Title 33, Chapter 18, Section 9
( 33-18-9)
(a) The Commissioner shall issue a certificate of authorization upon
compliance by the medical service corporation with this chapter and
other proper requirements of the Commissioner and upon being
satisfied upon the following points: (1) That all items required to be filed are in proper form and
meet the approval of the Commissioner; (2) That the applicant is established as a bona fide medical
service corporation, that the services rendered by the medical
service corporation are not an unnecessary duplication of similar
services in the community served, that they are desirable for
public necessity and convenience, and that a fair opportunity to
become participating physicians has been given to all practicing
physicians of standing in the area to be served; (3) That the solicitation of contracts by the medical service
corporation and its conditions or methods of operation are fair
and reasonable; (4) That the rates charged are fair, reasonable, adequate, and not
unfairly discriminatory and that benefits to be provided are fair,
reasonable, and not unfairly discriminatory. The rates may differ
between subscribers in recognized groups and individual
subscribers not in groups, subject to the approval of the
Commissioner; (5) That the amount of money actually available for working
capital is sufficient to carry all acquisition costs and operating
expenses for a period of at least six months from the date of the
issuance of the certificate; (6) That the amount provided as working capital shall only be
provided by individuals or groups who have no financial interest
in the activities of the medical service corporation or by the
participating physicians. Interest charged on the working capital,
if any, shall not exceed 6 percent per annum; and payment of
interest, if any, and repayment of the working capital shall be
permitted only after provision has been adequately made for
operating expenses, payments to participating physicians for
medical and surgical, dental, or podiatric services, and the
establishment of legal reserves and such other reserves as may be
required by the Commissioner; and (7) That a provision has been made in the subscription contract
authorizing medical and surgical, dental, or podiatric services by
other than participating physicians, in which case money benefits
shall be provided as specified in the subscription contract and
approved as fair by the Commissioner. (b) The certificate of authorization issued by the Commissioner to
operate a medical service plan or plans shall be limited by the
Commissioner to the contracts and practices approved by him. |