WILLIAM DONALD SCHAEFER, Governor                                Ch. 9

(B)     A CARRIER THAT OFFERS COVERAGE TO A SMALL EMPLOYER SHALL
OFFER COVERAGE TO ALL OF ITS ELIGIBLE EMPLOYEES AND, AT THE ELECTION OF
THE SMALL EMPLOYER, DEPENDENTS OF ELIGIBLE EMPLOYEES.

(C)     (1) A HEALTH MAINTENANCE ORGANIZATION NEED NOT OFFER
COVERAGE:

(I) TO A SMALL EMPLOYER THAT IS NOT LOCATED IN THE
HEALTH MAINTENANCE ORGANIZATION'S APPROVED SERVICE AREAS;

(II) TO AN ELIGIBLE EMPLOYEE WHO DOES NOT RESIDE WITHIN
THE HEALTH MAINTENANCE ORGANIZATION'S APPROVED SERVICE AREAS; OR

(III) WITHIN AN AREA WHERE THE HEALTH MAINTENANCE
ORGANIZATION REASONABLY ANTICIPATES, AND DEMONSTRATES TO THE
SATISFACTION OF THE COMMISSIONER, THAT IT WILL NOT HAVE THE CAPACITY
WITHIN THE AREA IN ITS NETWORK OF PROVIDERS TO DELIVER SERVICE
ADEQUATELY BECAUSE OF ITS OBLIGATIONS TO EXISTING GROUP CONTRACT
HOLDERS AND ENROLLEES.

(2) A HEALTH MAINTENANCE ORGANIZATION THAT DOES NOT OFFER
COVERAGE UNDER PARAGRAPH (1)(III) OF THIS SUBSECTION MAY NOT OFFER
COVERAGE IN THE APPLICABLE AREA TO ANY EMPLOYER GROUPS UNTIL THE
LATER OF 180 DAYS FOLLOWING ANY REFUSAL TO DO SO, OR THE DATE ON WHICH
THE CARRIER NOTIFIES THE COMMISSIONER THAT IT HAS REGAINED CAPACITY TO
DELIVER SERVICES TO SMALL EMPLOYER GROUPS.

(D)     A CARRIER MAY NOT BE REQUIRED TO OFFER COVERAGE UNDER
SUBSECTION (A) OF THIS SECTION FOR SO LONG AS THE COMMISSIONER FINDS THAT
THE COVERAGE WOULD PLACE THE CARRIER IN A FINANCIALLY IMPAIRED
CONDITION.

(E)      (1) TO SELL HEALTH BENEFIT PLANS TO SMALL EMPLOYERS IN THE
STATE, A CARRIER SHALL FILE ITS PROPOSED SMALL EMPLOYER HEALTH BENEFIT
PLANS WITH THE COMMISSIONER ON OR BEFORE MAY 1, 1994.

(2) UNLESS THE COMMISSIONER HAS PREVIOUSLY DISAPPROVED ITS
USE, THE CARRIER'S HEALTH BENEFIT PLANS FOR SMALL EMPLOYERS WILL BE
DEEMED APPROVED 60 DAYS AFTER FILING WITH THE COMMISSIONER.

705.

(A)     (1) EXCEPT AS PROVIDED IN SUBSECTION (C) OF THIS SECTION, A
CARRIER SHALL RENEW A HEALTH BENEFIT PLAN AT THE OPTION OF THE SMALL
EMPLOYER.

(2) ON RENEWAL A CARRIER MAY NOT EXCLUDE ELIGIBLE EMPLOYEES
OR DEPENDENTS FROM A SMALL EMPLOYER HEALTH BENEFIT PLAN.

(B)     A CARRIER MAY NOT CANCEL OR REFUSE TO RENEW A SMALL
EMPLOYER HEALTH BENEFIT PLAN EXCEPT:

(1) FOR NONPAYMENT OF THE REQUIRED PREMIUMS;

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