Title 21 — Insurance
53 chapters · 1,244 sections in this title.
AS 21.87.010 Applicability.
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(a) This chapter applies to every individual, person, firm, corporation, association, or organization of any kind hereafter engaging or purporting to engage in the provision of all or part of a health care service as defined in AS 21.87.330, for its subscribers in exchange for pe…
AS 21.87.020 Purpose and interpretation.
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(a) It is the purpose of this chapter to regulate in the public interest the formation and operation of prepaid health care service organizations, in order that the services may be made available upon a basis of fair and equitable contracts through state-licensed nonprofit organi…
AS 21.87.030 Provisions exclusive.
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A provision of this title does not apply to a health care service corporation unless contained or referred to in this chapter.
AS 21.87.040 Incorporation and certificate of authority required.
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A person otherwise subject to this chapter may not engage or purport to engage in the provision of any part or all of a health care service for its subscribers in exchange for periodic prepayments in identifiable amount unless it is a service corporation incorporated under the la…
AS 21.87.050 Incorporation, approval of articles and amendments.
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(a) A service corporation shall be formed as a nonprofit, nonstock medical service corporation, or hospital service corporation, or a combination medical and hospital service corporation, consistent with the applicable requirements of this chapter under the statutes of this state…
AS 21.87.060 Name of corporation.
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A service corporation may not have or use a corporate or business name that includes the words “insurance,” “casualty,” “surety,” “health and accident,” “mutual,” or other terms descriptive of an insurer or insurance business. A service corporation may not have or use a name so s…
AS 21.87.070 Qualifications for certificate of authority.
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[Repealed or reserved.]
AS 21.87.080 Application for certificate of authority.
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(a) Application for a certificate of authority to transact business as a service corporation shall be made to the director, on forms as prepared and furnished by the director and requiring the information relative to the applicant, its directors, officers, and affairs as the dire…
AS 21.87.090 Issuance or refusal of certificate of authority.
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(a) If, after the application for certificate of authority is completed, the director finds that the applicant is fully qualified for a certificate of authority in accordance with this chapter, and that the service agreements, subscribers contracts, schedule of rates are in compl…
AS 21.87.100 Continuance or expiration of certificate of authority.
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(a) A certificate of authority issued to a service corporation shall continue in force as long as the corporation is entitled to it under this chapter, and until suspended or revoked by the director or terminated at the request of the corporation; subject, however, to continuance…
AS 21.87.110 Suspension or revocation of certificate of authority.
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(a) The director shall suspend or revoke the certificate of authority of a service corporation that the director finds, after a hearing, is no longer qualified under this chapter. (b) The director may after a hearing, suspend or revoke the certificate of authority for a violation…
AS 21.87.120 Services and benefits that may be provided by medical service corporations.
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(a) A medical service corporation shall have the right to provide to its subscribers part or all of the following services and benefits only: (1) medical and surgical services furnished to the subscriber by participant providers; (2) indemnity in reasonable amount with respect to…
AS 21.87.130 Services and benefits that may be provided by hospital service corporations.
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(a) A hospital service corporation shall have the right to provide to its subscribers part or all of the following services and benefits only: (1) hospital services furnished to the subscriber by participant hospitals; (2) indemnity in a reasonable amount with respect to hospital…
AS 21.87.140 Medical service agreements.
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(a) A medical service corporation shall enter into service agreements with providers licensed by the state only. (b) Each service agreement shall require the participant providers to furnish to subscribers of the service corporation the medical or surgical services, or both, that…
AS 21.87.150 Hospital service agreements.
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(a) A hospital service corporation shall enter into service agreements with hospitals approved or licensed by the state only. (b) Each service agreement must require the participant hospital to furnish to subscribers of the service corporation the hospital services that are, unde…
AS 21.87.160 Subscriber's contracts.
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(a) Each subscriber's contract issued after July 1, 1966, by a service corporation constitutes a direct obligation of the participant providers or participant hospitals of the service corporation to render the medical or hospital services, as the case may be, as agreed to be rend…
AS 21.87.170 Minimum service benefits.
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(a) Each service agreement and subscriber's contract entered into or issued by a service corporation must provide for health care services of a substantial and broad character to be rendered to subscribers on a service basis by participant providers or participant hospitals. (b) …
AS 21.87.180 Filing and approval of agreements and contracts.
