Idaho Administrative Code
Title IDAPA 18 - Insurance, Department of
Rule 18.04.04 - THE MANAGED CARE REFORM ACT RULE
Section 18.04.04.011 - APPLICATION FOR CERTIFICATE OF AUTHORITY

Universal Citation: ID Admin Code 18.04.04.011

Current through August 31, 2023

01. Certificate of Authority. Any person offering a managed care plan on a predetermined and prepaid basis is transacting the business of insurance and needs to be authorized under a Certificate of Authority issued by the Director of Insurance. (3-31-22)

02. Application Requirements. The application for a Certificate of Authority will include the affidavits, statements, and other information as enumerated in Idaho Code, Sections 41-319, 41-3904, 41-3905, and 41-3906. After receiving these completed documents, the Director has the authority to request any supplemental information before final approval or disapproval is given. (3-31-22)

03. Capital Surplus and Deposit Requirements. (3-31-22)

a. The Director has established the following minimum capital fund requirements as per Section 41-3905(8), Idaho Code, based on the number of enrolled members:

Enrolled Members

Capital Funds

0-100

$200,000

101-300

$300,000

301-500

$400,000

501-700

$500,000

701-1,000

$1,000,000

1,001-2,000

$1,500,000

2,001-3,000

$2,000,000

b. In no event will the organization's capital funds be less than the following:

One year after the organization becomes subject to the Act

$1,000,000

Two years after the date the organization becomes subject to the Act

$1,500,000

Three years after the date the organization becomes subject to the Act

$2,000,000

c. Immediately upon becoming subject to the Act, the MCO's minimum statutory deposit requirements is calculated as fifty percent (50%) of the amount of the organization's Capital funds as calculated above up to a maximum of one million dollars ($1,000,000), but not less than two hundred thousand dollars ($200,000). The amount of the deposit so held by the Department is adjusted based on the organization's December 31st and June 30th financial statement filings each year. In no event will the minimum prescribed statutory deposit amount be reduced. Upon notification by the Department of the necessary increase in the deposit amount, the organization will have no more than thirty (30) days to come into compliance with the prescribed amount. Failure to increase the deposit as prescribed will subject the organization to suspension or revocation of its certificate of authority pursuant to Section 41-326, Idaho Code. (3-31-22)

Disclaimer: These regulations may not be the most recent version. Idaho may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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