Section 9.06. Changes in the business plan.

 

(1)  A health maintenance organization insurer or an insurer licensed to write only limited service health organization business shall file a written report of any proposed substantial change in its business plan. The insurer shall file the report at least 30 days prior to the effective date of the change. The office may disapprove the change. The insurer may not enter into any transaction, contract, amendment to a transaction or contract or take action or make any omission that is a substantial change in the insurer's business plan prior to the effective date of the change or if the change is disapproved. Substantial changes include changes in articles and bylaws, organization type, geographical service areas, provider agreements, provider availability, plan administration, financial projections and guarantees and any other change that might affect the financial solvency of the plan. Any changes in the items listed in s. Ins 9.05 (4) shall be filed under this section.

(2)  A change in the quality assurance plan conducted in accordance with s. Ins 9.40 and s. 609.32 , Stats., is not a reportable change in a business plan.

History: Cr. Register, February, 2000, No. 530 , eff. 3-1-00.