Haw. Code R. § 12-12-16 - Submission of plans by health care contractors

(a) After the approval of a health plan by the Hawaii State Insurance Commissioner or a signed statement that the plan does not require approval, the health care contractor shall submit eight copies of the plan to the department for review. Each plan shall have attached thereto the evidence of the insurance commissioner's approval or the statement that the plan does not require approval. Any plan submitted under section 393-7(b), HRS, which provides aggregate benefits that are more limited than those provided by plans qualifying under section 393-7(a), HRS, shall include certification that the employer has agreed to contribute at least one-half of the cost of the coverage of dependents under such plan.

(b) After written advice from the prepaid health care advisory council, the director shall notify the health care contractor of the proposed approval or disapproval of the plan. Any proposal to disapprove shall contain the reasons therefor.

(c) The health care contractor may apply for reconsideration in writing within fifteen days after receipt of the proposed disapproval. The request for reconsideration shall include a memorandum of the facts on the basis of which the contractor contends that the plan meets the requirements of section 393-7, HRS.

(d) The director shall notify the health care contractor of the final decision to approve or disapprove the plan.

Notes

Haw. Code R. § 12-12-16

[Eff: 5/7/81] (Auth: HRS § 393-32) (Imp: HRS §§ 393-7, 393-32)