(a) The commissioner may suspend, revoke, or refuse to extend any certificate of authority issued under this chapter and may deny any application for a certificate of authority if the commissioner finds that:

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Terms Used In Hawaii Revised Statutes 432G-13

  • Commissioner: means the insurance commissioner. See Hawaii Revised Statutes 432G-1
  • Contract: A legal written agreement that becomes binding when signed.
  • Dental care services: include the practices, acts, and operations pertaining to dentistry as defined in section 448-1. See Hawaii Revised Statutes 432G-1
  • Dental insurer: means any person who undertakes to provide or to arrange for or administer one or more dental insurance plans and who has met the requirements of chapter 423. See Hawaii Revised Statutes 432G-1
  • Enrollee: means an individual who is covered by a dental insurer. See Hawaii Revised Statutes 432G-1
  • insolvency: means that the dental insurer has been declared insolvent and placed under an order of supervision, rehabilitation, or liquidation by the commissioner or a court of competent jurisdiction. See Hawaii Revised Statutes 432G-1
  • Net worth: means the excess of total assets over total liabilities; provided that liabilities shall not include fully subordinated debt. See Hawaii Revised Statutes 432G-1
(1) The dental insurer is operating significantly in contravention of its basic organizational document or in a manner contrary to that described in any other information submitted under section 432G-2, unless amendments to such submissions have been filed with and approved by the commissioner;
(2) The dental insurer or applicant does not provide or arrange for basic dental care services;
(3) The dental insurer or applicant is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees;
(4) The dental insurer has failed to correct, within the time prescribed by subsection (b), any deficiency occurring due to the impairment of the dental insurer’s prescribed minimum net worth;
(5) The dental insurer, applicant, or any person acting on its behalf has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive, or unfair manner;
(6) The dental insurer, applicant, or any person acting on its behalf fails or refuses to produce or submit any of the documents required under sections 432G-4 and insolvency; net solvency report” class=”unlinked-ref” datatype=”S” sessionyear=”2022″ statecd=”HI”>432G-6;
(7) The operation or continued operation of the dental insurer would be hazardous to its enrollees; or
(8) The dental insurer or applicant has otherwise failed to substantially comply with this chapter.
(b) The following shall pertain when insufficient net worth is maintained:

(1) Whenever the commissioner finds that the net worth maintained by any dental insurer subject to this chapter is less than the minimum net worth required, the commissioner shall give written notice to the dental insurer of the amount of the deficiency and shall require the dental insurer to:

(A) File with the commissioner a plan for correction of the deficiency acceptable to the commissioner; and
(B) Correct the deficiency within a reasonable time, not to exceed sixty days, unless an extension of time, not to exceed sixty additional days, is granted by the commissioner. A deficiency in net worth shall be deemed an impairment. Failure to correct an impairment within the prescribed time shall be grounds for suspension or revocation of the certificate of authority or for placing the dental insurer in conservation, rehabilitation, or liquidation; and
(2) Unless allowed by the commissioner, no dental insurer or person acting on its behalf, directly or indirectly, may renew, issue, or deliver any certificate, agreement, or contract of coverage in this State, for which a premium is charged or collected, while the dental insurer is impaired and the fact of the impairment is known to the dental insurer or person. The existence of an impairment shall not prevent the issuance or renewal of a certificate, agreement, or contract if an enrollee exercises an option granted under the plan to obtain new, renewed, or converted coverage.
(c) A certificate of authority shall be suspended, revoked, or not extended, or an application for a certificate of authority denied, or an administrative fine imposed, only after compliance with the following requirements:

(1) Suspension or revocation of a certificate of authority, refusal to extend a certificate of authority, denial of an application, or imposition of an administrative fine pursuant to section 432G-15(a) shall be by written order of the commissioner, which shall be sent to the dental insurer or applicant by certified or registered mail. The written order shall state the grounds, charges, or conduct on which suspension, revocation, refusal to extend, denial, or administrative fine is based. The insurer or applicant may request in writing a hearing pursuant to § 431:2-308; and
(2) If the dental insurer or applicant requests a hearing pursuant to this section, the commissioner shall issue a written notice of hearing stating a specific time for the hearing, which may not be less than twenty nor more than thirty days after mailing of the notice of hearing and a specific place for the hearing. Notice of hearing shall be delivered to the insurer or applicant by certified or registered mail.
(d) When the certificate of authority of a dental insurer is suspended, the dental insurer shall not, during the period of suspension, enroll any additional enrollees except newborn children or other newly acquired dependents of existing subscribers, and shall not engage in any advertising or solicitation whatsoever.
(e) When the certificate of authority of a dental insurer is revoked, the insurer, immediately following the effective date of the order of revocation, shall proceed to wind up its affairs, and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of the insurer. It shall engage in no further advertising or solicitation whatsoever. The commissioner, by written order, may permit any further operation of the insurer as the commissioner may find to be in the best interest of enrollees, to the end that enrollees will be afforded the greatest practical opportunity to obtain continuing dental care coverage.

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