§432D-10 - Enrollment period.
[§432D-10] Enrollment period. (a) Inthe event of an insolvency of a health maintenance organization, upon order ofthe commissioner, all other carriers offered as alternatives to the insolventhealth maintenance organization at a group's last regular enrollment periodshall offer to those members of the group who enrolled in the insolvent healthmaintenance organization a thirty-day enrollment period commencing upon thedate of insolvency. Each carrier shall offer the enrollees of the insolventhealth maintenance organization the same coverages and rates that it hadoffered to the enrollees of the group at its last regular enrollment period.
(b) If no other carrier had been offered tosome groups enrolled in the insolvent health maintenance organization, or ifthe commissioner determines that the other health benefit plans lack sufficienthealth care delivery resources to assure that health care services will beavailable and accessible to all of the group's enrollees of the insolventhealth maintenance organization, then the commissioner shall equitably allocatethe insolvent health maintenance organization's group contracts for such groupsamong all health maintenance organizations that operate within a portion of theinsolvent health maintenance organization's service area, taking intoconsideration the health care delivery resources of each health maintenanceorganization. Each health maintenance organization to which a group is soallocated shall offer the group the health maintenance organization's existingcoverage that is most similar to each group's coverage with the insolventhealth maintenance organization at rates determined in accordance with thesuccessor health maintenance organization's existing rating methodology.
(c) The commissioner also shall allocateequitably the insolvent health maintenance organization's nongroup enrolleeswho are unable to obtain other coverage among all health maintenanceorganizations which operate within a portion of the insolvent healthmaintenance organization's service area, taking into consideration the healthcare delivery resources of each health maintenance organization. Each healthmaintenance organization to which nongroup enrollees are allocated shall offersuch nongroup enrollees the health maintenance organization's existing coveragefor individual or conversion coverage as determined by the enrollee's type ofcoverage in the insolvent health maintenance organization at rates determinedin accordance with the successor health maintenance organization's existingrating methodology. Successor health maintenance organizations that do notoffer direct nongroup enrollment may aggregate all of the allocated nongroupenrollees into one group for rating and coverage purposes. [L 1995, c 179, ptof §1]