Opinion ID: 871688
Heading Depth: 3
Heading Rank: 1

Heading: AlohaCare's opening brief

Text: In its opening brief, AlohaCare argues that [t]he HMO Act requires an entity that meets that Act's description of an HMO to obtain a certificate of authority (license) from the Insurance Commissioner prior to engaging in an HMO Act covered activity. In support of this argument, AlohaCare contends that the legislature that passed the HMO Act did so based on an understanding that the `field' of activities to which the Act applied (and for which it required a license) was not then subject to State insurance regulation and that the April 24, 2008 letter from the Insurance Division to United was the exact opposite of the understanding of the legislature that passed the HMO Act. Next, AlohaCare contends that the Insurance Commissioner's Decision reaches inconsistent conclusions. For example, AlohaCare notes that the [D]ecision holds that although [Ohana] and United are licensed or certified as risk-bearing entities, the certification or license both hold does not extend to their conduct under their QExA contracts. [17] As such, they were and are performing their QExA contracts under no licensing authority. Finally, AlohaCare argues that the Decision ignored canons of statutory construction when it considered the overlap between HRS chapter 431:10A and HRS chapter 432D. Specifically, AlohaCare argues that the plain language of the HMO Act is clear and unambiguous and the Insurance Commissioner should not have departed from the clear and unambiguous language. AlohaCare further argues that even if the terms in HRS chapter 432D could be construed as ambiguous, the proper course of action is to look to a dictionary to determine the ordinary meaning. Accordingly, AlohaCare argues that the Decision is contrary to [the] unambiguous language of the HMO Act and contravenes the legislature's stated intent of regulating HMOs in Hawaii. Finally, AlohaCare argues the HMO Act should be given full effect because the HMO Act `covers the whole subject which it relates,' all the way down to telling indemnity insurance licensees what to do to be HMOs.