40-19a04. Contracts; authorization.
40-19a04
40-19a04. Contracts; authorization.Corporations organized under the provisions of this act are empoweredand authorized to enter into contracts with groups and individuals toprovide professional service through their participating dentists and toindemnify covered persons who obtain professional services throughnonparticipating dentists. The services covered under such contracts shallbe of such type and kind as such corporation, through its board ofdirectors, may determine. Such contracts shall constitute directobligations of the participating dentists to the corporation's contractpurchasers. Nothing in any contract to be madeby any such corporation with a participating dentist or contract purchasershall have the effect of imposing upon any participating dentist anyobligation or liability for any act, omission or default of any otherparticipating dentist or such corporation. Such corporations may also enterinto contracts with any health maintenance organization, partnership,domestic or foreign corporation or association inthe state of Kansas or in other states or possessions of the United Statesor Canada, or with any local, state, or federal governments, or unitsthereof, so that:
(a) Reciprocity of benefits may be provided to subscribers of suchcorporations.
(b) Transfer of subscribers from one corporation to another may beeffected, if authorized under the contract with the group or thesubscriber, in order to conform to the subscriber's place of residence.
(c) Uniform benefits may be provided for all employees and thedependents of such employees of corporations and other organizationstransacting business in Kansas and elsewhere, and a composite rate, a raterepresenting predicted, or actual, composite experience, of the areasinvolved may be charged for such employees and their dependents.
(d) Service or indemnity benefits for dental care for the subscribers,members or policyholders of such corporations or associations may beprovided but not to exceed reasonable and customary charges that asubscriber may incur for these services, or the ceding or accepting ofreinsurance may be done.
(e) Administrative, accounting, data processing, cost control,marketing, claims processing, fiscal and other services may be provided fora dental care or other health service plan with any agency, instrumentalityor political subdivision of the United States or the state of Kansas, orwith any person, corporation, health maintenance organization, partnership,group or association providing such dental care or other health serviceplan under any applicable state or federal law. Such contract mayauthorize such corporation to accept, receive and administer in trust,funds directly or indirectly made available for the purposes set forth in the contract.
(f) Administrative, accounting, data processing, cost control,marketing, claims processing, fiscal and other services may be provided toemployers or voluntary employees' beneficiary associations where suchemployers or voluntary employees' beneficiary associations provideindemnity for dental care or other health services to their employees ormembers under the terms of a plan of indemnification. Such contract mayauthorize such corporation to accept, receive and administer in trust,funds directly or indirectly made available for the purposes set forth inthe contract. Contracts entered into pursuant to the provisions of thissubsection shall provide for recoupment of all expenses incurred by thecorporation in performing the services required by the contract and shallnot adversely affect the interests of subscribers. Such corporation mayenter into contracts with participating dentists to provide professionalservices and other health services for such employees or members.
(g) Experimental or demonstration projects may be undertaken todetermine the relative advantages and disadvantages of various alternativemethods of providing service or indemnity benefits for health services. Such projects may include payment systems to providers designed toencourage providers to use their facilities and personnel more efficientlyand thereby to reduce the total costs of professional services and otherhealth services involved without adversely affecting the quality of such services.
History: L. 1972, ch. 174, § 4; L. 1984, ch. 171, § 1; July 1.