Oklahoma § 36-6944 - Challenge of determination or action by Insurance

§ 36-6944. Challenge of determination or action by Insurance

Commissioner - Required events - Hearing.

Upon the occurrence of any of the events specified in this

section, the health maintenance organization shall have the right to

a confidential departmental hearing, on the record, at which time

the health maintenance organization may challenge any determination

or action by the Insurance Commissioner. The health maintenance

organization shall notify the Commissioner of its request for a

hearing within five (5) days after the notification by the

Commissioner pursuant to the provisions of paragraph 1, 2, 3 or 4 of

this section. Upon receipt of the health maintenance organization’s

request for a hearing, the Commissioner shall set a date for the

hearing, which shall be not less than ten (10), nor more than thirty

(30) days after the date of the health maintenance organization’s

request. The events include:

1. Notification to a health maintenance organization by the

Commissioner of an adjusted Risk-Based Capital (RBC) report;

2. Notification to a health maintenance organization by the

Commissioner that:

a.

the health maintenance organization’s RBC plan or

revised RBC plan is unsatisfactory, and

b.

notification constitutes a Regulatory Action Level

Event with respect to the health maintenance

organization;

3. Notification to a health maintenance organization by the

Commissioner that the health maintenance organization has failed to

adhere to its RBC plan or revised RBC plan and that the failure has

a substantial adverse effect on the ability of the health

maintenance organization to eliminate the Company Action Level Event

with respect to the health maintenance organization in accordance

with its RBC plan or revised RBC plan; or

4. Notification to a health maintenance organization by the

Commissioner of a corrective order with respect to the health

maintenance organization.

Added by Laws 2003, c. 197, § 44, eff. Nov. 1, 2003.

Oklahoma Statutes - Title 36. Insurance