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