NAC695C.165. Geographic area of service: Expansion.

     1. Any organization which wants to expand its geographic area of service from that stated in its application shall submit to the Division:

     (a) A copy of a written description of the area it proposes to serve;

     (b) A list of the providers who will offer comprehensive health care services to the enrollees of the organization in that area;

     (c) A copy of the contract with those providers;

     (d) A statement describing the effect of the expansion on the operation and financial position of the organization and certifying that the organization is financially able to expand;

     (e) A statement describing the method of marketing and the projected number of enrollees from the new area;

     (f) Proof that the organization has notified its insurers for its contracts of surety, fidelity and stop-loss insurance of the proposed changes; and

     (g) The fee for amending its certificate of authority.

     2. A health maintenance organization that wants to expand its geographic area shall send one copy of its submission to the State Board of Health for its review.

     3. Any request by an organization to expand the area of its service will be treated by the Division as a material modification of the operation of the organization. If the organization subsequently submits information amending the request for expansion, the Division will presume that the original request has been withdrawn and the period for approval or disapproval will be computed from the date of receipt of the amended request.

     (Added to NAC by Comm’r of Insurance, eff. 6-11-86; A 5-27-92; R148-99, 1-27-2000)