6.6.5079A GUARANTEED AVAILABILITY OF COVERAGE IN THE SMALL GROUP MARKET - GUARANTEED ISSUE REQUIREMENTS - EXCEPTIONS
(1) Except for coverage offered only through a bona fide
association, and subject to (2) , (3) , and (4) , each small group carrier that
offers health insurance coverage in the small group market must offer, to any
small employer in the state, all products that are approved for sale in the
small group market and that the issuer is actively marketing, and must accept
any small employer that applies for any of those products.
small employer carrier is not required to issue coverage to a small group
employer that does not meet the minimum participation and contribution
requirements of the carrier, as permitted by 33-22-1811(3) (d) , MCA. If a
carrier refuses to issue any plan to a small employer on the basis that the
small employer does not meet participation or contribution requirements, the
carrier may not issue any other plan to the small group employer.
small employer carrier is not required to issue coverage in circumstances set
forth in 33-22-1811(4) , MCA. In the event that a small employer carrier denies
coverage to a small employer under that section and is prevented from offering
coverage for 180 days, the responsibilities of the small employer carrier to
renew existing coverage pursuant to 33-22-524 and 33-22-1810, MCA, continue.
small employer carrier may not issue coverage to a small employer under
circumstances described in 33-22-1811(3) (e) (iv) , MCA.
purposes of this rule, "product" refers to a health benefit plan, and
includes all contract provisions included in the contract language for a health
benefit plan issued to a small group employer.
History: Sec. 33-22-1822, MCA; IMP, Sec. 33-22-1811, MCA; NEW, 1998 MAR p. 1698, Eff. 6/26/98.