- (a) Within 10 days after receipt of an application for a certificate of authority, the director shall forward a copy of the application to the commissioner of health. Within 60 days after the commissioner of health receives the copy of the application, the commissioner shall make a recommendation regarding the granting of the certificate of authority.
(b) The director shall either issue or deny a certificate of authority within 30 days after receipt of the commissioner of health's recommendation. However, the director may extend the time for issuance or denial of a certificate of authority if additional information is needed in order to make a decision, and notice of the extension is provided to the applicant by the 90th day after the director received the application. A certificate of authority shall be issued if the director determines that the following conditions are met:
- (1) the persons responsible for the conduct of the affairs of the applicant are competent and trustworthy;
- (2) the applicant will effectively provide or arrange for the provision of basic health care services on a prepaid basis, through insurance or otherwise, except to the extent of reasonable requirements for copayments;
(3) the applicant is financially responsible and may reasonably be expected to meet its obligations to enrollees and prospective enrollees; in determining if this condition is met, the director may consider
- (A) the financial soundness of the arrangements for health care services and the schedule of charges used in connection with those services;
- (B) the adequacy of working capital;
- (C) an agreement with an insurer, a hospital or medical service corporation, a government, or other organization for ensuring the payment of the cost of health care services or providing for automatic applicability of an alternative coverage if the health maintenance organization is discontinued;
- (D) an agreement with providers for the provision of health care services; and
- (E) a deposit of cash or securities submitted under AS 21.86.140;
- (4) the enrollees will be afforded an opportunity to participate in matters of policy and operation as provided in AS 21.86.040;
- (5) nothing in the proposed method of operation, as shown by the information submitted under AS 21.86.010 or by independent investigation, is contrary to the public interest;
- (6) the information submitted under AS 21.86.010(b)(12) indicates that the applicant will be able to comply with state and federal statutes and regulations regarding the quality of health care.
- (c) If a certificate of authority is denied under this section, the applicant may request a hearing under AS 21.86.200.