§431:2-201.5 Conformity to federal law.
(a) [Subsection effective until June 30, 2000. For subsection effective July 1, 2000, see below.] The provisions of the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as it relates to group and individual health insurance, shall apply to title 24, except:(1) Where state law provides greater health benefits or coverage than the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191 then the state law shall be applicable;
(2) This section shall not be applicable or affect life insurance, endowment, or annuity contracts, or any supplemental contract thereto, described in section 431:10A-101(4);
(3) The following definitions shall be used when applying the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191:
(A) "Employee" means an employee who works on a full-time basis with a normal workweek of twenty hours or more;
(B) "Group health issuer" means all persons offering benefits under group health plans, but shall not include those persons offering benefits exempted from Title I of the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191 under section 706(c) of the Employee Retirement Income Security Act of 1974 and sections 2747 and 2791(c) of the Public Health Service Act; and
(C) "Small employer" means an employer who employs between one and no more than fifty employees;
(4) All group health issuers shall offer group health plans to small employers whose employees live, work, or reside in the group health issuer's service areas; provided that the commissioner may exempt a group health issuer if the commissioner determines that the group health issuer does not have the capacity to deliver services adequately to enrollees of additional groups given its obligation to existing employer groups; and
(5) A group health issuer shall be prohibited from imposing any preexisting condition exclusion.
(a) [Subsection effective July 1, 2000. For subsection effective until June 30, 2000, see above.] The provisions of the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191, as it relates to group and individual health insurance and to long-term care insurance to the extent provided in article 10H of chapter 431, shall apply to title 24, except:
(1) Where state law provides greater health benefits or coverage than the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191 then the state law shall be applicable;
(2) This section shall not be applicable or affect life insurance, endowment, or annuity contracts, or any supplemental contract thereto, described in section 431:10A-101(4);
(3) The following definitions shall be used when applying the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191:
(A) "Employee" means an employee who works on a full-time basis with a normal workweek of twenty hours or more;
(B) "Group health issuer" means all persons offering benefits under group health plans, but shall not include those persons offering benefits exempted from Title I of the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191 under section 706(c) of the Employee Retirement Income Security Act of 1974 and sections 2747 and 2791(c) of the Public Health Service Act; and
(C) "Small employer" means an employer who employs between one and no more than fifty employees;
(4) All group health issuers shall offer group health plans to small employers whose employees live, work, or reside in the group health issuer's service areas; provided that the commissioner may exempt a group health issuer if the commissioner determines that the group health issuer does not have the capacity to deliver services adequately to enrollees of additional groups given its obligation to existing employer groups; and
(5) A group health issuer shall be prohibited from imposing any preexisting condition exclusion.
(b) The insurance commissioner may adopt rules to implement, clarify, or conform title 24 to the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191.
(c) The adoption of the Health Insurance Portability and Accountability Act of 1996, P.L. 104-191 for the purposes of title 24 is not an adoption for any purposes for income taxes under chapter 235. [L 1997, c 291, §2; am L 1999, c 93, §5]