40-2209m.Same; marketing of coverage;prohibited activities; agents andbrokers; written denial of coverage; third-party administrators; treatment ofaffiliated carriers.(a) Each small employer carrier shall actively market health benefit plancoverage toeligiblesmall employers in the state.
(b) (1) Except as provided in paragraph (2), no small employer carrier,agent or broker shall, directly or indirectly, engage in the followingactivities:
(A) Encouraging or directing small employers to refrain from filing anapplication for coverage with the small employer carrier because of the healthstatus, claims experience, industry, occupation or geographic location of thesmall employer;
(B) encouraging or directing small employers to seek coverage from anothercarrier because of the health status, claims experience, industry, occupationor geographic location of the small employer.
(2) The provisions of paragraph (1) shall not apply with respect toinformation provided by a small employer carrier or producer to a smallemployer regarding the established geographic service area or a restrictednetwork provision of a small employer carrier.
(c) (1) Except as provided in paragraph (2), no small employer carriershall, directly or indirectly, enter into any contract, agreement orarrangement with an agent or broker that provides for or results in thecompensation paid to such person for the sale of a health benefit plan to bevaried because of the health status, claims experience, industry, occupation orgeographic location of the small employer.
(2) Paragraph (1) shall not apply with respect to a compensation arrangementthat provides compensation to an agent or broker on the basis of percentage ofpremium, provided that the percentage shall not vary because of the healthstatus, claims experience, industry, occupation or geographic area of the smallemployer.
(d) No small employer carrier shall terminate, fail to renew or limit itscontract or agreement of representation with an agent or broker for any reasonrelated to the health status, claims experience, occupation, or geographiclocation of the small employers placed by the agent or broker with the smallemployer carrier.
(e) No small employer carrier, agent or broker shall induce orotherwiseencourage a small employer to separate or otherwise exclude an employee fromhealth coverage or benefits provided in connection with the employee'semployment.
(f) Denial by a small employer carrier of an application forcoverage from asmall employer shall be in writing and shall state the reason or reasons forthe denial.
(g) The commissioner may adopt rules and regulations settingforthadditional standards to provide for the fair marketing and broad availabilityof health benefit plans to small employers in this state.
(h) If a small employer carrier enters into a contract,agreement or otherarrangement with a third-party administrator to provide administrative,marketing or other services related to the offering of health benefit plans tosmall employers in this state, the third-party administrator shall be subjectto this section as if it were a small employer carrier.
(i) Except as provided in paragraph (l) [(j)], for the purposes ofthis act,carriers that are affiliated companies or that are eligible to file aconsolidated tax return shall be treated as one carrier and any restrictions orlimitations imposed by this act shall apply as if all health benefit plansissued to small employers in this state by such affiliated carriers were issuedby one carrier.
(j) An affiliated carrier that is a health maintenanceorganization having acertificate of authority under K.S.A. 40-3201 et seq. and amendmentsthereto, may be considered to be a separate carrier for the purpose of thisact.
History: L. 1992, ch. 200, § 12;L. 1998, ch. 174, § 10;L. 2000, ch. 34, § 3; July 1.
40-2209m.Same; marketing of coverage;prohibited activities; agents andbrokers; written denial of coverage; third-party administrators; treatment ofaffiliated carriers.(a) Each small employer carrier shall actively market health benefit plancoverage toeligiblesmall employers in the state.
(b) (1) Except as provided in paragraph (2), no small employer carrier,agent or broker shall, directly or indirectly, engage in the followingactivities:
(A) Encouraging or directing small employers to refrain from filing anapplication for coverage with the small employer carrier because of the healthstatus, claims experience, industry, occupation or geographic location of thesmall employer;
(B) encouraging or directing small employers to seek coverage from anothercarrier because of the health status, claims experience, industry, occupationor geographic location of the small employer.
(2) The provisions of paragraph (1) shall not apply with respect toinformation provided by a small employer carrier or producer to a smallemployer regarding the established geographic service area or a restrictednetwork provision of a small employer carrier.
(c) (1) Except as provided in paragraph (2), no small employer carriershall, directly or indirectly, enter into any contract, agreement orarrangement with an agent or broker that provides for or results in thecompensation paid to such person for the sale of a health benefit plan to bevaried because of the health status, claims experience, industry, occupation orgeographic location of the small employer.
(2) Paragraph (1) shall not apply with respect to a compensation arrangementthat provides compensation to an agent or broker on the basis of percentage ofpremium, provided that the percentage shall not vary because of the healthstatus, claims experience, industry, occupation or geographic area of the smallemployer.
