2025 Session Last amended: 2004 session

§ 62D.042 — Initial Net Worth Requirement

Plain-Language Summary

This section sets the minimum net worth that new HMOs must maintain. A beginning HMO must have a net worth of at least 8-1/3 percent of its expected first-year expenses, or $1,500,000, whichever is more. The HMO can reduce this calculation by subtracting 90% of its reinsurance premiums.

Practical Notes
The net worth requirement ensures new HMOs have enough financial resources to cover their obligations to members. The $1,500,000 floor means even small HMOs must have significant capital. HMOs that purchase reinsurance get credit for those costs, which encourages them to protect against large losses.