REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE
Definition of terms.
Chapter applicable to small employer benefit plans.
Regulations on premium rates.
Base rate increase to be filed with director--Approval or disapproval.
Disclosure in solicitation and sales materials.
Information and documentation required--Disclosure.
Suspension of rate requirements.
Application of chapter.
Health maintenance organization considered separate carrier.
Ceding arrangements resulting in less than fifty percent of obligation or
risk retained by carrier prohibited.
Transition period when acquiring additional class of business.
Rate changes only for small employer business.
Provisions for premium rates.
Limit on premium rates.
Promulgation of rules for rating practices.
Small employer carrier to issue plan to any small employer--Criteria--Exceptions--Two percent earned premium threshold.
Uniform application of requirements used to determine eligibility of
Application of minimum participation and minimum employer
Considerations in applying minimum participation requirements--Premium
Increase in minimum requirements for employee participation or employer
contribution prohibited after acceptance for coverage.
Modification to exclude certain diseases prohibited.
Exclusion of benefits for injury while under the influence of alcohol or
drugs prohibited--Exception for sickness or injury caused in commission
Requirements lifted from small employer carrier in financially impaired
Director to promulgate rules regulating sale of multiple employer trusts
and welfare arrangements--Scope of rules.
Rules governing implementation and administration of this chapter.
Marketing health benefit plans--Denial of coverage to employer.
Prohibited activities of small employer carriers or insurance producers.
Information regarding restricted network provision of carrier.
Agent compensation based on characteristics of small employer
prohibited--Commission on sale of health insurance plan through
Compensation of insurance producer based on percentage of premium.
Status of insurance producer's employment may not be affected by health
status, claims experience, occupation, or location of small employer placed
Carrier or agent not to induce or encourage employer to exclude employee
Reasons for denial of coverage to be in writing.
Rules for additional standards for fair marketing and broad availability of
benefit plans to small employers--Penalties.
Third-party administrator treated as small employer carrier.
Chapter not applicable to certain group health insurance plans.
Establishing risk adjusters.
Minimum inpatient care coverage following delivery.
Shorter hospital stay permitted--Follow-up visit within forty-eight hours
Notice to employees--Disclosures.
Health insurance policies to provide coverage for biologically-based
Supplemental or short term individual health benefit plans exempt from
provisions of chapter--Conditions.
Policies to provide coverage for diabetes supplies, equipment and
education--Exceptions--Conditions and limitations.
Diabetes coverage not required of certain plans.
Health benefit plans to provide coverage for prostate cancer screening.
Association exempt from application of rating requirements of chapter--Criteria.