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      RS 22:1260.4     

  

§1260.4. Procedure for registration

            A. An applicant for registration shall submit an application to the commissioner and pay the application fee of two hundred fifty dollars.

            B. The application shall be on a form prescribed by the commissioner, accompanied by any supporting documentation and shall be signed and verified by the applicant. The information required by the application shall include the following items:

            (1) The articles of incorporation or articles of organization and name of the entity operating the discount medical plan and any trade or business names used by that entity in connection with the operation of the discount medical plan.

            (2) The names and addresses of every officer and director of the entity operating the discount medical plan as well as the name and address of the corporate officer designated by the plan as the corporate representative to receive, review, and resolve all grievances addressed to the plan.

            (3) The name and address of every person owning, directly or indirectly, ten percent or more of the entity operating the discount medical plan.

            (4) The principal place of business of the discount medical plan.

            (5) A general description of the operation of the discount medical plan which includes a statement that the plan does not provide indemnity insurance coverage for medical services.

            (6) A sample copy of a contract with a member which includes a general description of the member's rights under the discount medical plan.

            (7) A sample copy of a contract, absent the fee schedule, with a health care provider which includes a general description of the health care provider's rights under the discount medical plan.

            (8) A description of the proposed methods of marketing, including, but not limited to, describing the use of marketers, the use of the Internet, sales by telephone, and use of salespersons to market the discount medical plan benefits.

            (9) A description of the member complaint procedures to be established and maintained by the applicant.

            (10) The name and address of the applicant's Louisiana statutory agent for service of process, notice of demand, or if not domiciled in this state, the name and address of the applicant's appointed Louisiana statutory agent for service of process or a power of attorney executed by the applicant, appointing the commissioner as the true and lawful attorney of the applicant in and for this state upon whom all law process in any legal action or proceeding against the discount medical plan organization on a cause of action arising in this state may be served.

            C. A registration for purposes of this Section shall be effective for two years, unless the registration is renewed, suspended or revoked.

            D. To renew the registration, no later than ninety days before its registration expires, the discount medical plan organization shall submit a renewal application on the form that the commissioner requires and the renewal fee of two hundred fifty dollars.

            E. The commissioner may suspend the authority of a discount medical plan organization to enroll new members or refuse to renew or revoke a registration if the commissioner finds that any of the following conditions exist:

            (1) The discount medical plan organization is not operating in compliance with this Subpart.

            (2) The discount medical plan organization has advertised, merchandised or attempted to merchandise its services in such a manner as to misrepresent its services or capacity for service or has engaged in deceptive, misleading or unfair practices with respect to advertising or merchandising.

            (3) The discount medical plan organization is not fulfilling its obligations as a discount medical plan organization.

            (4) The continued operation of the discount medical plan organization would be hazardous to its members.

            F. Whenever the discount medical plan organization has been found to have violated any provision of this Subpart, the commissioner may:

            (1) Issue or cause to be served upon the organization charged with the violation a copy of the findings and an order requiring the organization to cease and desist from engaging in the act or practice that constitutes the violation.

            (2) Impose a monetary penalty of not more than two thousand five hundred dollars for each violation, but not to exceed an aggregate penalty of seventy-five thousand dollars.

            (3) Nothing in this Section shall affect the authority of the commissioner to impose any other penalties provided for in this Title, or by rule, regulation, or order.

            G. Each registered discount medical plan organization shall notify the commissioner immediately whenever the discount medical plan organization's registration, or other form of authority, to operate as a discount medical plan organization in another state is suspended, revoked or non-renewed in that state.

            H. A provider who provides discounts to his own patients without any cost or fee of any kind to the patient is not required to maintain a registration under this Subpart as a discount medical plan organization.

            I. Nothing in this Subpart shall be construed to apply to a customer discount or membership card issued by a store or buying club for use at the store or buying club exclusively.

            J. Any decision pursuant to this Subpart shall be subject to the provisions of Chapter 12 of Title 22 of the Louisiana Revised Statutes of 1950.

            Acts 2008, No. 442, §1, eff. Jan. 1, 2009; Redesignated by Acts 2009, No. 503, §3; Acts 2016, No. 3, §1.



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