NC H967

Establishes licensing requirements for prepaid health plans (PHPs) operating under Medicaid and NC Health Choice contracts, administered by the Department of Insurance Commissioner.

Requires PHPs to maintain minimum capital and surplus of $1,000,000 or higher amounts based on risk-based capital provisions, plus initial working capital of at least $1,500,000.

Mandates minimum deposit of $500,000 and requires PHPs to have adequate plans for protection against insolvency, including reinsurance agreements and continuation of benefits for enrollees if the PHP becomes insolvent.

Grants the Commissioner authority to examine PHPs at least once every five years, suspend or revoke licenses for non-compliance, and order corrective actions for hazardous financial conditions.

Establishes application procedures requiring disclosure of organizational documents, management information, financial statements, and feasibility studies; violation of the Article is a Class 1 misdemeanor.