58-50A-1. Definitions. The following definitions apply in this Article: (1) Employer member. – A person or entity acting directly as the employer of at least one employee, or a working owner, either of whom is a participant covered under a Path 2 MEWA. (2) Employee welfare benefit plan. – The term as defined in Section […]
58-50A-10. Sponsoring association requirements. No insurer shall deliver or issue for delivery a group health plan to a sponsoring association or an employer member of a sponsoring association unless that sponsoring association meets the requirements of a Path 2 MEWA. (2019-202, s. 1.)
58-50A-15. Membership requirements. (a) Group health plans offered by a sponsoring association may only provide coverage to the following: (1) Eligible employees of the employer member as defined in G.S. 58-51-80(c) and working owners pursuant to 29 C.F.R. 2510.3-5. (2) The spouse or dependent children of any individual identified in subdivision (1) of subsection (a) […]
58-50A-20. Health plan requirements. Any group health plan offered by a sponsoring association must meet all of the following requirements: (1) Neither be offered nor advertised to the public generally. (2) Provides a level of coverage equal to or greater than sixty percent (60%) of the actuarial value of allowed costs for covered benefits. (3) […]
58-50A-25. Solvency requirements. No insurer shall deliver or issue for delivery a group health plan to a sponsoring association or an employer member of a sponsoring association unless the sponsoring association meets all of the following solvency requirements: (1) Has been established and maintained in good faith for a period of at least three years. […]
58-50A-30. Nondiscrimination. (a) No sponsoring association may condition eligibility for coverage, including continuing eligibility for coverage, on any of the following health-status factors: (1) Health status. (2) Medical condition, including both physical and mental illness. (3) Claims experience. (4) Receipt of health care. (5) Medical history. (6) Genetic information. (7) Evidence of insurability. (8) Disability. […]
58-50A-35. Premium contributions. (a) Neither an insurer nor a sponsoring association shall require any individual, as a condition of initial enrollment or continued enrollment in the plan, to pay a premium or contribution that is greater than the premium or contribution for a similarly situated individual enrolled in the plan on the basis of any […]
58-50A-40. Use of licensed agents and brokers. Nothing in this Article shall preclude a sponsoring association from engaging a broker or agent licensed to sell insurance in this State for the purposes of reviewing and considering any group health plan offered to a sponsoring association under this section. (2019-202, s. 1.)
58-50A-5. Compliance with requirements. Regardless of the domicile of the sponsoring association receiving the policy, no group health plan shall be offered by a sponsoring association in this State unless it complies with the requirements of this Chapter. Nothing in this Article shall be interpreted to regulate or prohibit any group health insurance policy that […]
58-50A-60. Multiple employer welfare arrangements; administrators. (a) Repealed by Session Laws 2019-202, s. 3(a), effective October 1, 2019, and applicable to contracts entered into, amended, or renewed on or after January 1, 2020. (b) Each insurer licensed to do business in this State that administers a MEWA shall, at the request of the Commissioner, provide […]
58-50A-65. Multiple employer welfare arrangements; license required; penalty. (a) It is unlawful to operate, maintain, or establish a MEWA unless the MEWA has a valid license issued by the Commissioner. Any MEWA operating in this State without a valid license is an unauthorized insurer. (b) G.S. 58-50A-60 through G.S. 58-50A-95 do not apply to a […]
58-50A-70. Qualifications for licensure. (a) To meet the requirements for issuance of a license and to maintain a MEWA, a MEWA must be: (1) Nonprofit. (2) Either of the following: a. Established by a trade association, industry association, or professional association of employers or professionals that has a constitution or bylaws and that has been […]
58-50A-75. Certain words prohibited in name of MEWA. No licensed MEWA shall use in its name, contracts, literature, advertising in any medium, or any other printed matter the words "insurance", "casualty", "surety", "mutual", or any other words descriptive of the insurance business or deceptively similar to the name or description of any insurer doing business […]
58-50A-80. Filing of application. An association sponsoring a MEWA shall file with the Commissioner an application for a license on a form prescribed by the Commissioner and signed under oath by officers of the association. The application shall include or have attached the following: (1) A copy of the articles of incorporation, constitution, and bylaws […]
58-50A-85. Examinations; deposits; solvency regulation. (a) The provisions of Articles 2, 5, and 30 of this Chapter regarding examinations, deposits, and supervision and receivership respectively apply to MEWAs. The provisions of Article 62 of this Chapter and of Article 8B of Chapter 105 of the General Statutes do not apply to MEWAs. (b) An audit […]
58-50A-90. Annual reports; actuarial certifications; quarterly reports. (a) Every MEWA shall, within 150 days after the end of each of its fiscal years or within any such extension of time that the Commissioner for good cause grants, file a report with the Commissioner, on forms prescribed by the Commissioner and verified by the oath of […]
58-50A-95. Denial, suspension, or revocation of license. (a) The Commissioner shall deny, suspend, or revoke a MEWA’s license if the Commissioner finds that the MEWA: (1) Is insolvent; (2) Is using such methods and practices in the conduct of its business as to render its further transaction of business in this State hazardous or injurious […]
