(a) If the commissioner finds that any person or organization has violated any provision of this article, the commissioner may impose a penalty of not more than $500 for each violation; provided that if the commissioner finds the violation to be wilful, the commissioner may impose a penalty of not more than $5,000 for each violation. The penalties may be in addition to any other penalty provided by law. For purposes of this section, any managed care plan using a rate for which the managed care plan has failed to file the rate, supplementary rating information, underwriting rules or guides, or supporting information as required by this article, shall have committed a separate violation for each day the failure to file continues.
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Terms Used In Hawaii Revised Statutes 431:14G-111

  • Affirmed: In the practice of the appellate courts, the decree or order is declared valid and will stand as rendered in the lower court.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Commissioner: means the insurance commissioner. See Hawaii Revised Statutes 431:14G-102
  • plan: means a health plan as defined in section 431:10A, or chapter 432 or 432D, regardless of form, offered or administered by a health care insurer, including but not limited to a mutual benefit society or health maintenance organization, or voluntary employee beneficiary associations, but shall not include disability insurers licensed under chapter 431. See Hawaii Revised Statutes 431:14G-102
  • Rate: means every rate, charge, classification, schedule, practice, or rule. See Hawaii Revised Statutes 431:14G-102
  • Supplementary rating information: includes any manual or plan of rates, classification, rating schedule, minimum premium, policy fee, rating rule, underwriting rule, statistical plan, and any other similar information needed to determine the applicable rates in effect or to be in effect. See Hawaii Revised Statutes 431:14G-102
  • Supporting information: means :

    (1) The experience and judgment of the filer and the experience or data of other organizations relied on by the filer;

    (2) The interpretation of any other data relied upon by the filer; and

    (3) Descriptions of methods used in making the rates and any other information required by the commissioner to be filed. See Hawaii Revised Statutes 431:14G-102

(b) The commissioner may suspend the license or operating authority of any managed care plan that fails to comply with an order of the commissioner within the time limited by the order, or any extension thereof that the commissioner may grant. The commissioner shall not suspend the license of any managed care plan for failure to comply with an order until the time prescribed for an appeal from the order has expired or, if an appeal has been taken, until the order has been affirmed. The commissioner may determine when a suspension of license or operating authority shall become effective and it shall remain in effect for the period fixed by the commissioner unless the commissioner modifies or rescinds the suspension, or until the order upon which the suspension is based is modified, rescinded, or reversed.
(c) No penalty shall be imposed and no license or operating authority shall be suspended or revoked except upon a written order of the commissioner, stating the commissioner’s findings, made after a hearing held upon not less than ten days’ written notice to the person or organization. The notice shall specify the alleged violation.

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