Compilation of Rules and Regulations of the State of Georgia
Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER
Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE
Subject 120-2-75 - REGULATION OF PROVIDER SPONSORED HEALTH CARE CORPORATIONS
Rule 120-2-75-.06 - Protection Against Insolvency

(1) Subscriber Surplus Requirements.

(2) Reinsurance Requirements. In order to further protect against insolvency and protect the subscribers of provider sponsored health care corporations, each provider sponsored health care corporation shall obtain and thereafter maintain an aggregate excess reinsurance policy that is acceptable to the Commissioner. Such policy must be procured from a company licensed and authorized to transact business in this State and must have a retention amount that is commensurate with the financial strength of the provider sponsored health care corporation.

(3) Assets and Investments. In determining the financial condition of provider sponsored health care corporations, admitted assets will be limited to those assets described in O.C.G.A. § 33-10-1. Pursuant to O.C.G.A. § 33-20-22, provider sponsored health care corporations shall invest their funds in the same manner as domestic life insurers pursuant to O.C.G.A. § 33-11-1et seq.

(4) Liabilities. Every provider sponsored health care corporation shall, when determining liabilities, include an amount estimated in the aggregate to provide for any unearned premium or subscription fees and reserves for the payment of all claims for health care expenditures which have been incurred, whether reported or unreported, which are unpaid and for which the health care corporation is or may be liable, and to provide for the expense of adjustment or settlement of such claims.

(5) Hold Harmless.

(6) Continuation of Benefits. Each provider sponsored health care corporation shall have a plan satisfactory to the Commissioner for handling insolvency which guarantees the continuation of benefits to enrollees or subscribers who are confined on the date of insolvency in an inpatient facility until the earlier of their discharge or expiration of benefits.