58-68-25. Definitions; excepted benefits; employer size rule. (a) Definitions. – In addition to other definitions throughout this Article, the following definitions and their cognates apply in this Article: (1) "Bona fide association". – With respect to health insurance coverage offered in this State, an association that: a. Has been actively in existence for at least […]
58-68-30. Increased portability through limitation on preexisting condition exclusions. (a) Limitation on Preexisting Condition Exclusion Period; Crediting for Periods of Previous Coverage. – Subject to subsection (d) of this section, a group health insurer may, with respect to a participant or beneficiary, impose a preexisting condition exclusion only if: (1) The exclusion relates to a […]
58-68-35. Prohibiting discrimination against individual participants and beneficiaries based on health status. (a) In Eligibility To Enroll. – (1) In general. – Subject to subdivision (2) of this subsection, a group health insurer shall not establish rules for eligibility, including continued eligibility, of any individual to enroll under the terms of the health insurer’s plan […]
58-68-40. Guaranteed availability of coverage for employers in the small group market. (a) Issuance of Coverage in the Small Group Market. – (1) In general. – Subject to subsections (c) through (f) of this section, each health insurer that offers health insurance coverage in the small group market in this State: a. Must accept every […]
58-68-45. Guaranteed renewability of coverage for employers in the group market. (a) In General. – Except as provided in this section, if a health insurer offers health insurance coverage in the small or large group market, the health insurer must renew or continue in force the coverage at the option of the employer. (b) General […]
58-68-50. Disclosure of information. (a) Disclosure of Information by Health Insurers. – In connection with the offering of any health insurance coverage to a small employer, a health insurer: (1) Shall make a reasonable disclosure to the employer, as part of its solicitation and sales materials, of the availability of information described in subsection (b) […]
58-68-55. Exclusion of certain plans. (a) Exception for Certain Benefits. – The requirements of Subparts 1 and 2 of this Part do not apply to any group health insurance coverage in relation to its provision of excepted benefits described in G.S. 58-68-25(b)(1). (b) Exception for Certain Benefits if Certain Conditions Met. – (1) Limited, excepted […]
58-68-60. Guaranteed availability of individual health insurance coverage to certain individuals with prior group coverage. (a) Guaranteed Availability. – (1) In general. – Subject to the succeeding subsections of this section, each health insurer that offers health insurance coverage in the individual market in this State shall not, with respect to an eligible individual desiring […]
58-68-65. Guaranteed renewability of individual health insurance coverage. (a) In General. – Except as provided in this section, a health insurer that provides individual health insurance coverage to an individual shall renew or continue in force the coverage at the option of the individual. (b) General Exceptions. – A health insurer may nonrenew or discontinue […]
58-68-70. Certification of coverage. G.S. 58-68-30(e) applies to health insurance coverage offered by a health insurer in the individual market in the same manner that it applies to health insurance coverage offered by a health insurer in the small or large group market. (1997-259, s. 1(c).)
58-68-75. General exceptions. (a) Exception for Certain Benefits. – This Part does not apply to any health insurance coverage in relation to its provision of excepted benefits described in G.S. 58-68-25(b)(1). (b) Exception for Certain Benefits if Certain Conditions Met. – This Part does not apply to any health insurance coverage in relation to its […]
