Cal. Code Regs. tit. 28 § 1300.84.3

Current through Register 2024 Notice Reg. No. 45, November 8, 2024
Section 1300.84.3 - Monthly Financial Reports
(a) Each plan that has not been licensed by the Department and operated as a health care service plan for twelve (12) consecutive calendar months shall file with the Department the "Monthly DMHC Financial Reporting Form," hereinafter "Monthly Report" (Form No. 10-070), dated July 1, 2022, as incorporated herein by reference, and published by the Department on its website: www.dmhc.ca.gov, within 30 calendar days after the last day of the month.
(b) Each plan shall file the Monthly Report with the Department within 30 calendar days after the last day of any month during which its:
(1) Tangible net equity, individually or on a combined basis with affiliates, is less than 150%, or less than 130% for a point-of-service contract, of the minimum tangible net equity required by subdivisions (a) or (b) of Rule 1300.76, as applicable; or
(2) Report # 2 within the Monthly Report, individually or on a combined basis with affiliates, reflects a loss for the month the amount of which exceeds the difference between the tangible net equity of the plan (or the combined entity) as of the end of such month and the minimum net equity required by subdivisions (a) or (b) of Rule 1300.76, as applicable.
(c) A plan shall continue to file the Monthly Report required by subdivisions (a) or (b) of this Rule each month until it demonstrates and is notified by the Department that the plan has met all of the following conditions:
(1) The plan's tangible net equity, individually or on a combined basis with affiliates, has been 150% or more, or 130% or more for a point-of-service contract, of the minimum tangible net equity required by subdivisions (a) or (b) of Rule 1300.76, as applicable, for six consecutive calendar months;
(2) The plan has met the requirements of subdivision (a) of Rule 1300.75.1, as demonstrated in the plan's Monthly Report filing for six consecutive calendar months; and
(3) The plan has been licensed and operated as a health care service plan for at least twelve consecutive calendar months.
(d) The Monthly Report shall include all the requested information prescribed in both the Monthly Report and the Annual, Quarterly, and Monthly Financial Reporting Forms Instruction Manual, as incorporated by reference in Rule 1300.84.1. The Monthly Report shall be submitted to the Department in the manner described in, and shall cover the applicable time period specified in, the Annual, Quarterly, and Monthly Financial Reporting Forms Instruction Manual, as incorporated by reference in Rule 1300.84.1.

Cal. Code Regs. Tit. 28, § 1300.84.3

1. Amendment of subsection (d) filed 6-2-78; effective thirtieth day thereafter (Register 78, No. 22).
2. Amendment of subsection (d) filed 7-3-84; effective thirtieth day thereafter (Register 84, No. 27).
3. Amendment filed 7-21-86; effective thirtieth day thereafter (Register 86, No. 30).
4. Change without regulatory effect of subsection (d) (Register 86, No. 38).
5. Amendment of subsection (d) filed 12-14-90; operative 12-31-90 (Register 91, No. 6).
6. Change without regulatory effect amending subsection (e) filed 4-4-2000 pursuant to section 100, title 1, California Code of Regulations (Register 2000, No. 14).
7. Change without regulatory effect amending subsections (b), (c) and (d) filed 7-18-2000 pursuant to section 100, title 1, California Code of Regulations (Register 2000, No. 29).
8. Amendment of subsection (d)(1) and repealer of subsections (d)(1)(A)-(G) filed 12-9-2015; operative 4-1-2016 (Register 2015, No. 50).
9. Repealer and new section and amendment of NOTE filed 5-18-2022; operative 7-1-2022 (Register 2022, No. 20).

Note: Authority cited: Sections 1344, 1348.95 and 1384, Health and Safety Code. Reference: Sections 1348.95 and 1384, Health and Safety Code.

1. Amendment of subsection (d) filed 6-2-78; effective thirtieth day thereafter (Register 78, No. 22).
2. Amendment of subsection (d) filed 7-3-84; effective thirtieth day thereafter (Register 84, No. 27).
3. Amendment filed 7-21-86; effective thirtieth day thereafter (Register 86, No. 30).
4. Change without regulatory effect of subsection (d) (Register 86, No. 38).
5. Amendment of subsection (d) filed 12-14-90; operative 12-31-90 (Register 91, No. 6).
6. Change without regulatory effect amending subsection (e) filed 4-4-2000 pursuant to section 100, title 1, California Code of Regulations (Register 2000, No. 14).
7. Change without regulatory effect amending subsections (b), (c) and (d) filed 7-18-2000 pursuant to section 100, title 1, California Code of Regulations (Register 2000, No. 29).
8. Amendment of subsection (d)(1) and repealer of subsections (d)(1)(A)-(G) filed 12-9-2015; operative 4/1/2016 (Register 2015, No. 50).
9. Repealer and new section and amendment of Note filed 5-18-2022; operative 7/1/2022 (Register 2022, No. 20).