(a) A health care insurer that offers, issues for delivery, delivers, or renews a health care insurance plan in the group market may not establish rules for eligibility, including continued eligibility and waiting periods under the plan, for an individual or dependent of an individual based on (1) health status; (2) medical condition, including physical […]
A health care insurer that offers, issues, delivers, or renews a health care insurance plan in the group market shall allow an eligible employee or dependent of an employee to enroll for coverage under the terms of the plan if the employee or dependent (1) is covered by Medicaid under 42 U.S.C. 1396 – 1396u […]
(a) A health care insurance plan offered, issued for delivery, delivered, or renewed in the group market may not contain a preexisting condition exclusion that (1) relates to a condition, regardless of cause, for which medical advice, diagnosis, care, or treatment was recommended or received more than six months before the enrollment date; (2) considers […]
(a) A health care insurer that offers, issues for delivery, delivers, or renews in this state a health care insurance plan in the group market shall count a period of creditable coverage based on (1) the standard method authorized by 42 U.S.C. 300gg (Health Insurance Portability and Accountability Act of 1996) for determining creditable coverage […]
(a) Except for a multiple employer welfare arrangement, a health care insurer that offers, issues for delivery, delivers, or renews in this state a health care insurance plan in the group market shall renew or continue in force the coverage under the plan at the option of the plan sponsor unless (1) the plan sponsor […]
A health benefit plan that is a multiple employer welfare arrangement subject to this title may not deny an employer whose employees are covered under the plan continued access to the same or a different plan according to the terms of the plan, except (1) for nonpayment of contributions; (2) for fraud or other intentional […]
A health care insurer that offers a health care insurance plan in the group market shall comply with the mental health or substance use disorder benefit requirements established under 42 U.S.C. 300gg-26.
“Excepted benefits” means benefits under one or more or any combination of the following: (1) benefits under (A) coverage only for accident, disability income insurance, or both; (B) coverage issued as a supplement to liability insurance; (C) liability insurance, including general liability insurance and automobile liability insurance; (D) workers’ compensation or substantially similar insurance; (E) […]
The determination of whether an employer is a large or small employer is subject to the following: (1) the size of an employer that was not in existence throughout the preceding calendar year must be based on the average number of employees that the employer is reasonably expected to employ on the business days in […]
