Ins 3.49(3)(d)1.1. A strategy whereby an applicant to the Plan denied insurance or an insured under the Plan whose insurance is terminated might repursuit the committee to evaluation the denial or termicountry and by which an insurer subscribing to the Plan might research the committee to evaluation actions or decisions of the Plan which adversely influence the insurer. The method shall specify that researches for evaluation should be made in writing to the Plan and also that the decision of the committee in regard to the review might be appealed by the applicant, insured or insurer to the commissioner of insurance as provided for in ch. Ins 5. A request for review does continue to be the termination of coverage.
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Ins 3.49(3)(d)2.2. The committee"s decision under subd. 1. shall be in writing and also shall include notice of the appropriate to a hearing under ch. Ins 5 if the perchild files a petition for a hearing through the commissioner of insurance not later than 30 days after the notice is mailed. The alert shall define the demands of s. Ins 5.11 (1).
Ins 3.49(3)(d)3.3. The office of the commissioner of insurance shall hold a hearing within 30 days after receipt of a complete petition under subd. 2., unless the petitioner waives the ideal to a hearing within 30 days. At the hearing, the petitioner has the burden of proving by a preponderance of the proof that the committee"s decision is erroneous under the plan terms or the plan"s rules.
Ins 3.49(3)(d)4.4. Filing a petition under subd. 2. does not continue to be the activity of the setup via respect to termination of coverage. The setup shall comply through the final decision and also order in the challenged case proceeding.
Ins 3.49(3)(e)(e) The commissioner shall maintain files of the Plan"s apshowed rules, prices, and creates and such records must be made available for public inspection at the office of the commissioner of insurance.
Ins 3.51(1)(a)(a) “Accountant" suggests an independent certified public accountant who is duly registered to practice and also in great standing under the regulations of this state or a state with equivalent licensing requirements.
Ins 3.51(1)(b)(b) “Individual practice association" means an individual practice association as identified under s. 600.03 (23g), Stats., which contracts through a health maintenance company insurer or a limited service health and wellness company to carry out health and wellness care solutions which are principally medical professional solutions.
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Ins 3.51(1)(c)(c) “Work papers" are the documents kept by the accountant of the actions adhered to, the tests percreated, the indevelopment derived, and conclusions reached pertinent to the examicountry of the financial statements of the independent practice association. Work records include, however are not limited to, work-related programs, evaluation, memorandum, letters of confirmation and representation, management letters, abstracts of company documents and schedules or commentaries ready or acquired by the accountant in the course of the examination of the financial statements of the independent exercise association and also which assistance the accountant"s opinion.
Ins 3.51(2)(2) Filing of annual audited financial reports. Unmuch less otherwise ordered by the commissioner, an individual practice association shall file an yearly audited financial report via the commissioner within 180 days after the end of each individual practice association"s fiscal year. This area applies to individual exercise associations for fiscal years terminating on or after March 31, 1991. The yearly audited financial report shall report the assets, liabilities and net worth; the results of operations; and the transforms in net worth for the fiscal year then finished on the accrual basis in conformity via mostly accepted accounting practices. The yearly audited financial report shall not be presented on the cash basis or the income taxes basis or any type of other basis that does not totally account for all the independent exercise association"s liabilities incurred as of the finish of the fiscal year. The yearly audited financial report shall include all of the following: