KRS 304.11-045: Jurisdiction over providers of health care benefits.

(1) The purpose of this section is to give Kentucky jurisdiction over providers of health

care benefits; to indicate how each provider of health care benefits may show under

what jurisdiction it falls; to allow for examination by Kentucky if the provider of

health care benefits is unable to show it is subject to another jurisdiction; to make

such a provider of health care benefits subject to the laws of Kentucky if it cannot

show that it is subject to another jurisdiction; and to disclose to purchasers of such

health care benefits whether or not the plans are fully insured.

(2) Notwithstanding any other provision of law, and except as provided herein, any

person or other entity which provides coverage in this state for medical, surgical,

chiropractic, physical t herapy, speech pathology, audiology, professional mental

health, dental, hospital, or optometric expenses, whether such coverage is by direct

payment, reimbursement, or otherwise, shall be presumed to be subject to the

jurisdiction of the department, unles s the person or other entity shows that while

providing such services it is subject to the jurisdiction of another agency of this

state, any subdivision thereof, or the federal government.

(3) If a person or entity wishes to show that it is subject to the jurisdiction of another

agency of this state, any subdivision thereof, or the federal government, such

showing shall be made by providing to the commissioner the appropriate certificate,

license, or other document issued by other governmental agency which permits or

qualifies it to provide those services.

(4) Any person or entity which is unable to show under subsection (3) that it is subject

to the jurisdiction of another agency of this state, any subdivision thereof, or the

federal government, shall submi t to an examination by the commissioner to

determine the organization and solvency of the person or the entity, and to

determine whether or not such person or entity complies with the applicable

provisions of this chapter.

(5) Any person or entity unable t o show that it is subject to the jurisdiction of another

agency of this state, any subdivision thereof, or the federal government, shall be

subject to all appropriate provisions of this code regarding the conduct of its

business.

(6) Any production agency or administrator which advertises, sells, transacts, or

administers the coverage in this state described in subsection (2) of this section and

which is required to submit to an examination by the commissioner under

subsection (4) of this section shall, if said coverage is not fully insured or otherwise

fully covered by an authorized life or health insurer, nonprofit hospital, medical -

surgical, dental, and health service corporation, health maintenance organization, or

prepaid dental plan organization, advise every purchaser, prospective purchaser, and

covered person of such lack of insurance or other coverage. Any administrator

which advertises or administers the coverage in this state described in subsection (2)

of this section which is required to submit t o an examination by the commissioner

under subsection (4) of this section shall advise any production agency of the

elements of the coverage, including the amount of "stop loss" insurance in effect.