Chapter 20:06:40 - Employer plans
- Section 20:06:40:01 - Waiting periods, affiliation periods, and applications relating to breaks in coverage. Repealed
- Section 20:06:40:01.01 - Waiting periods and affiliation periods relating to breaks in coverage
- Section 20:06:40:02 - Short-term, limited duration policies
- Section 20:06:40:03 - Certificates required upon losing coverage. Repealed
- Section 20:06:40:03.01 - Certificates required upon losing coverage
- Section 20:06:40:04 - Standards for determinations on length of preexisting waiting periods
- Section 20:06:40:05 - Special enrollment periods for marriage, birth, and adoption
- Section 20:06:40:05.01 - Special enrollment periods for loss of other coverage
- Section 20:06:40:06 - Affiliation periods for health maintenance organizations. Repealed
- Section 20:06:40:07 - Nondiscrimination in determining eligibility for coverage.Repealed
- Section 20:06:40:08 - Standards for determining when a condition is preexisting. Repealed
- Section 20:06:40:09 - Notification of determinations on preexisting waiting periods and appeal and reconsideration procedures. Repealed
- Section 20:06:40:10 - Creditable coverage and preexisting waiting periods for newborn and adopted children. Repealed
- Section 20:06:40:11 - Renewal rights under association plans. Repealed
- Section 20:06:40:12 - Health benefit arrangement defined.Repealed
- Section 20:06:40:13 - Public health plan defined
- Section 20:06:40:14 - Carrier defined. Repealed
- Section 20:06:40:15 - Permissible methods of crediting coverage - Alternative method prohibited. Repealed
- Section 20:06:40:16 - Notice describing plan's special enrollment required
- Section 20:06:40:17 - Group health plans to offer breast reconstruction options after covered mastectomy
- Section 20:06:40:17.01 - Written notification regarding coverage of reconstructive surgery after a mastectomy required
- Section 20:06:40:17.02 - Prohibited practices
- Section 20:06:40:17.03 - Not a termination of collective bargaining agreement
- Section 20:06:40:17.04 - Applicability
- Section 20:06:40:18 - Claims experience defined
- Section 20:06:40:19 - Additional continuation election. Repealed
- Section 20:06:40:20 - Period of special continuation. Repealed
- Section 20:06:40:21 - Treatment of special continuation. Repealed
- Section 20:06:40:22 - Premium subsidy. Repealed
- Section 20:06:40:23 - Medically necessary leave of absence defined
- Section 20:06:40:24 - Dependent coverage
- Section 20:06:40:25 - Notification
- Section 20:06:40:26 - Continued application in case of changed coverage
- Section 20:06:40:27 - Effective date
- Section 20:06:40:28 - Creditable coverage - Children's Health Insurance Program
- Section 20:06:40:29 - Definitions
- Section 20:06:40:30 - Group rating based on health factors
- Section 20:06:40:31 - No group-based discrimination based on genetic information
- Section 20:06:40:32 - Limitation on requesting or requiring genetic testing
- Section 20:06:40:33 - Exceptions to requiring genetic testing
- Section 20:06:40:34 - Research exception
- Section 20:06:40:35 - Prohibitions on collection of genetic information for underwriting purposes
- Section 20:06:40:36 - Medical appropriateness
- Section 20:06:40:37 - Collection of genetic information prior to or in connection with enrollment
- Section 20:06:40:38 - Incidental collection exception
- Section 20:06:40:39 - General exception for certain small group health plans
- Section 20:06:40:40 - Applicability to excepted benefits
- Section 20:06:40:41 - Effective date
- Section 20:06:40:42 - Definitions. Repealed
- Section 20:06:40:43 - Parity requirements with respect to aggregate lifetime and annual dollar limits. Repealed
- Section 20:06:40:44 - Plan with no limit or limits on less than one-third of all medical or surgical benefits. Repealed
- Section 20:06:40:45 - Plan with a limit on at least two-thirds of all medical or surgical benefits. Repealed
