Rule 120-2-80-.05. Reporting Requirements

1. (1) Managed care entities with annual and quarterly statement requirements which report premiums and claims, enrollment, utilization of services, numbers of contracting providers and numbers of complaints and grievances shall continue to capture and report this information on standard financial and other required reporting formats as they relate to managed care plans under this Regulation Chapter.

2. (2) Managed care entities not subject to specific reporting requirements for their managed care plans shall gather and prepare such information on a quarterly and annual basis as is necessary to capture and report, including, but not limited to:

   1. (a) premiums and claims;
   2. (b) enrollment;
   3. (c) utilization of services; and
   4. (d) numbers of contracting providers; and

   5. (e) numbers of complaints and grievances.

      These reports shall be marked as "Patient Protection Act Statistical Reports" and shall bear the name and NAIC number of the reporting entity, and shall be submitted as supplements to normal quarterly and annual financial reports presently required. The Commissioner, at his or her discretion, may specify additional reporting requirements for managed care plans.

Authority: O.C.G.A. Secs. 33-2-9, 33-20A-2, 33-20A-4, 33-20A-5.

History. Original Rule entitled "Reporting Requirements" adopted. F. Mar. 20, 1998; eff. Apr. 9, 1998.