, the term of the insurance shall, subject to the acceptance by the insurer, commence not more than 30 days following the insurer's receipt of the debtor's request for the insurance. The term of such insurance shall not extend more than 15 days beyond the maturity date of the indebtedness or final installment thereof; but the term of the insurance may be less than the term of the indebtedness to provide truncated coverage in connection with transactions having initial terms of more than 60 months or consistent with any age or other termination provisions contained in the policy. If the indebtedness is discharged due to prepayment, the insurance in force shall be terminated unless otherwise requested by the insured in writing. If the indebtedness is discharged due to renewal or refinancing prior to such maturity date, the insurance in force shall be terminated before any new insurance may be issued in connection with the renewed or refinanced indebtedness. In all cases of termination prior to scheduled maturity, a refund shall be paid or credited as provided in G.S. 58-57-50. (1975, c. 660, s. 1; 1991, c. 720, s. 30; 1993, c. 226, s. 4.)
NC Gen Stat § 58-57-30 (2021)
2021 North Carolina General Statutes|Chapter 58 - Insurance|Article 57 - Regulation of Credit Insurance.|§ 58-57-30 - Forms to be filed with Commissioner; approval or disapproval by Commissioner.

 58-57-30. Forms to be filed with Commissioner; approval or disapproval by Commissioner.(a) All forms of policies, certificates of insurance, notices of proposed insurance, endorsements and riders intended for use in this State shall be filed with the Commissioner.(b) The Commissioner shall, within 90 days after the filing of any such policies, certificates of insurance, notices of proposed insurance, endorsements and riders, disapprove any such form if it contains provisions which are contrary to, or not in accordance with, any provision of this Article, Article 38 of this Chapter, or of any rule or regulation promulgated thereunder. Unless disapproved in writing within such 90 days, a form shall be deemed approved.(c) If the Commissioner notifies the insurer that the form is disapproved, it is unlawful thereafter for such insurer to issue or use such form for a period of 60 days, or until the Commissioner has issued a final order after hearing, whichever is earlier. In such notice, the Commissioner shall specify the reason for his disapproval and state that a hearing will be granted within 20 days after request in writing by the insurer. No such policy, certificate of insurance, notice of proposed insurance, endorsement or rider shall be issued or used until the expiration of 30 days after it has been so filed, unless the Commissioner shall give his prior written approval thereto.(d) The Commissioner may, at any time after a hearing held not less than 20 days after written notice to the insurer, withdraw his approval of any such form on any ground set forth in subsection (b) above. The written notice of such hearing shall state the reason for the proposed withdrawal.(e) No insurer shall issue such forms or use them after the effective date of such withdrawal. (1975, c. 660, s. 1; 1979, c. 755, s. 16.)