Nebraska Statutes 44-32,143. Insolvency; plan required
The director shall require that each health maintenance organization have a plan for handling insolvency which allows for continuation of benefits for the duration of the contract period for which premiums have been paid and continuation of benefits to members who are confined on the date of insolvency in an inpatient facility until their discharge or expiration of benefits. The director may require:
Terms Used In Nebraska Statutes 44-32,143
- Contract: A legal written agreement that becomes binding when signed.
- Director: shall mean the Director of Insurance. See Nebraska Statutes 44-3298
- 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
- Provider: shall mean any physician, hospital, or other person licensed or otherwise authorized to furnish health care services. See Nebraska Statutes 44-32,111
(1) Insurance to cover the expenses to be paid for continued benefits after an insolvency;
(2) Provisions in provider contracts that obligate the provider to provide services for the duration of the period after the health maintenance organization’s insolvency for which premium payment has been made and until the enrollees’ discharge from inpatient facilities;
(3) Insolvency reserves;
(4) Acceptable letters of credit; and
(5) Any other arrangements to assure that benefits are continued as specified in this section.