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Rule Title: STATUS OF CARRIERS AS SMALL EMPLOYER CARRIERS - PERMISSION TO REENTER - ANNUAL REPORTING REQUIREMENTS
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Department: STATE AUDITOR
Chapter: INSURANCE DEPARTMENT
Subchapter: Small Employer Health Insurance Rules
 
Latest version of the adopted rule presented in Administrative Rules of Montana (ARM):

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6.6.5050    STATUS OF CARRIERS AS SMALL EMPLOYER CARRIERS - PERMISSION TO REENTER - ANNUAL REPORTING REQUIREMENTS

(1) In order to enter the small employer market, health insurance carriers must:

(a) Have prior approval by the commissioner of at least one basic and one standard health benefit plan for issuance in the small employer market; and

(b) Notify the commissioner of:

(i) All the carrier's health benefit plans intended for use in the small employer market, and the date of approval of all forms used in connection with those plans; and

(ii) The carrier's intent to comply with all provisions of the Small Employer Health Insurance Availability Act, including guaranteed issue requirements for all health benefit plans actively marketed by the carrier.

(2) Each new carrier applying for a certificate of authority to sell disability insurance in this state shall include with its application a statement whether it intends to operate as a small employer carrier in this state.

(3) If a carrier opts to discontinue operating as a small employer carrier in this state, the carrier may continue to provide coverage under health benefit plans previously issued to small employers in this state as provided in 33-22-1811(1) (c) , MCA.

(4) If a small employer carrier opts to discontinue offering a particular type or all group health insurance coverage in the small group market, the provisions of 33-22-524 and 33-22-1810, MCA, apply.

(5) A carrier that has been prohibited from writing coverage for small employers in this state pursuant to 33-22-1810(1) (g) , MCA, may not resume offering health benefit plans to small employers in this state until the carrier has received permission from the commissioner to reenter the small employer market as a small employer carrier.

(6) No later than March 1 of each year, each carrier shall file with the commissioner the following information related to health benefit plans issued or marketed by that carrier to small employers in this state:

(a) The number of small employers that were issued health benefit plans in the previous calendar year, indicating the number of newly issued plans and the number of renewals;

(b) The number of small employers that were issued basic health benefit plans and the number of small employers that were issued standard health benefit plans in the previous calendar year, arranged separately, showing the number of newly issued plans and the number of renewals as to each class of business;

(c) The number of small employer health benefit plans in force in each county of the state as of December 31 of the previous calendar year;

(d) The number of small employer health benefit plans that were voluntarily not renewed by small employers in the previous calendar year;

(e) The number of small employer health benefit plans that were terminated or nonrenewed, for reasons other than nonpayment of premium, by the carrier in the previous calendar year;

(f) The number of small employer health benefit plans that were issued to small employers that were uninsured for at least 3 months prior to issue; and

(g) A list of all health benefit plans being actively marketed by the carrier in the small employer market, together with a list of all form numbers used in connection with those plans and the date of approval for each such form. In the case that a health benefit plan is not being actively marketed, the list must specify the date on which the carrier notified the commissioner that the carrier ceased actively marketing the plan.

History: Sec. 33-1-313, 33-22-143, and 33-22-1822, MCA; IMP, Sec. 33-22-1802, 33-22-1810, 33-22-1811, 33-22-1812, and 33-22-1814, MCA; NEW, 1994 MAR p. 1528, Eff. 6/10/94; AMD, 1994 MAR p. 2926, Eff. 11/11/94; AMD, 1995 MAR p. 2127, Eff. 10/13/95; AMD, 1998 MAR p. 1698, Eff. 6/26/98.


 

 
MAR Notices Effective From Effective To History Notes
6/26/1998 Current History: Sec. 33-1-313, 33-22-143, and 33-22-1822, MCA; IMP, Sec. 33-22-1802, 33-22-1810, 33-22-1811, 33-22-1812, and 33-22-1814, MCA; NEW, 1994 MAR p. 1528, Eff. 6/10/94; AMD, 1994 MAR p. 2926, Eff. 11/11/94; AMD, 1995 MAR p. 2127, Eff. 10/13/95; AMD, 1998 MAR p. 1698, Eff. 6/26/98.
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