31A-30-111 - Limitations on high risk enrollees.
31A-30-111. Limitations on high risk enrollees.
(1) (a) The requirements of this chapter do not apply to any carrier that is currently in astate of supervision, insolvency, or liquidation.
(b) If a carrier demonstrates to the satisfaction of the commissioner that the requirementsof this chapter would place the carrier in a state of supervision, insolvency, or liquidation thecommissioner may waive or modify the requirements of Sections 31A-30-108 and 31A-30-110.
(2) (a) A modification or waiver by the commissioner under Subsection (1)(b) shall beeffective for a period of not more than one year.
(b) At the end of the period described in Subsection (2)(a), a carrier is subject to Sections31A-30-108 and 31A-30-110 unless the carrier demonstrates to the satisfaction of thecommissioner the need for a modification or waiver in accordance with Subsection (1)(b).
(3) Notwithstanding the requirements of this chapter, a carrier may deny health benefitplan coverage in the small employer and individual market if the carrier demonstrates to thesatisfaction of the commissioner that the carrier:
(a) does not have the financial reserves necessary to underwrite additional coverage;
(b) is applying this section uniformly to all small employers and individuals withoutregard to:
(i) any health status-related factor of the individuals; or
(ii) whether the individuals are eligible individuals.
(1) (a) The requirements of this chapter do not apply to any carrier that is currently in astate of supervision, insolvency, or liquidation.
(b) If a carrier demonstrates to the satisfaction of the commissioner that the requirementsof this chapter would place the carrier in a state of supervision, insolvency, or liquidation thecommissioner may waive or modify the requirements of Sections 31A-30-108 and 31A-30-110.
(2) (a) A modification or waiver by the commissioner under Subsection (1)(b) shall beeffective for a period of not more than one year.
(b) At the end of the period described in Subsection (2)(a), a carrier is subject to Sections31A-30-108 and 31A-30-110 unless the carrier demonstrates to the satisfaction of thecommissioner the need for a modification or waiver in accordance with Subsection (1)(b).
(3) Notwithstanding the requirements of this chapter, a carrier may deny health benefitplan coverage in the small employer and individual market if the carrier demonstrates to thesatisfaction of the commissioner that the carrier:
(a) does not have the financial reserves necessary to underwrite additional coverage;
(b) is applying this section uniformly to all small employers and individuals withoutregard to:
(i) any health status-related factor of the individuals; or
(ii) whether the individuals are eligible individuals.
Amended by Chapter 308, 2002 General Session