Nebraska Statutes 44-32,134. Filings; required
(1) Every health maintenance organization shall file annually, on or before March 1, an annual financial statement with the Director of Insurance, with a copy to the Department of Health and Human Services, covering the preceding calendar year. The annual financial statement shall be on forms prescribed by the Director of Insurance and shall be prepared in accordance with annual statement instructions and accounting practices and procedures manuals as prescribed by the director which conform substantially to the annual statement instructions and the Accounting Practices and Procedures Manuals of the National Association of Insurance Commissioners.
Terms Used In Nebraska Statutes 44-32,134
- Contract: A legal written agreement that becomes binding when signed.
- Department: shall mean the Department of Insurance. See Nebraska Statutes 44-103
- Director: shall mean the Director of Insurance. See Nebraska Statutes 44-3298
- Grievance: shall mean a written complaint submitted in accordance with the health maintenance organization's formal grievance procedure by or on behalf of the enrollee regarding any aspect of the health maintenance organization relative to the enrollee. See Nebraska Statutes 44-32,102
- Health maintenance organization: shall mean any person who undertakes to provide or arrange for the delivery of basic health care services to enrollees on a prepaid basis except for enrollee responsibility for copayments or deductibles. See Nebraska Statutes 44-32,105
- Year: shall mean calendar year. See Nebraska Statutes 49-801
(2) Every health maintenance organization shall file annually, on or before March 1, with the Director of Insurance, with a copy to the department:
(a) A list of the providers who have executed a contract that complies with section 44-32,141 ; and
(b) A description of the grievance procedures, the total number of grievances handled through such procedures, a compilation of the causes underlying those grievances, and a summary of the final disposition of those grievances.
(3) Every health maintenance organization shall file annually, on or before June 1, audited financial statements with the Director of Insurance, with a copy to the department.
(4) The Director of Insurance may require such additional reports as are deemed necessary and appropriate to carry out his or her duties under the Health Maintenance Organization Act.