ARTICLE 11.5. Individual Access to Contracts for Health Care Services [1399.801. - 1399.818.]
Heading of Article 11.5 renumbered from Article 10.5 by Stats. 2001, Ch. 159, Sec. 126.
§§ 1399.801–1399.818 · 15 sections
- § 1399.801 As used in this article: (a) “Creditable coverage” means: (1) Any individual or group policy, contract, or program that is written or administered by a…
- § 1399.802 (a) Every health care service plan offering plan contracts to individuals shall, in addition to complying with the provisions of this chapter and the rules…
- § 1399.803 Nothing in this article shall be construed to preclude the application of this chapter to either of the following: (a) an association, trust, or other…
- § 1399.804 (a) Commencing January 1, 2001, a plan shall fairly and affirmatively offer, market, and sell the health care service plan contracts described in subdivision…
- § 1399.805 (a) (1) After the federally eligible defined individual submits a completed application form for a plan contract, the plan shall, within 30 days, notify the…
- § 1399.806 A plan may not exclude any federally eligible defined individual, or his or her dependents, who would otherwise be entitled to health care services on the…
- § 1399.809 The director may require a plan to discontinue the offering of contracts or the acceptance of applications from any individual upon a determination by the…
- § 1399.810 All health care service plan contracts offered to a federally eligible defined individual shall be renewable with respect to the individual and dependents at…
- § 1399.811 (a) (1) Premiums for contracts offered, delivered, amended, or renewed by plans on or after January 1, 2001, shall be subject to the following requirements:…
- § 1399.812 Plans shall apply premiums consistently with respect to all federally eligible defined individuals who apply for coverage.
- § 1399.813 In connection with the offering for sale of any plan contract to an individual, each plan shall make a reasonable disclosure, as part of its solicitation and…
- § 1399.814 Nothing in this article shall be construed to require a health benefit plan to offer a contract to an individual if the plan does not otherwise offer contracts…
- § 1399.815 (a) At least 20 business days prior to renewing or amending a plan contract subject to this article, or at least 20 business days prior to the initial offering…
- § 1399.817 The director may issue regulations that are necessary to carry out the purposes of this article. Any rules and regulations adopted pursuant to this article may…
- § 1399.818 This article shall apply to health care service plan contracts offered, delivered, amended, or renewed on or after January 1, 2001.