Minn. R. agency 120, ch. 2740, SOLICITATION, APPLICATION, AND ENROLLMENT, pt. 2740.3700

Current through Register Vol. 49, No. 18, October 28, 2024

Part 2740.3700 - ASSOCIATION'S RESPONSE

Subpart 1.Time limitation.

Within 30 days of receipt of a complete certificate of eligibility and enrollment form pursuant to part 2740.3600, subpart 2, items A, B, and C, the association or the writing carrier shall accept the certificate of eligibility or shall reject the certificate of eligibility for failure to meet the eligibility requirements.

Subp. 2.Acceptance.

If the association or its writing carrier accepts the certificate of eligibility, it shall forward a notice of acceptance, billing information, and a policy or contract or certificate that shall evidence coverage under the state plan.

A. Such policy or contract or certificate of coverage shall include but not be limited to:

(1) a statement that the person is covered under the state plan from the effective date contained therein;

(2) specification of the type of state plan under which the person is covered;

(3) a statement that the plan is provided by the association;

(4) a description of the benefits provided by the plan, conditions for eligibility, and exclusions and limitations of coverage; and

(5) provision for an identification card for each insured person indicating the type of state plan and also that coverage is being provided by the association.

B. When the state plan premium is received by the association or its writing carrier for the first billing period and accepted in accordance with this part, the coverage shall be effective retroactive to the date of receipt by the association or its writing carrier of the completed certificate of eligibility pursuant to part 2740.3600, subpart 2, items A, B, and C unless otherwise requested by the insured person and approved by the board.

Subp. 3.Nonacceptance.

If the association does not accept the certificate of eligibility, the applicant shall be informed of the reason for the rejection and shall have the opportunity to submit additional information to substantiate eligibility for coverage under the state plan and to request reconsideration of the decision. The board may establish a review mechanism for reviewing requests for reconsideration of rejected certificates of eligibility. The association shall give notice of a final determination of ineligibility to the applicant stating the reasons therefor and advising the applicant of the right to appeal to the commissioner within a reasonable period of time.

Minn. R. agency 120, ch. 2740, SOLICITATION, APPLICATION, AND ENROLLMENT, pt. 2740.3700

10 SR 474

Statutory Authority: MS s 62E.09