<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 31.10.22.05" title_num="31" subtitle_num="10" chapter_num="22" heading="Net Worth Requirements.">
  <paragraph num="A.">
    <text>Initial Net Worth. An applicant may not obtain a certificate of authority unless the applicant has an initial net worth of at least:</text>
    <paragraph num="(1)">
      <text>$1,500,000; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>$1,000,000, based on evidence from the applicant's financial plan, as required by 42 CFR §422.384, demonstrating to the Commissioner's satisfaction that the applicant has available to it an administrative infrastructure that the Commissioner considers appropriate to reduce, control, or eliminate start-up administrative costs.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Minimum Net Worth.</text>
    <paragraph num="(1)">
      <text>After issuance of a certificate of authority, a provider-sponsored organization shall maintain at least the minimum net worth required under this section.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Except as provided in §C of this regulation, each provider-sponsored organization shall maintain a minimum net worth equal to the greater of:</text>
      <paragraph num="(a)">
        <text>$1,000,000;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>2 percent of annual premium revenues as reported on the most recent annual financial statement filed with the Commissioner on the first $150,000,000 of premium and 1 percent of annual premium revenues on the premium in excess of $150,000,000;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>An amount equal to the sum of 3 months uncovered health care expenditures as reported on the most recent financial statement filed with the Commissioner; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Using the most recent annual financial statement filed with the Commissioner, an amount equal to the sum of:</text>
        <paragraph num="(i)">
          <text>8 percent of annual health care expenditures paid on a non-capitated basis to non-affiliated providers,</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>4 percent of annual health care expenditures paid on a capitated basis to non-affiliated providers plus annual health care expenditures paid on a non-capitated basis to affiliated providers, and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Annual health care expenditures that are paid on a capitated basis to affiliated providers that are not included in the calculation of the net worth requirement under §§A and B(2)(d)(i) and (ii) of this regulation.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Determining Net Worth. In determining net worth:</text>
    <paragraph num="(1)">
      <text>A debt may not be considered fully subordinated unless the subordination clause is in a form acceptable to the Commissioner;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Any interest obligation relating to the repayment of a subordinated debt shall be similarly subordinated;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The interest expense relating to the repayment of any fully subordinated debt shall be considered covered expenses; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Any debt incurred by a note meeting the requirements of this section, and otherwise acceptable to the Commissioner, is not considered a liability and shall be recorded as equity.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Composition of Assets. To meet the minimum net worth requirements, a provider-sponsored organization shall have the following composition of assets:</text>
    <paragraph num="(1)">
      <text>At the time of application, at least $750,000 of the minimum net worth shall be in cash or cash equivalents;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>After the effective date of the Medicare+Choice contract, the greater of $750,000 or 40 percent of the minimum net worth amount shall be in cash or cash equivalents;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>During the licensing process, up to 10 percent of the minimum net worth amount may be comprised of intangible assets except that, if a provider-sponsored organization keeps $1,000,000 in cash or cash equivalents and does not use the administrative reduction, then up to 20 percent of that provider-sponsored organization's minimum net worth may be comprised of intangible assets;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>After the licensing process, a provider-sponsored organization shall keep the greater of $1,000,000 or 67 percent of the ongoing minimum net worth in cash or cash equivalents to qualify for the 20 percent level on intangibles;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Subject to §D(1)—(4) of this regulation, health care delivery assets may be admitted at 100 percent of their value according to generally accepted accounting principles (GAAP); and</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Subject to §D(1)—(5) of this regulation, other assets may be admitted according to their value under statutory accounting practices (SAP).</text>
    </paragraph>
  </paragraph>
</regulation>