Certificate of authority: Issuance. The Commissioner shall issue or deny a certificate of authority to any person filing an application pursuant to NRS 695C.060 within 90 days of receipt of the certification from the State Board of Health. Issuance of a certificate of authority must be granted upon payment of the fees prescribed in NRS 695C.230 if the Commissioner is satisfied that the following conditions are met:
1. The persons responsible for the conduct of the affairs of the applicant are competent, trustworthy and possess good reputations.
2. The State Board of Health certifies, in accordance with NRS 695C.080, that the health maintenance organization’s proposed plan of operation meets the requirements of subsection 2 of NRS 695C.080.
3. The health care plan furnishes comprehensive health care services.
4. The health maintenance organization is financially responsible and may reasonably be expected to meet its obligations to enrollees and prospective enrollees. In making this determination, the Commissioner may consider:
(a) The financial soundness of the health care plan’s arrangements for health care services and the schedule of charges used in connection therewith;
(b) The adequacy of working capital;
(c) Any agreement with an insurer, a government, or any other organization for insuring the payment of the cost of health care services;
(d) Any agreement with providers for the provision of health care services; and
(e) Any surety bond or deposit of cash or securities submitted in accordance with NRS 695C.270 as a guarantee that the obligations will be duly performed.
5. The enrollees will be afforded an opportunity to participate in matters of program content pursuant to NRS 695C.110.
6. Nothing in the proposed method of operation, as shown by the information submitted pursuant to NRS 695C.060, 695C.070 and 695C.140, or by independent investigation is contrary to the public interest.
Last modified: February 27, 2006