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(a) A service corporation may not issue or use a basic form of service agreement or subscriber's contract, or application, identification, supplement, or endorsement to be connected with the agreement or contract, until the form has been filed with and approved by the director. T…
AS 21.87.190 Charges and rates; rating methods.
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(a) Subscription rates, fees, and payments to be charged by a service corporation to or on account of its subscribers may not be excessive, inadequate, or unfairly discriminatory; and rates of payments to be made to participant providers and participant hospitals for services ren…
AS 21.87.200 Reserves.
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In addition to the surplus fund provided for in AS 21.87.210, each service corporation shall establish and maintain unimpaired reserves and liabilities required under AS 21.18.050.
AS 21.87.210 Surplus fund.
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(a) Each service corporation shall set aside into a “surplus fund” an amount of money equal to not less than two percent of all sums hereafter received by it on account of subscriber's contracts, until the surplus fund amounts to not less than $50,000 if a medical service corpora…
AS 21.87.220 Investments.
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(a) A service corporation shall invest and have invested its funds in the following investments only: (1) cash on deposit or in savings accounts in banks or trust companies in this state; (2) deposits in or shares of the savings and loan associations that are insured by an instru…
AS 21.87.230 Records and accounts.
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(a) Every service corporation shall establish and maintain complete and accurate records and accounts covering its transactions and affairs, in accordance with common and accepted principles and practices of insurance accounting and record keeping as applied to the business of th…
AS 21.87.240 Annual statement and fees.
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(a) Each service corporation shall annually before March 2 file with the director a statement of its financial condition as at the preceding December 31. The statement must be in the form, and provide for the information relative to the corporation's affairs, that the director pr…
AS 21.87.250 Examination.
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Every service corporation shall be subject to examination by the director, with the same rights and powers and in the same manner as is provided in this title for the examination of insurers; and for the purposes thereof AS 21.06.120 — 21.06.180 shall, to the extent applicable, a…
AS 21.87.260 Taxation.
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Every hospital and medical service corporation doing business under this chapter shall be taxed as provided in AS 21.09.210.
AS 21.87.270 Joint operations.
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(a) A hospital service corporation and a medical service corporation may operate under joint management for the purpose of reducing operating costs. (b) Separate records and accounts shall be kept for each corporation, and the funds and assets of one may not be commingled with th…
AS 21.87.280 Combined corporation.
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(a) A service corporation may be formed as, or may by suitable amendment of its articles of incorporation become, a combined medical service and hospital service corporation. As to its medical services each combined service corporation shall fully comply with those provisions of …
AS 21.87.290 Contracts covering workers' compensation risks.
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A service corporation may not issue a subscriber's contract covering, or otherwise insure, an industrial injury or illness if health care service or indemnity benefits are provided by either federal or state law, or under the Alaska Workers' Compensation Act.
AS 21.87.300 Annual adjustment of service payments.
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(a) At least once each year each service corporation shall make a special accounting, at which time any prorated settlements for bills submitted by participant providers or hospitals for services rendered during the preceding calendar year shall be adjusted, and any deficits made…
AS 21.87.310 Fidelity bond.
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Each service corporation shall procure and maintain in force a fidelity bond or bonds, with authorized corporate surety, covering every officer or employee entrusted with the handling of its funds, in an amount, but not less than $5,000, that may be fixed by its board of director…
AS 21.87.320 Fee and licenses. [Repealed, § 30 ch 26 SLA 1985.]
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[Repealed or reserved.]
AS 21.87.330 Definitions.
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In this chapter, (1) “health care service” means a service rendered to an individual for diagnosis, relief, or treatment of an injury, ailment, or bodily condition; (2) “hospital service corporation” means a service corporation that principally provides hospital services; (3) “me…
AS 21.87.340 Other provisions applicable.
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In addition to the provisions contained or referred to previously in this chapter, the following chapters and provisions of this title also apply with respect to service corporations to the extent applicable and not in conflict with the express provisions of this chapter and the …
AS 21.87.350 Existing certificates of authority.
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A health care service contractor registered to do business in this state on July 1, 1966, is entitled to be registered under this chapter, whether or not it meets the requirements of this chapter.