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-.10 - Renewal; Annual Report; Semi-annual Financial Statements; Membership Reporting

Current through Rules and Regulations filed through June 27, 2024
(1) Each authorized health plan purchasing
				cooperative shall file with the Commissioner a full and true report of its
				financial condition, transactions, and affairs. The report shall be filed
				annually on or before May 1 or within such extension of time therefore as the
				Commissioner for good cause may have granted and shall be for the preceding
				calendar year. The report shall be in such form and contain such matters as the
				Commissioner prescribes and shall be verified by at least two officers of the
				health plan purchasing cooperative filing the report. The second financial
				condition filing shall be filed on or before October 1 or within such extension
				of time therefore as the Commissioner for good cause may have granted and shall
				be for the second quarter for the current calendar year.
(2) Each authorized health plan purchasing
				cooperative shall file with the Commissioner a semiannual financial statement
				in such form as the Commissioner prescribes. Such statement shall be verified
				by at least two officers of the health plan purchasing cooperative filing the
				report.
(3) Each authorized health
				plan purchasing cooperative shall file with the Commissioner an annual
				independent audit by a certified public accountant in accordance with O.C.G.A.
				§
									33-30A-4(d)(2).
(4) The annual report shall include the
				complete names, addresses, NAIC company and NAIC group number of all
				participating carriers with which the health plan purchasing cooperative had a
				contract or service agreement during the preceding fiscal year.
(5) The annual report shall show a detailed
				accounting of the specific services offered as well as evidence of proper
				handling of premium collection and record keeping in accordance with O.C.G.A.
				§
									33-30A-4(d)(3).
(6) The annual report shall provide
				verification of the continuation of the surety bond or other appropriate
				liability coverage, as stipulated in this regulation.
(7) Along with the annual report shall be a
				written disclosure relating to paragraphs (a) through (I) of §
									120-2-79-.04. This disclosure must
				include copies of any changes in documentation that occurred during the
				previous year's operation.
(8) Each
				health plan purchasing cooperative shall file with the Commissioner of
				Insurance on or before May 1st in each year, a certification executed by an
				authorized officer of the health plan purchasing cooperative wherein it is
				stated that the advertisements disseminated by the health plan purchasing
				cooperative during the preceding calendar year complied, or were made to comply
				in all respects, with the advertising laws, rules and regulations of this
				State.
(9) Fees shall be required
				for the renewal of the health plan purchasing cooperative as provided in the
				application materials.
(10) In
				addition, the health plan purchasing cooperative shall maintain information on
				members of the health plan purchasing cooperative on an annual basis, by market
				type, total individuals enrolled in coverage through the health plan purchasing
				cooperative, broken down by total employees, total dependents, and total
				individuals in each category by health benefit plan, or any other reporting
				information deemed appropriate by the Commissioner. The Commissioner shall
				prescribe a reporting format for such information. All purchasing cooperatives
				shall disclose such information in the prescribed format no later than May 1st
				of every year for every previous year's operations.
O.C.G.A. Secs.
				  33-2-9,
				  33-8-1,
				  33-30A-4,
				  33-30A-5,
				  33-30A-9.