Idaho State Statutes - Idaho Attorney Directory

The director shall
not issue or permit to exist a certificate of authority to be or act as a
service corporation, as to any corporation not fulfilling the following
qualifications:
(1) Must be incorporated as provided in section 41-3406, Idaho Code, as a
professional service corporation.
(2) Must intend to and actually conduct its business in good faith as a
nonprofit corporation.
(3) Must have in force service agreements with participant licensees
located in the areas of the subscribers' residences convenient as to location
and sufficient in numbers, capacity and facilities reasonably to furnish
respective categories of health care services then provided or proposed to be
provided by the corporation to its subscribers. Said professional service
corporation shall be ready and willing at all times to enter into service
agreements with all licensees of the category or categories specified in its
articles of incorporation who are qualified under the laws of the state of
Idaho and who desire to become participant licensees of said corporation and
who practice within the general area served by said professional service
corporation.
(4) If a newly formed corporation, it must possess sufficient available
working funds to pay all reasonably anticipated cost of acquisition of new
business and operating expenses, other than payment for professional services,
for a period of not less than the six (6) months next following the date of
issuance of the certificate of authority, if issued.
[5] (6) Nothing in this section shall preclude a service corporation from
refusing to contract with a health care licensee who is unqualified or who
does not meet the terms and conditions of the participating licensee contract
of the service corporation or from terminating or refusing to renew the
contract of a participating health care licensee who is unqualified or who
does not comply with, or who refuses to comply with, the terms and conditions
of the participating health care licensee contract including, but not limited
to, practice standards and quality requirements. The contract shall provide
for written notice to the participating health care licensee setting forth any
breach of contract for which the service corporation proposes that the
contract be terminated or not renewed and shall provide for a reasonable
period of time for the participating health care licensee to cure such breach
prior to termination or nonrenewal. If the breach has not been cured within
such period of time the contract may be terminated or not renewed. Provided
however, that if the breach of contract for which the service corporation
proposes that the contract be terminated or not renewed is a willful breach,
fraud or a breach which poses an immediate danger to the public health or
safety, the contract may be terminated or not renewed immediately.
[6] (7) Every service corporation issuing benefits pursuant to this
chapter shall establish a grievance system for licensees. Such grievance
system shall provide for arbitration according to chapter 9, title 7, Idaho
Code, or for such other system which provides reasonable due process
provisions for the resolution of grievances and the protection of the rights
of the parties.
[7] (8) (5) Must fulfill all other applicable requirements of this
chapter.

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