806 KAR 38:040. Financial projections; area overlapping

Link to law: http://www.lrc.ky.gov/kar/806/038/040.htm
Published: 2015

      806 KAR 38:040.

Financial projections; area overlapping.

 

      RELATES TO: KRS

304.38-040

      STATUTORY AUTHORITY:

KRS 304.38-150

      NECESSITY, FUNCTION,

AND CONFORMITY: KRS 304.38-040 provides that a health maintenance organization

supply the executive director information upon

application for certificate of authority. This administrative regulation

explains the authenticity of the health maintenance organization's financial

projections and possibility of overlapping health maintenance organizations

within a particular geographic area.

 

      Section 1. The three

(3) year projections for the financial program of the applicant health

maintenance organization shall be prepared by an individual who has satisfied

the executive director by virtue of his

training, education and experience that he is qualified to make such

projections.

 

      Section 2. The

existence or proposed operation of health maintenance organizations in the same

geographic area that could affect the number of prospective enrollees of the

applicant health maintenance organization shall be disclosed to the executive

director in the description of the initial geographic area to be

served.

 

      Section 3. In noting

the sources of working capital and funding, the proposed health maintenance

organization shall inform the executive director

whether there are grants, loans or loan guarantees from the federal government;

if so, the amounts thereof, rates of interest, if any, the schedule of

repayment, if any, of the principal and interest. If the working capital and

funding is derived from other than through the federal government, indicate

such source, giving details of such program, including any schedule of

repayments of principal and interest on loans which may have been made. (1

Ky.R. 1090; eff. 7-2-75; TAm eff. 8-9-2007.)
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