State Codes and Statutes

Statutes > New-york > Pbh > Article-44 > 4402

§  4402. Health maintenance organizations; application for certificate  of authority. 1. No person or groups of persons  may  operate  a  health  maintenance  organization  or  issue  a  contract  to  an  enrollee  for  membership  in  a  comprehensive  health  services  plan  without  first  obtaining a certificate of authority from the commissioner.    2.  In  order  to receive such a certificate of authority, a person or  persons, hereinafter designated as the applicant, intending to operate a  health maintenance organization  shall  file  an  application  for  such  certificate  on such form as the commissioner shall prescribe, and shall  provide to the satisfaction of the commissioner the following:    (a)  a  copy  of  each  of  the  basic  organizational  documents  and  agreements  of  the  applicant and all participating entities, including  all contracts and agreements relating to the provision of  comprehensive  health services;    (b)  a copy of the bylaws, rules and regulations on internal governing  documents of the applicant;    (c) a list of the names,  addresses  and  official  positions  of  the  persons  comprising  the  applicant  and  all  entities  referred  to in  paragraph (a) other than those possessing a valid operating  certificate  under  the provisions of article twenty-eight of this chapter, including  all owners of record or beneficial, all members of the  governing  body,  the  officers  and  directors  in  the  case  of  a corporation, and the  partners or members in the case of a partnership or corporation, and the  agent for service of process;    (d) a statement  of  the  financial  condition  of  the  organization,  including,  if  appropriate,  an  income  statement,  balance  sheet and  projected sources and uses of funds;    (e) a statement generally describing the  proposed  operation  of  the  health  maintenance  organization  as to the location of its facilities,  the type and quantity  of  health  care  personnel  engaged  to  provide  services,  its  quality  assurance  mechanism,  its grievance procedure,  participating hospitals and such other data as may be  required  by  the  commissioner;    (f)  a  copy  of each enrollee contract filed with and approved by the  superintendent pursuant  to  section  forty-four  hundred  six  of  this  article; and    (g)  such  other information as may be required by the commissioner to  make the determinations required in section forty-four hundred three  of  this article.

State Codes and Statutes

Statutes > New-york > Pbh > Article-44 > 4402

§  4402. Health maintenance organizations; application for certificate  of authority. 1. No person or groups of persons  may  operate  a  health  maintenance  organization  or  issue  a  contract  to  an  enrollee  for  membership  in  a  comprehensive  health  services  plan  without  first  obtaining a certificate of authority from the commissioner.    2.  In  order  to receive such a certificate of authority, a person or  persons, hereinafter designated as the applicant, intending to operate a  health maintenance organization  shall  file  an  application  for  such  certificate  on such form as the commissioner shall prescribe, and shall  provide to the satisfaction of the commissioner the following:    (a)  a  copy  of  each  of  the  basic  organizational  documents  and  agreements  of  the  applicant and all participating entities, including  all contracts and agreements relating to the provision of  comprehensive  health services;    (b)  a copy of the bylaws, rules and regulations on internal governing  documents of the applicant;    (c) a list of the names,  addresses  and  official  positions  of  the  persons  comprising  the  applicant  and  all  entities  referred  to in  paragraph (a) other than those possessing a valid operating  certificate  under  the provisions of article twenty-eight of this chapter, including  all owners of record or beneficial, all members of the  governing  body,  the  officers  and  directors  in  the  case  of  a corporation, and the  partners or members in the case of a partnership or corporation, and the  agent for service of process;    (d) a statement  of  the  financial  condition  of  the  organization,  including,  if  appropriate,  an  income  statement,  balance  sheet and  projected sources and uses of funds;    (e) a statement generally describing the  proposed  operation  of  the  health  maintenance  organization  as to the location of its facilities,  the type and quantity  of  health  care  personnel  engaged  to  provide  services,  its  quality  assurance  mechanism,  its grievance procedure,  participating hospitals and such other data as may be  required  by  the  commissioner;    (f)  a  copy  of each enrollee contract filed with and approved by the  superintendent pursuant  to  section  forty-four  hundred  six  of  this  article; and    (g)  such  other information as may be required by the commissioner to  make the determinations required in section forty-four hundred three  of  this article.

State Codes and Statutes

State Codes and Statutes

Statutes > New-york > Pbh > Article-44 > 4402

§  4402. Health maintenance organizations; application for certificate  of authority. 1. No person or groups of persons  may  operate  a  health  maintenance  organization  or  issue  a  contract  to  an  enrollee  for  membership  in  a  comprehensive  health  services  plan  without  first  obtaining a certificate of authority from the commissioner.    2.  In  order  to receive such a certificate of authority, a person or  persons, hereinafter designated as the applicant, intending to operate a  health maintenance organization  shall  file  an  application  for  such  certificate  on such form as the commissioner shall prescribe, and shall  provide to the satisfaction of the commissioner the following:    (a)  a  copy  of  each  of  the  basic  organizational  documents  and  agreements  of  the  applicant and all participating entities, including  all contracts and agreements relating to the provision of  comprehensive  health services;    (b)  a copy of the bylaws, rules and regulations on internal governing  documents of the applicant;    (c) a list of the names,  addresses  and  official  positions  of  the  persons  comprising  the  applicant  and  all  entities  referred  to in  paragraph (a) other than those possessing a valid operating  certificate  under  the provisions of article twenty-eight of this chapter, including  all owners of record or beneficial, all members of the  governing  body,  the  officers  and  directors  in  the  case  of  a corporation, and the  partners or members in the case of a partnership or corporation, and the  agent for service of process;    (d) a statement  of  the  financial  condition  of  the  organization,  including,  if  appropriate,  an  income  statement,  balance  sheet and  projected sources and uses of funds;    (e) a statement generally describing the  proposed  operation  of  the  health  maintenance  organization  as to the location of its facilities,  the type and quantity  of  health  care  personnel  engaged  to  provide  services,  its  quality  assurance  mechanism,  its grievance procedure,  participating hospitals and such other data as may be  required  by  the  commissioner;    (f)  a  copy  of each enrollee contract filed with and approved by the  superintendent pursuant  to  section  forty-four  hundred  six  of  this  article; and    (g)  such  other information as may be required by the commissioner to  make the determinations required in section forty-four hundred three  of  this article.