Except as provided in Subsection (2), each health maintenance organization authorized in this state shall maintain a deposit with the commissioner under Section 31A-2-206 in an amount equal to the sum of:
Terms Used In Utah Code 31A-8-211
Filed: means that a filing is:
(i)
submitted to the department as required by and in accordance with applicable statute, rule, or filing order;
(ii)
received by the department within the time period provided in applicable statute, rule, or filing order; and
(iii)
accompanied by the appropriate fee in accordance with:
minimum required capital: means the capital that must be constantly maintained by a stock insurance corporation as required by statute. See Utah Code 31A-1-301
Permanent surplus: means the surplus of an insurer or organization that is designated by the insurer or organization as permanent. See Utah Code 31A-1-301
State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
Surplus: means the excess of assets over the sum of paid-in capital and liabilities. See Utah Code 31A-1-301
(a)
$100,000; and
(b)
50% of the greater of:
(i)
$900,000;
(ii)
2% of the annual premium revenues as reported on the most recent annual financial statement filed with the commissioner; or
(iii)
an amount equal to the sum of three months uncovered health care expenditures as reported on the most recent financial statement filed with the commissioner.
(2)
(a)
The commissioner may exempt a health maintenance organization from the deposit requirement of Subsection (1) if:
(i)
the commissioner determines that the enrollees’ interests are adequately protected;
(ii)
the health maintenance organization has been continuously authorized to do business in this state for at least five years; and
(iii)
the health maintenance organization has $5,000,000 surplus in excess of the health maintenance organization’s company action level RBC as defined in Subsection 31A-17-601(8)(b).
(b)
The commissioner may rescind an exemption given under Subsection (2)(a).
(3)
(a)
Each limited health plan authorized in this state shall maintain a deposit with the commissioner under Section 31A-2-206 in an amount equal to the minimum capital or permanent surplus plus 50% of the greater of:
(i)
.5 times minimum required capital or minimum permanent surplus; or
(ii)
(A)
during the first year of operation, 10% of the limited health plan’s projected uncovered expenditures for the first year of operation;
(B)
during the second year of operation, 12% of the limited health plan’s projected uncovered expenditures for the second year of operation;
(C)
during the third year of operation, 14% of the limited health plan’s projected uncovered expenditures for the third year of operation;
(D)
during the fourth year of operation, 18% of the limited health plan’s projected uncovered expenditures during the fourth year of operation; or
(E)
during the fifth year of operation, and during all subsequent years, 20% of the limited health plan’s projected uncovered expenditures for the previous 12 months.
(b)
Projections of future uncovered expenditures shall be established in a manner that is approved by the commissioner.
(4)
A deposit required by this section may be counted toward the minimum capital or minimum permanent surplus required under Section 31A-8-209.
