KRS 304.38A-090: Suspension or revocation of certificate of authority -- Notification --

Winding up affairs -- Applicable provisions.

(1) The commissioner may suspend or revoke the certificate of authority issued to a

limited health service organization pursuant t o this subtitle upon determining that

any of the following conditions exist:

(a) The limited health service organization is operating significantly in

contravention of its basic organizational document or in a manner contrary to

that described in and reaso nably inferred from any other information

submitted pursuant to KRS 304.38A -030, unless amendments to the

submissions have been filed with and approved by the commissioner;

(b) The limited health service organization issues an evidence of coverage or

schedule of charges for limited health services which does not comply with

the requirements of Subtitle 17C of this chapter;

(c) The limited health service organization is unable to fulfill its obligations to

furnish limited health services;

(d) The limited health service organization is not financially responsible and may

reasonably be expected to be unable to meet its obligations to enrollees or

prospective enrollees;

(e) The net worth of the limited health service organization is less than that

required by KR S 304.38A-080 or the limited health service organization has

failed to correct any deficiency in its net worth as required by the

commissioner;

(f) The continued operation of the limited health service organization would be

hazardous to its enrollees; or

(g) The limited health service organization has otherwise failed to comply with

this subtitle.

(2) If the commissioner has cause to believe that grounds for the suspension or

revocation of a certificate of authority exist, he or she shall notify the limited health

service organization in writing specifically stating the grounds for suspension or

revocation and fixing a time not more than sixty (60) days thereafter for a hearing

on the matter in accordance with KRS Chapter 13B.

(3) When the certificate of authority of a limited health service organization is revoked,

the organization shall proceed immediately following the effective date of the order

of revocation to wind up its affairs, and shall conduct no further business except as

may be essential to the o rderly conclusion of the affairs of the organization. It shall

engage in no further advertising or solicitation whatsoever. The commissioner may,

by written order, permit such further operation of the organization as he or she may

find to be in the best in terest of enrollees, to the end that enrollees will be afforded

the greatest practical opportunity to obtain continuing limited health services.

(4) A limited health service organization shall be subject to the provisions of KRS

304.2-210 to 304.2 -300 and to the provisions of Subtitle 2 of this chapter for

determining financial condition, market conduct, and business practices.