Pennsylvania Code
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COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 5598 (August 31, 2024).

31 Pa. Code § 301.321. Department examinations of HMOs.

DEPARTMENT EXAMINATIONS


§ 301.321. Department examinations of HMOs.

 (a)  The Department is authorized to conduct financial examinations of HMOs under section 901 of The Insurance Department Act of 1921 (40 P. S. §  323.1).

 (b)  In its periodic financial examinations and other financial analyses of HMOs, the Department will continue to hold HMOs ultimately responsible for the liabilities arising under its subscriber agreements, regardless of whether the HMO has elected to contract with one or more IDSs to perform or arrange for the performance of services to HMO members.

 (c)  HMOs that contract with IDSs shall ensure that the HMOs remain able to meet their statutory financial reporting requirements, and otherwise comply with Department requests for information under section 11 of the act (40 P. S. §  1561) and section 903(a) of The Insurance Department Act of 1921 (40 P. S. §  323.1(a)).


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