- Section 20:06:40:46 - Determining one-third and two-thirds of all medical or surgical benefits. Repealed
- Section 20:06:40:47 - Plan not described in sections 20:06:40:44 or 20:06:40:45 of this chapter. Repealed
- Section 20:06:40:48 - Parity requirements with respect to financial requirements and treatment limitations - Clarification of classification of benefits. Repealed
- Section 20:06:40:49 - Parity requirements with respect to financial requirements and treatment limitations - Clarification of type of financial requirement or treatment limitation. Repealed
- Section 20:06:40:50 - Parity requirements with respect to financial requirements and treatment limitations - Clarification of level of a type of financial requirement or treatment limitation. Repealed
- Section 20:06:40:51 - Parity requirements with respect to financial requirements and treatment limitations - Clarification of coverage unit. Repealed
- Section 20:06:40:52 - General parity requirement. Repealed
- Section 20:06:40:53 - Classifications of benefits used for applying rules. Repealed
- Section 20:06:40:54 - Application to out-of-network providers. Repealed
- Section 20:06:40:55 - Financial requirements and quantitative treatment limitations - Determining substantially all. Repealed
- Section 20:06:40:56 - Financial requirements and quantitative treatment limitations - Determining predominant. Repealed
- Section 20:06:40:57 - Financial requirements and quantitative treatment limitations - Determining portion based on plan payments. Repealed
- Section 20:06:40:58 - Financial requirements and quantitative treatment limitations - Determining clarifications for certain threshold requirements. Repealed
- Section 20:06:40:59 - Application to different coverage units. Repealed
- Section 20:06:40:60 - Special rule for multi-tiered prescription drug benefits. Repealed
- Section 20:06:40:61 - No separate cumulative financial requirements or cumulative quantitative treatment limitations. Repealed
- Section 20:06:40:62 - Nonquantitative treatment limitations. Repealed
- Section 20:06:40:63 - Illustrative list of nonquantitative treatment limitations. Repealed
- Section 20:06:40:64 - Exemptions. Repealed
- Section 20:06:40:65 - Availability of plan information - Criteria for medical necessity determinations. Repealed
- Section 20:06:40:66 - Availability of plan information - Reasons for denial. Repealed
- Section 20:06:40:67 - Applicability - Group health plans. Repealed
- Section 20:06:40:68 - Applicability - Health insurance issuers. Repealed
- Section 20:06:40:69 - Scope. Repealed
- Section 20:06:40:70 - Small employer exemption. Repealed
- Section 20:06:40:71 - Determining employer size. Repealed
- Section 20:06:40:72 - Sale of nonparity health insurance coverage. Repealed
- Section 20:06:40:73 - Special effective date for certain collectively-bargained plans. Repealed
- Section 20:06:40:74 - Establishment of sub-classifications for determining parity for outpatient benefits. Repealed
- Section 20:06:40:75 - Definitions
- Section 20:06:40:76 - Guaranteed issue
- Section 20:06:40:77 - Disclosure requirements
- Section 20:06:40:78 - Guaranteed availability of coverage in the group market
- Section 20:06:40:79 - Denial of coverage
- Section 20:06:40:80 - Special enrollment period effective dates
- Section 20:06:40:81 - Special enrollment triggers
- Section 20:06:40:82 - Nonrenew or discontinuance of coverage
- Section 20:06:40:83 - Discontinuing a particular product
- Section 20:06:40:84 - Discontinuing all coverage
- Section 20:06:40:85 - Exception for uniform modification of coverage
- Section 20:06:40:86 - Preexisting condition exclusion and waiting period prohibited
- Section 20:06:40:87 - Clinical trial
- Section 20:06:40:88 - Full-time equivalents treated as full-time employees
- Section 20:06:40:89 - Applicability
- Appendix A - Example of Certificate of Prior Group Health Plan Coverage, repealed, 39 SDR 203, effective June 10, 2013
- Appendix B - Notice of Research Exception