§ 23-86-510. Premium rates
(a) The health insurance purchasing group may determine what rating characteristics it will allow in the health benefit plan, including, but not limited to, age, sex, industry, geography, or health. (b) If health is used as a rating characteristic, then the rates for the size groups two through twenty-five (2-25) will be subject to the […]
§ 23-86-401. Title
This subchapter may be cited as the “Freedom of Choice Among Health Benefit Plans Act of 1999”.
§ 23-86-511. Rules
The Insurance Commissioner may promulgate rules necessary to implement the provisions of this subchapter.
§ 23-86-402. Legislative finding
The General Assembly finds that: (1) Citizens covered by health benefit plans should have the opportunity to obtain healthcare services at an affordable price; (2) The cost of health benefit plans can vary depending upon the kind of arrangement the health benefit plan has with providers of healthcare services; (3) In order to provide affordable […]
§ 23-86-403. Definitions
As used in this subchapter: (1) “Benefit level” means an obligation of the health maintenance organization or insurance company under its health benefit plan. The benefit level is actuarially determined considering the copayments, deductibles, and dollar limits of the health benefit plan; (2) “Covered healthcare services” means services rendered or products sold by a healthcare […]
§ 23-86-404. Optional health benefit plans
(a) A health maintenance organization may offer and issue health benefit plans that reimburse or arrange for covered healthcare services to covered persons through a limited network plan if: (1) The health maintenance organization provides itself, or arranges through an insurance company, for an annual option for covered persons to choose a health benefit plan […]
§ 23-86-405. Effect of subchapter on pricing
Nothing in this subchapter shall be construed to prohibit a health maintenance organization from pricing any health benefit plan according to sound actuarial principles.
§ 23-86-406. Effect of subchapter on coverage of specific services
Nothing in this subchapter shall be construed to require a health maintenance organization to cover any specific healthcare service.
§ 23-86-501. Title
This subchapter shall be known and cited as the “Small Employer Health Insurance Purchasing Group Act of 2001”.
§ 23-86-502. Definitions
As used in this subchapter: (1) “Commissioner” means the Insurance Commissioner; (2) “Eligible employee” means an employee or individual who is a full-time employee of an eligible employer and is qualified to enroll in a health benefit plan offered through a health insurance purchasing group; (3) “Eligible employer” means an employer employing no more than […]