Iowa Admin. Code r. 191-71.12

Current through Register Vol. 47, No. 13, December 25, 2024

Rule 191-71.12 - Status of carriers as small employer carriers

(1) Subject to 71.12(2), a carrier shall not offer health insurance coverages to small employers or continue to provide coverage under health insurance coverages previously issued to small employers in this state unless the carrier has made a filing with the commissioner or director that the carrier intends to operate as a small employer carrier in this state under the terms of this chapter.

(2)

a. If a carrier does not intend to operate as a small employer carrier in this state, the carrier may continue to provide coverage under health insurance coverages previously issued to small employers in this state only if the carrier complies with the following provisions:

(1) The carrier complies with the requirements of Iowa Code chapter 513B (other than Iowa Code sections 513B11. to 513B13. ) with respect to each of the health insurance coverages previously issued to small employers by the carrier.

(2) The carrier provides coverage to each new entrant to health insurance coverage previously issued to a small employer by the carrier. The provisions of Iowa Code chapter 513B (other than Iowa Code sections 513B11. to 513B13. ) and this chapter shall apply to the coverage issued new entrants.

(3) The carrier complies with the requirements of Iowa Code section 513B17A., and rule 191-7113. (513B), 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.

b. A carrier that continues to provide coverage pursuant to this subrule shall not be eligible to participate in the reinsurance program established under Iowa Code section 513B11..

(3) If 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 71.12(2)) for a period of five years from the date of this chapter. 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.

Iowa Admin. Code r. 191-71.12

Amended by IAB March 14, 2018/Volume XL, Number 19, effective 4/18/2018