Prepaid Health Plans
Prepaid Health Plans
The North Carolina Department of Insurance is the North Carolina agency responsible for the licensing and financial regulation of a Prepaid Health Plan (“PHP”) under Chapter 58, Article 93 of the North Carolina General Statutes (The Prepaid Health Plan Licensing Act).
Filing an Application for a North Carolina PHP License
An application for a PHP license is required to be submitted by (a) new companies wishing to be initially licensed as a PHP in North Carolina and (b) insurers already licensed in North Carolina that meet the definition of a Licensed Health Organization (“LHO”) pursuant to North Carolina General Statute 58-93-2(7) that are requesting to add a PHP license to their current authority.
Such applications and associated templates are as follows:
Please be advised that the Application for PHP License and the LHO Request to Add PHP License above contain lists of information to be provided by applicants or LHOs. The lists are intended to be used as guides and are not all-inclusive. As such, it is recommended that interested persons refer to Chapter 58, Article 93 of the North Carolina General Statutes when applying for or requesting a PHP license.
Applications and Requests for PHP licenses will be reviewed by the Financial Analysis Division and the Actuarial Services Division. Pursuant to North Carolina General Statute 58-93-4, the Commissioner may contract with consultants and other professionals, as needed, to expedite and complete the review process, the cost of which shall be reimbursed by the applicant or the LHO. Applicants and LHOs requesting a PHP license are requested to complete the following Agreement, should the Department contract with consultants and other professionals, and submit it with their application or request to ensure an expedited review:
Reference Materials
Contact Information
Questions about obtaining a PHP license can be directed to:
Scott Wicker
Company Admissions Manager
919-807-6142
scott.wicker@ncdoi.gov