044-49 Wyo. Code R. § 49-15

Current through April 27, 2019
Section 49-15 - Status of Carriers as Small Employer Carriers

(a)

  • (i) Within sixty (60) days after the effective date of this Regulation, each carrier providing health benefit plans in this state that has not filed with the commissioner the basic and standard plans pursuant to W.S. § 26-19-306(b) 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.
  • (ii) Carriers that have filed with the commissioner the basic and standard plans pursuant to W.S. § 26-19-306(b) shall be considered as operating as a small employer carrier in the state.

(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 the following provisions:

  • (i) The carrier complies with the requirements W.S. § 26-19-301 et seq. with respect to each of the health benefit plans previously issued to small employers by the carrier.
  • (ii) 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 W.S. § 26-19-301 et seq. and this Regulation shall apply to the coverage issued to such new entrants.
  • (iii) The carrier complies with the requirements of Sections 7, 8, and 13 of this Regulation as they apply to eligible employees and dependents of small employers whose coverage has been denied, limited, or restricted by the carrier, or whose rates are in violation of W.S. § 26-19-304(a)(iv).

(d) 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 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.

044-49 Wyo. Code R. § 49-15