44-7612. Coverage notification; summary plan description; claim or appeal denial notice; statement required.
195 words·~1 min read·
/ne/chapter-44/44-7612A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(1)A multiple employer welfare arrangement shall notify in writing each participating employer and each covered individual applying for coverage by the multiple employer welfare arrangement that a health benefit plan provided by the multiple employer welfare arrangement is not:
(a)Insurance;
(b)Subject to state laws and requirements that apply to health insurance offered by a licensed insurer; and
(c)Covered by the Nebraska Life and Health Insurance Guaranty Association.
(2)The notice required by subsection
(1)of this section shall, in ten-point or greater type, disclose that the multiple employer welfare arrangement is authorized under state law to assess participating employers for claims under the health benefit plan in addition to other remedies the multiple employer welfare arrangement may take if the multiple employer welfare arrangement is unable to pay claims.
(3)If the multiple employer welfare arrangement provides coverage to covered individuals who are self-employed individuals, the multiple employer welfare arrangement shall include a statement in the summary plan description and any claim or appeal denial notice that self-employed covered individuals may contact the Director of Insurance. Such statement shall include the mailing address and telephone number for the Department of Insurance.