Kentucky Statutes 304.17A-840 – Suspension or revocation of certificate of filing
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(1) The commissioner may suspend or revoke any certificate of filing issued to a self- insured employer-organized association group if the commissioner finds that any of the following conditions exist:
(a) The self-insured employer-organized association group is operating significantly in contravention of its basic organizational document or in a manner contrary to that described in and reasonably inferred from any other information submitted under KRS § 304.17A-800 to KRS § 304.17A-844, unless amendments to the submissions have been filed with and approved by the commissioner;
(b) The self-insured employer-organized association group is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to participants or prospective participants;
(c) The self-insured employer-organized association group, or any person at its direction, has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive, or unfair manner;
(d) The self-insured employer-organized association group has engaged in any unfair or deceptive practices under its certificate of filing; or
(e) The self-insured employer-organized association group has failed to correct a violation of KRS § 304.17A-800 to KRS § 304.17A-844 or the administrative regulations promulgated thereunder, within a reasonable time period established by the commissioner in administrative regulations.
(2) A certificate of filing shall be suspended or revoked only after compliance with the hearing procedure set forth in KRS § 304.2-310 to KRS § 304.2-370.
(3) When a certificate of filing of a self-insured employer-organized association group is suspended, the group shall not, during the period of suspension, enroll any new participants and shall not engage in any advertising or solicitation.
(4) If the certificate of filing of a self-insured employer-organized association group is revoked, the group shall proceed, immediately following the effective date of the order of revocation, 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 organization. It shall engage in no further advertising or solicitation. The commissioner may, by written order, prevent further operation of the group if he or she finds it to be in the best interest of the participants, to the end that the participants will be afforded the greatest practical opportunity to obtain health coverage elsewhere. If the commissioner permits further operation, the self-insured employer-organized association group shall continue to collect the contributions required of participants.
Effective: July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1269, effective July 15, 2010. — Created
2003 Ky. Acts ch. 78, sec. 21, effective June 24, 2003.
(a) The self-insured employer-organized association group is operating significantly in contravention of its basic organizational document or in a manner contrary to that described in and reasonably inferred from any other information submitted under KRS § 304.17A-800 to KRS § 304.17A-844, unless amendments to the submissions have been filed with and approved by the commissioner;
Terms Used In Kentucky Statutes 304.17A-840
- Association: means an entity, other than an employer-organized association, that has been organized and is maintained in good faith for purposes other than that of obtaining insurance for its members and that has a constitution and bylaws. See Kentucky Statutes 304.17A-005
- Employer-organized association: means any of the following:
(a) Any entity that was qualified by the commissioner as an eligible association prior to April 10, 1998, and that has actively marketed a health insurance program to its members since September 8, 1996, and which is not insurer- controlled. See Kentucky Statutes 304.17A-005
(b) The self-insured employer-organized association group is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to participants or prospective participants;
(c) The self-insured employer-organized association group, or any person at its direction, has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive, or unfair manner;
(d) The self-insured employer-organized association group has engaged in any unfair or deceptive practices under its certificate of filing; or
(e) The self-insured employer-organized association group has failed to correct a violation of KRS § 304.17A-800 to KRS § 304.17A-844 or the administrative regulations promulgated thereunder, within a reasonable time period established by the commissioner in administrative regulations.
(2) A certificate of filing shall be suspended or revoked only after compliance with the hearing procedure set forth in KRS § 304.2-310 to KRS § 304.2-370.
(3) When a certificate of filing of a self-insured employer-organized association group is suspended, the group shall not, during the period of suspension, enroll any new participants and shall not engage in any advertising or solicitation.
(4) If the certificate of filing of a self-insured employer-organized association group is revoked, the group shall proceed, immediately following the effective date of the order of revocation, 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 organization. It shall engage in no further advertising or solicitation. The commissioner may, by written order, prevent further operation of the group if he or she finds it to be in the best interest of the participants, to the end that the participants will be afforded the greatest practical opportunity to obtain health coverage elsewhere. If the commissioner permits further operation, the self-insured employer-organized association group shall continue to collect the contributions required of participants.
Effective: July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1269, effective July 15, 2010. — Created
2003 Ky. Acts ch. 78, sec. 21, effective June 24, 2003.