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CHAPTER 20:06:55

 

MARKET REGULATIONS

Section

20:06:55:01        Eligibility of children up to age 26.

20:06:55:02        Restrictions on plan definition of dependent.

20:06:55:03        Coverage of grandchildren not required.

20:06:55:04        Uniformity irrespective of age.

20:06:55:05        Individuals whose coverage ended by reason of reaching a dependent eligibility threshold -- Applicability.

20:06:55:06        Individuals whose coverage ended by reason of reaching a dependent eligibility threshold -- Opportunity to enroll required.

20:06:55:07        Individuals whose coverage ended by reason of reaching a dependent eligibility threshold -- Written notice.

20:06:55:08        Individuals whose coverage ended by reason of reaching a dependent eligibility threshold -- Effective date.

20:06:55:09        Individuals whose coverage ended by reason of reaching a dependent eligibility threshold -- Group health plan special enrollee.

20:06:55:10        Special rule for grandfathered group health plans.

20:06:55:11        Applicability.

20:06:55:12        Choice of primary care providers.

20:06:55:13        Emergency services.

20:06:55:14        Rescissions.

20:06:55:15        Group plans -- Lifetime limits.

20:06:55:16        Group plans -- Annual limits.

20:06:55:17        Group plans -- Eligibility.

20:06:55:18        Group plans -- Notices and enrollment.

20:06:55:19        Group plans -- Special enrollment.

20:06:55:20        Group plans -- Applicability.

20:06:55:21        Individual plans -- Lifetime limits.

20:06:55:22        Individual plans -- Annual limits.

20:06:55:23        Reinstatement of coverage.

20:06:55:24        Individual plans -- Applicability.

20:06:55:25        Individual plans -- No preexisting condition for a person under the age of 19 -- Open enrollment. Repealed January 1, 2014.

20:06:55:25.01   Individual plans -- No preexisting condition.

20:06:55:26        Group plans -- No preexisting condition.

20:06:55:27        Excepted benefits -- Defined.

20:06:55:28        Disproportionate share reporting. Repealed January 1, 2014.

20:06:55:29        Disproportionate share based on loss ratio. Repealed January 1, 2014.

20:06:55:30        Disproportionate share based upon covered lives. Repealed January 1, 2014.

20:06:55:31        Length of disproportionate share approval. Repealed January 1, 2014.

20:06:55:32        Definitions.

20:06:55:33        Certifying qualified health plans.

20:06:55:34        Issuer standards and certification criteria.

20:06:55:35        Qualified health plan defined.

20:06:55:36        Exchange network adequacy standards.

20:06:55:37        Network adequacy standards.

20:06:55:38        Essential community providers defined.

20:06:55:39        Essential community providers.

20:06:55:40        Payment of federally-qualified health centers.

20:06:55:41        Treatment of direct primary care medical homes.

20:06:55:42        Recertification of qualified health plans.

20:06:55:43        Decertification of qualified health plan.

20:06:55:44        Non-renewal and decertification of qualified health plans.

20:06:55:45        Rates.

20:06:55:46        Health plan applications and notices.

20:06:55:47        Accreditation of qualified health plan issuers.

20:06:55:48        Initial open enrollment period.

20:06:55:49        Annual open enrollment period.

20:06:55:50        Changing qualified health plans.

20:06:55:50.01   Loss of coverage.

20:06:55:50.02   Special enrollment period effective dates.

20:06:55:51        Compensation.

20:06:55:52        Plan offerings in the exchange.

20:06:55:53        Applicability and effective dates.

Appendix A  Model Choice of Health Care Professional Notice Language.


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