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-.04 - Application and Issuance of Certificate of Authority

Current through Rules and Regulations filed through June 27, 2024
(1) It is unlawful
				for any person or entity to act as or hold itself out to be a health plan
				purchasing cooperative in this State without a valid certificate of authority
				issued by the Commissioner of Insurance. To qualify for and hold a certificate
				of authority to act as a health plan purchasing cooperative in this State, a
				health plan purchasing cooperative must otherwise be in compliance with
				O.C.G.A. §
									33-30A-1
et seq.
,
				this Regulation Chapter, and the bylaws of the health plan purchasing
				cooperative.
(2) The health plan
				purchasing cooperative shall file with the Commissioner an application for a
				certificate of authority upon a form to be furnished by the Commissioner. The
				application shall include or have attached the following information and
				documents:
(a) All basic organizational
				documents of the health plan purchasing cooperative including certificate of
				existence, the articles of incorporation, and other applicable documents, and
				all amendments to those documents;
(b) The bylaws, rules and regulations,
				statements of policy or similar documents regulating the conduct or the
				internal affairs of the health plan purchasing cooperative;
(c) The names, addresses, official positions,
				and professional qualifications of the individuals who are responsible for the
				conduct of the affairs of the health plan purchasing cooperative, including all
				members of the board of directors, board of trustees, executive committee, or
				other governing board or committee, the principal officers of the corporation,
				the membership of any advisory group or groups, and any other person who
				exercises control or influence over the affairs of the health plan purchasing
				cooperative;
(d) Audited annual
				statements or reports for each of the three most recent years, compiled by a
				certified public accountant, or such other information as the Commissioner may
				require in order to review the current financial condition of the applicant
				which ultimately reflects a minimum net worth amount of $200,000;
(e) If the applicant is not currently acting
				as a health plan purchasing cooperative, a statement of the amounts and sources
				of the funds available for organizational expenses and the proposed
				arrangements for reimbursement and compensation of incorporators or other
				principals;
(f) Fees required of a
				health plan purchasing cooperative as provided in the application
				materials;
(g) A business plan
				detailing the operation of the health plan purchasing cooperative in Georgia
				that includes the applicant's method(s) of solicitation, names of insurers and
				insurance products offered through the cooperative and the geographic area(s)
				the health plan purchasing cooperative is intending to serve;
(h) A copy of the guarantee of uninterrupted
				coverage as stipulated by O.C.G.A. §
										33-30A-8(c);
				and
(i) Copies of all agreements
				between the health plan purchasing cooperative and the carrier(s) as stipulated
				by O.C.G.A. §
										33-30A-4(f)  as
				well as any administrator agreement(s) and/or agent agreement(s) used in the
				operations of the applicant.