Utah Admin. Code R590-235-4 - Licensure and Regulatory Requirements
(1) A stand-alone Medicare PDP sponsor shall
be licensed as a risk-bearing entity in the jurisdiction where the sponsor
proposes to serve Medicare Part D beneficiaries.
(2) A stand-alone Medicare PDP may be
licensed and regulated as either a Utah domiciled health maintenance
organization (HMO), a limited health plan, or a Utah domiciled or foreign
indemnity insurer.
(a) Regulatory requirements
for a Utah domiciled standalone Medicare PDP organized as an HMO or limited
health plan are established by Title 31A, Chapter 8, Health Maintenance
Organizations and Limited Health Plans.
(b) Regulatory requirements for a Utah
domiciled standalone Medicare PDP organized as an indemnity insurer are
established by Title 31A, Chapter 5, Domestic Stock and Mutual Insurance
Corporations.
(c) Regulatory
requirements for a foreign indemnity insurer are established by Title 31A,
Chapter 14, Foreign Insurers.
(3) A stand-alone Medicare PDP shall file
Quarterly and Annual Statement Blanks pursuant to the instructions provided by
the NAIC and in accordance with statutory accounting principles.
(4) A stand-alone Medicare PDP applicant
shall apply for licensure using the appropriate NAIC Uniform Certificate of
Authority Application form:
(a) Primary
Application Form, for a Utah domiciled insurer stand-alone Medicare PDP;
or
(b) Expansion Application Form,
for a foreign indemnity insurer stand-alone Medicare PDP.
Notes
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