(a)A health benefit plan subject to this act shall be
renewable with respect to all eligible employees or dependents
at the option of the employer except in the following cases:
(i)Nonpayment of the required premiums;
(ii)Fraud or misrepresentation of the employer or,
with respect to coverage of individual insureds, the insureds or
their representatives;
(iii)Noncompliance with the carrier's minimum
participation requirements;
(iv)Noncompliance with the carrier's employer
contribution requirements;
(v)Repeated misuse of a provider network provision;
(vi)The carrier elects not to renew all of its
health benefit plans issued to small employers in this state.
In such a case, the carrier shall:
(A)Provide advanced notice of its decision
under this paragraph to the commissioner in each
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(a) A health benefit plan subject to this act shall be
renewable with respect to all eligible employees or dependents
at the option of the employer except in the following cases:
(i) Nonpayment of the required premiums;
(ii) Fraud or misrepresentation of the employer or,
with respect to coverage of individual insureds, the insureds or
their representatives;
(iii) Noncompliance with the carrier's minimum
participation requirements;
(iv) Noncompliance with the carrier's employer
contribution requirements;
(v) Repeated misuse of a provider network provision;
(vi) The carrier elects not to renew all of its
health benefit plans issued to small employers in this state.
In such a case, the carrier shall:
(A) Provide advanced notice of its decision
under this paragraph to the commissioner in each state in which
it is licensed; and
(B) Provide notice of the decision not to renew
coverage to all affected health benefit plans and to the
commissioner in each state in which an affected insured
individual is known to reside at least one hundred eighty (180)
days prior to the nonrenewal of any health benefit plans by the
carrier. Notice to the commissioner under this subparagraph
shall be provided at least three (3) working days prior to the
notice to the affected health plans.
(vii) The commissioner finds that the continuation of
the coverage would:
(A) Not be in the best interests of the
policyholders or certificate holders; or
(B) Impair the carrier's ability to meet its
contractual obligations.
(b) If the commissioner finds that the carrier may elect
not to renew coverage under paragraph (vii) of subsection (a) of
this section he shall assist affected small employers in finding
replacement coverage.
(c) A carrier that elects not to renew a health benefit
plan under paragraph (vi) of subsection (a) of this section
shall be prohibited from writing new business in the small
employer market for a period of five (5) years from the date of
notice to the commissioner.
(d) In the case of a health maintenance organization doing
business in the small employer market in one (1) established
geographic service area of the state, the provisions set forth
in this section shall apply to the health maintenance
organization's operations in that service area.