500.3707 Health benefit plan; marketing; affiliation period.

308 words·~1 min read·/mi/chapter-500/500-3707

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Sec. 3707.

(1)As a condition of transacting business in this state with small employers, every small employer carrier shall make available to small employers all health benefit plans it markets to small employers in this state. A small employer carrier shall be considered to be marketing a health benefit plan if it offers that plan to a small employer not currently receiving a health benefit plan from that small employer carrier. A small employer carrier shall issue any health benefit plan to any small employer that applies for the plan and agrees to make the required premium payments and to satisfy the other reasonable provisions of the health benefit plan not inconsistent with this chapter.

(2)Except as otherwise provided in this subsection, a small employer carrier shall not offer or sell to small employers a health benefit plan that contains a waiting period applicable to new enrollees or late enrollees. However, a small employer carrier may offer or sell to small employers other than sole proprietors a health benefit plan that provides for an affiliation period of time that must expire before coverage becomes effective for a new enrollee or a late enrollee if all of the following are met:

(a)The affiliation period is applied uniformly to all new and late enrollees and dependents of the new and late enrollees of the small employer and without regard to any health status-related factor.

(b)The affiliation period does not exceed 60 days for new enrollees and does not exceed 90 days for late enrollees.

(c)The small employer carrier does not charge any premiums for the enrollee during the affiliation period.

(d)The coverage issued is not effective for the enrollee during the affiliation period.

History: Add. 2003, Act 88 , Eff. Jan. 23, 2004

Popular Name: Act 218