Compilation of Rules and Regulations of the State of Georgia › Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER › Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE › Subject 120-2-79 - HEALTH PLAN PURCHASING COOPERATIVES › Rule 120-2-79-.07 - Maintenance of Information; Books and Records; Annual Report to the Carrier(s); Return Credits

Current through Rules and Regulations filed through June 27, 2024
(1) Every health plan purchasing cooperative
				shall maintain at its principal administrative office for the duration of the
				written agreement referred to in §
									120-2-79-.06 and five years
				thereafter books and records of all transactions between it, carriers and
				insured persons. The Commissioner shall have access to such books and records
				for the purpose of examination, audit and inspection. Any trade secrets
				contained therein, including but not limited to the identity and addresses of
				policyholders and certificate holders, shall be confidential, except the
				Commissioner may use such information in any proceedings instituted against the
				health plan purchasing cooperative. The participating carrier shall retain the
				right to continuing access to such books and records of the health plan
				purchasing cooperative sufficient to permit the carrier to fulfill all of its
				contractual obligations to insured persons, subject to any restrictions in the
				written agreement between the carrier and health plan purchasing cooperative on
				the proprietary rights of the parties in such books and records.
(2) Health plan purchasing cooperatives shall
				maintain detailed books and records that reflect all transactions specifically
				in regard to premiums, premium taxes, agent commissions, fees, contributions
				received and deposited.
(3) The
				detailed preparation, journalizing, and posting of such books and records shall
				be made in accordance with the terms and conditions of the service agreement or
				contract between the health plan purchasing cooperative and the carrier, and in
				accordance with the "Employee Retirement and Income Security Act of 1974," 88
				Stat. 829, 29 U.S.C. §
										1001
et seq.
, as amended and
				to enable the carrier to complete the National Association of Insurance
				Commissioners' (NAIC) annual financial statement.
(4) Health plan purchasing cooperatives shall
				maintain a cash receipts register of all premiums or contributions received.
				The minimum detail required in the register shall be date received and
				deposited, the mode of payment, the policy number, name of policyholder and
				names of certificate-holders and individual premium amounts and
				agent.
(5) The description of a
				disbursement shall be in sufficient detail to identify the source document
				substantiating the purpose of the disbursement, and shall include all of the
				following:
(a) The check number;
(b) The date of disbursement;
(c) The person to whom the disbursement was
				made;
(d) The amount disbursed,
				provided that if the amount disbursed does not agree with the amount billed or
				authorized, the health plan purchasing cooperative shall prepare a written
				record as to the application for the disbursement; and
(e) Ledger account number.