A. A person shall not establish or operate a health care services organization in this state, or sell or offer to sell, or solicit offers to purchase, or receive advance or periodic consideration in conjunction with a health care plan without obtaining and maintaining a certificate of authority pursuant to this article.

Terms Used In Arizona Laws 20-1052

  • Health care plan: means any contractual arrangement whereby any health care services organization undertakes to provide directly or to arrange for all or a portion of contractually covered health care services and to pay or make reimbursement for any remaining portion of the health care services on a prepaid basis through insurance or otherwise. See Arizona Laws 20-1051
  • Health care services: means services for the purpose of diagnosing, preventing, alleviating, curing or healing human illness or injury. See Arizona Laws 20-1051
  • Health care services organization: means any person that undertakes to conduct one or more health care plans. See Arizona Laws 20-1051
  • Person: means any natural or artificial person including individuals, partnerships, associations, providers of health care, trusts, insurers, hospital or medical service corporations or other corporations, prepaid group practice plans, foundations for medical care and health maintenance organizations. See Arizona Laws 20-1051
  • Provider: means any physician, hospital or other person that is licensed or otherwise authorized to furnish health care services in this state. See Arizona Laws 20-1051

B. A health care services organization shall be incorporated under the laws of this or any other state.

C. A health care services organization shall possess and maintain unimpaired capital or surplus, or both, in the amount of one million five hundred thousand dollars at the time of obtaining a certificate of authority. Thereafter, a health care services organization that is subject to the unimpaired capital or surplus requirements of this section shall maintain unimpaired capital or surplus, or both, in the amount of one million dollars or in the amount prescribed in chapter 2, article 12 of this title, whichever is greater.

D. Unless preempted under federal law or unless federal law imposes greater requirements than this section, this section applies to a provider sponsored health care services organization.