Oklahoma § 36-6922 - Order to rectify financial condition or violation Required actions - Remedies and measures available to Insurance

§ 36-6922. Order to rectify financial condition or violation Required actions - Remedies and measures available to Insurance

Commissioner.

A. Whenever the Insurance Commissioner determines that the

financial condition of a health maintenance organization (HMO) is

such that its continued operation might be hazardous to its

enrollees, creditors or the general public, or that the HMO has

violated any provision of the Health Maintenance Organization Act of

2003, the Insurance Commissioner may, after notice and opportunity

for hearing, order the health maintenance organization to take

action reasonably necessary to rectify the condition or violation

including, but not limited, to one or more of the following:

Oklahoma Statutes - Title 36. Insurance

1. Reduce the total amount of present and potential liability

for benefits by reinsurance or other method acceptable to the

Insurance Commissioner;

2. Reduce the volume of new business being accepted;

3. Reduce expenses by specified methods;

4. Suspend or limit the writing of new business for a period of

time;

5. Increase the health maintenance organization’s capital and

surplus by contribution; or

6. Take other steps the Insurance Commissioner may deem

appropriate under the circumstances.

B. For purposes of this section, the violation by a health

maintenance organization of any law of this state to which the

health maintenance organization is subject shall be deemed a

violation of this act.

C. Rules of the Insurance Commissioner establishing criteria

that the Insurance Commissioner may consider in making a

determination that the condition of any insurer is such that

continuation of such insurer's business may be hazardous to the

public or to holders of its policies or certificates of insurance

may be used by the Insurance Commissioner for early warning that the

continued operation of any health maintenance organization might be

hazardous to its enrollees, creditors, or the general public and to

set standards for evaluating the financial condition of any health

maintenance organization.

D. The remedies and measures available to the Insurance

Commissioner under this section shall be in addition to, and not in

lieu of, the remedies and measures available to the Insurance

Commissioner under the provisions of Section 1904 of Title 36 of the

Oklahoma Statutes.

Added by Laws 2003, c. 197, § 22, eff. Nov. 1, 2003.