§ 27-8-15-19 — Cancellation or refusal of renewal of plans

Indiana § 27-8-15-19

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 8: LIFE, ACCIDENT, AND HEALTH
• Ch. 15: Small Employer Group Health Insurance

Text

Except as provided in section 20 of this
chapter, a small employer insurer may only cancel or refuse to renew
a health insurance plan for the following reasons:
(1) Nonpayment of required premiums.
(2) Fraud or misrepresentation of the small employer, or with
respect to coverage of an insured individual, fraud or
misrepresentation by the insured individual or the individual's
representative.
(3) The small employer has failed to comply with a material plan
provision relating to employer contribution or group participation
rules.
(4) In the case of a small employer insurer that offers coverage in
a market through a network plan, there is no longer any insured
individual in connection with the plan who lives, resides, or
works:
(A) in the service area of the small employer insurer; or
(B) in the area for which the issuer is authorized to do business.
(5) In the case of coverage that is made available through one (1)
or more bona fide associations, the membership of the small
employer in the association ceases, but only if the coverage is
terminated under this subdivision uniformly without regard to any
health status related factor relating to an insured individual.
(6) In a case in which an insurer decides to discontinue offering
a particular type of group health insurance coverage offered in the
small employer market, that coverage may be discontinued by the
insurer only if:
(A) the insurer provides notice of the insurer's intent to
discontinue the coverage to each small employer provided with
the coverage;
(B) the insurer offers the option to purchase all other health
insurance coverage currently being offered by the insurer to the
small employer to each small employer that is provided with the
coverage; and
(C) in exercising the option to discontinue the coverage in
offering the option of coverage under clause (B), the insurer
acts uniformly without regard to:
(i) the claims experience of the small employer groups; or
(ii) any health status related factor relating to any eligible
employee or dependent of an eligible employee who is
covered or who may become eligible for the coverage.

Legislative History

As added by P.L.127-1992, SEC.1. Amended by P.L.93-1995, SEC.14; P.L.91-1998, SEC.17.