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CHAPTER 20:06:40

 

EMPLOYER PLANS

Section

20:06:40:01        Waiting periods, affiliation periods, and applications relating to breaks in coverage. Repealed January 1, 2014.

20:06:40:01.01   Waiting periods and affiliation periods relating to breaks in coverage. Effective January 1, 2014.

20:06:40:02        Short-term, limited duration policies.

20:06:40:03        Certificates required upon losing coverage. Repealed January 1, 2014.

20:06:40:03.01   Certificates required upon losing coverage. Effective January 1, 2014.

20:06:40:04        Standards for determinations on length of preexisting waiting periods.

20:06:40:05        Special enrollment periods for marriage, birth, and adoption.

20:06:40:05.01   Special enrollment periods for loss of other coverage.

20:06:40:06        Repealed.

20:06:40:07        Repealed.

20:06:40:08        Repealed.

20:06:40:09        Repealed.

20:06:40:10        Repealed.

20:06:40:11        Repealed.

20:06:40:12        Repealed.

20:06:40:13        Public health plan defined.

20:06:40:14        Repealed.

20:06:40:15        Repealed.

20:06:40:16        Notice describing plan’s special enrollment required.

20:06:40:17        Group health plans to offer breast reconstruction options after covered mastectomy.

20:06:40:17.01   Written notification regarding coverage of reconstructive surgery after a mastectomy required.

20:06:40:17.02   Prohibited practices.

20:06:40:17.03   Not a termination of collective bargaining agreement.

20:06:40:17.04   Applicability.

20:06:40:18        Claims experience defined.

20:06:40:19        Repealed.

20:06:40:20        Repealed.

20:06:40:21        Repealed.

20:06:40:22        Repealed.

20:06:40:23        Medically necessary leave of absence defined.

20:06:40:24        Dependent coverage.

20:06:40:25        Notification.

20:06:40:26        Continued application in case of changed coverage.

20:06:40:27        Effective date.

20:06:40:28        Creditable coverage -- Children's Health Insurance Program.

20:06:40:29        Definitions.

20:06:40:30        Group rating based on health factors.

20:06:40:31        No group-based discrimination based on genetic information.

20:06:40:32        Limitation on requesting or requiring genetic testing.

20:06:40:33        Exceptions to requiring genetic testing.

20:06:40:34        Research exception.

20:06:40:35        Prohibitions on collection of genetic information for underwriting purposes.

20:06:40:36        Medical appropriateness.

20:06:40:37        Collection of genetic information prior to or in connection with enrollment.

20:06:40:38        Incidental collection exception.

20:06:40:39        General exception for certain small group health plans.

20:06:40:40        Applicability to excepted benefits.

20:06:40:41        Effective date.

20:06:40:42        Repealed.

20:06:40:43        Repealed.

20:06:40:44        Repealed.

20:06:40:45        Repealed.

20:06:40:46        Repealed.

20:06:40:47        Repealed.

20:06:40:48        Repealed.

20:06:40:49        Repealed.

20:06:40:50        Repealed.

20:06:40:51        Repealed.

20:06:40:52        Repealed.

20:06:40:53        Repealed.

20:06:40:54        Repealed.

20:06:40:55        Repealed.

20:06:40:56        Repealed.

20:06:40:57        Repealed.

20:06:40:58        Repealed.

20:06:40:59        Repealed.

20:06:40:60        Repealed.

20:06:40:61        Repealed.

20:06:40:62        Repealed.

20:06:40:63        Repealed.

20:06:40:64        Repealed.

20:06:40:65        Repealed.

20:06:40:66        Repealed.

20:06:40:67        Repealed.

20:06:40:68        Repealed.

20:06:40:69        Repealed.

20:06:40:70        Repealed.

20:06:40:71        Repealed.

20:06:40:72        Repealed.

20:06:40:73        Repealed.

20:06:40:74        Repealed.

20:06:40:75        Definitions.

20:06:40:76        Guaranteed issue.

20:06:40:77        Disclosure requirements.

20:06:40:78        Guaranteed availability of coverage in the group market.

20:06:40:79        Denial of coverage.

20:06:40:80        Special enrollment period effective dates.

20:06:40:81        Special enrollment triggers.

20:06:40:82        Nonrenew or discontinuance of coverage.

20:06:40:83        Discontinuing a particular product.

20:06:40:84        Discontinuing all coverage.

20:06:40:85        Exception for uniform modification of coverage.

20:06:40:86        Preexisting condition exclusion and waiting period prohibited.

20:06:40:87        Clinical trial.

20:06:40:88        Full-time equivalents treated as full-time employees.

20:06:40:89        Applicability

Appendix A  Example of Certificate of Prior Group Health Plan Coverage, repealed, 39 SDR 203, effective June 10, 2013.

Appendix B  Notice of Research Exception.


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