(d) No small employer carrier shall terminate, fail to renew or limit itscontract or agreement of representation with an agent or broker for any reasonrelated to the health status, claims experience, occupation, or geographiclocation of the small employers placed by the agent or broker with the smallemployer carrier.
(e) No small employer carrier, agent or broker shall induce orotherwiseencourage a small employer to separate or otherwise exclude an employee fromhealth coverage or benefits provided in connection with the employee'semployment.
(f) Denial by a small employer carrier of an application forcoverage from asmall employer shall be in writing and shall state the reason or reasons forthe denial.
(g) The commissioner may adopt rules and regulations settingforthadditional standards to provide for the fair marketing and broad availabilityof health benefit plans to small employers in this state.
(h) If a small employer carrier enters into a contract,agreement or otherarrangement with a third-party administrator to provide administrative,marketing or other services related to the offering of health benefit plans tosmall employers in this state, the third-party administrator shall be subjectto this section as if it were a small employer carrier.
(i) Except as provided in paragraph (l) [(j)], for the purposes ofthis act,carriers that are affiliated companies or that are eligible to file aconsolidated tax return shall be treated as one carrier and any restrictions orlimitations imposed by this act shall apply as if all health benefit plansissued to small employers in this state by such affiliated carriers were issuedby one carrier.
(j) An affiliated carrier that is a health maintenanceorganization having acertificate of authority under K.S.A. 40-3201 et seq. and amendmentsthereto, may be considered to be a separate carrier for the purpose of thisact.
History: L. 1992, ch. 200, § 12;L. 1998, ch. 174, § 10;L. 2000, ch. 34, § 3; July 1.
40-2209m.Same; marketing of coverage;prohibited activities; agents andbrokers; written denial of coverage; third-party administrators; treatment ofaffiliated carriers.(a) Each small employer carrier shall actively market health benefit plancoverage toeligiblesmall employers in the state.
(b) (1) Except as provided in paragraph (2), no small employer carrier,agent or broker shall, directly or indirectly, engage in the followingactivities:
(A) Encouraging or directing small employers to refrain from filing anapplication for coverage with the small employer carrier because of the healthstatus, claims experience, industry, occupation or geographic location of thesmall employer;
(B) encouraging or directing small employers to seek coverage from anothercarrier because of the health status, claims experience, industry, occupationor geographic location of the small employer.
(2) The provisions of paragraph (1) shall not apply with respect toinformation provided by a small employer carrier or producer to a smallemployer regarding the established geographic service area or a restrictednetwork provision of a small employer carrier.
(c) (1) Except as provided in paragraph (2), no small employer carriershall, directly or indirectly, enter into any contract, agreement orarrangement with an agent or broker that provides for or results in thecompensation paid to such person for the sale of a health benefit plan to bevaried because of the health status, claims experience, industry, occupation orgeographic location of the small employer.
(2) Paragraph (1) shall not apply with respect to a compensation arrangementthat provides compensation to an agent or broker on the basis of percentage ofpremium, provided that the percentage shall not vary because of the healthstatus, claims experience, industry, occupation or geographic area of the smallemployer.
(d) No small employer carrier shall terminate, fail to renew or limit itscontract or agreement of representation with an agent or broker for any reasonrelated to the health status, claims experience, occupation, or geographiclocation of the small employers placed by the agent or broker with the smallemployer carrier.
(e) No small employer carrier, agent or broker shall induce orotherwiseencourage a small employer to separate or otherwise exclude an employee fromhealth coverage or benefits provided in connection with the employee'semployment.
(f) Denial by a small employer carrier of an application forcoverage from asmall employer shall be in writing and shall state the reason or reasons forthe denial.
(g) The commissioner may adopt rules and regulations settingforthadditional standards to provide for the fair marketing and broad availabilityof health benefit plans to small employers in this state.
(h) If a small employer carrier enters into a contract,agreement or otherarrangement with a third-party administrator to provide administrative,marketing or other services related to the offering of health benefit plans tosmall employers in this state, the third-party administrator shall be subjectto this section as if it were a small employer carrier.
(i) Except as provided in paragraph (l) [(j)], for the purposes ofthis act,carriers that are affiliated companies or that are eligible to file aconsolidated tax return shall be treated as one carrier and any restrictions orlimitations imposed by this act shall apply as if all health benefit plansissued to small employers in this state by such affiliated carriers were issuedby one carrier.
(j) An affiliated carrier that is a health maintenanceorganization having acertificate of authority under K.S.A. 40-3201 et seq. and amendmentsthereto, may be considered to be a separate carrier for the purpose of thisact.
History: L. 1992, ch. 200, § 12;L. 1998, ch. 174, § 10;L. 2000, ch. 34, § 3; July 1.
