Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 52 Pa.B. 7348 (November 26, 2022).

31 Pa. Code § 152.9. Minimum capital and reserves.

§ 152.9. Minimum capital and reserves.

 (a)  General. Unless the Commissioner determines that additional capital or reserves are required for the protection of policyholders, enrollees, creditors or the public, a risk-assuming preferred provider organization which is not a licensed insurer shall be deemed to have adequate working capital and reserves if its admitted assets exceed its liabilities by $50,000 in excess of the minimum capital and surplus required of a stock casualty insurer with accident and health powers at the time it commences operations, and if it thereafter maintains its admitted assets in excess of liabilities by at least the minimum capital and surplus required of a stock casualty insurer with accident and health powers.

 (b)  Exemption. If the risk-assuming preferred provider organization which is not a licensed insurer only provides or covers limited health care services (for example, dental or vision care services), or is only liable for incentive payments to providers or physicians, the Commissioner may exempt it from the requirements of subsection (a) and establish a lower capital and reserve requirement.

Cross References

   This section cited in 31 Pa. Code §  152.11 (relating to review of application by the Commissioner).



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