Ala. Admin. Code r. 482-1-116-.09

Current through Register Vol. 43, No. 1, October 31, 2024

Section 482-1-116-.09 - Status Of Carriers As Small Employer Carriers

(a) Within thirty (30) days after the effective date of the Act, each carrier providing health benefit plans in this state shall make a filing with the Commissioner indicating whether the carrier intends to operate as a small employer carrier in this state under the terms of this regulation.

(b) Subject to Subsection (c), a carrier shall not offer health benefit plans to small employers, or continue to provide coverage under health benefit plans previously issued to small employers in this state, unless the filing provided pursuant to Subsection (a) indicates that the carrier intends to operate as a small employer carrier in this state.

(c) If the filing made pursuant Subsection (a) indicates that a carrier does not intend to operate as a small employer carrier in this state, the carrier may continue to provide coverage under health benefit plans previously issued to small employers in this state only if the carrier complies with all of the following provisions:

(1) The carrier complies with the requirements of this Regulation with respect to each of the health benefit plans previously issued to small employers by the carrier.

(2) The carrier provides coverage to each new entrant to a health benefit plan previously issued to a small employer by the carrier. The provisions of this Regulation shall apply to the coverage issued to such new entrants.

(3) The carrier complies with the requirements of Sections 10 and 11 of this regulation as they apply to small employers whose coverage has been terminated by the carrier and to individuals and small employers whose coverage has been limited or restricted by the carrier.

(d) If the filing made pursuant to Subsection (a) indicates that a carrier does not intend to operate as a small employer carrier in this state, the carrier shall be precluded from operating as a small employer carrier in this state, except as provided for in Subsection (c), for a period of five (5) years from the date of the filing. Upon a written request from such a carrier, the Commissioner may reduce the period provided for in the previous sentence if the Commissioner finds that permitting the carrier to operate as a small employer carrier would be in the best interests of the small employers in the state.

Author: Reyn Norman, Associate Counsel

Ala. Admin. Code r. 482-1-116-.09

New Rule: September 3, 1997; effective September 28, 1997. Amended: October 14, 1999; effective January 1, 2000. Amended: September 12, 2001; effective October 1, 2001. Filed with LRS September 14, 2001. Rule is not subject to the Alabama Administrative Procedure Act.

Statutory Authority:Code of Ala. 1975, § 27-52-21.